CSF Form
Request For New PAN Card Or/And Changes Or Correction in PAN Data
To avoid mistakes, please refer
Guidelines and Instructions
Status of the Applicant.
Please Select First*
Select Status
Artificial Judicial Person
Association of Person
Association of Persons(Trust)
Body of Individual
Company
Firm
Hindu Undivided family
Individual
Limited Liability Partnership
Local Authority
Permanent Account Number (PAN)
*
Applicant has to fill in all the mandatory fields freshly but select tick mark
only in the box(es) relevant to the fields (from sr. no. 1 to 11) that require a change/correction.
All mandatory fields are indicated by
*
on this form page. Clicking on the Box indicated by
puts a tick mark
marking the field for applying the change/correction.
1. Full Name
*
(Full extended name, address, dob to be mentioned as appearing in proof of identity /address/ dob documents. Initials are not allowed)
Select Title
KUMARI
M/S
SHRI
SMT
Last Name/Surname
First Name
Middle Name
Name you would like it printed on the PAN card
2. Details of Parents(applicable only for Individual applicants)
*
Father's Name(Mandatory - Even married woman should fill in father's name only)
*
Lastname/Surname
First Name
Middle Name
Mother's Name (optional)
Lastname/Surname
First Name
Middle Name
Select the name of either father or mother which you may like to be printed on PAN card (Select one only)
Select Option
FATHER'S NAME
MOTHER'S NAME
3. Date of Birth / Incorporation/Agreement/Partnership or Trust Deed/Formation of Body of Individuals/Association of Persons
*
4. Gender(for 'Individual' applicant only)
*
Select Gender
FEMALE
MALE
5. Photo Mismatch
*
6. Signature Mismatch
*
7. Address for Communication
*
Select Address for Communication
OFFICE
RESIDENCE
Name of the Office (to be filled only in case of office address)
Flat/Room/Door/Block No.
Name of Premises/Building/Village
Road/Street/Lane/Post Office
Area/Locality/Taluka/Sub-Division
Town/City/District
Town/City/District
State/Union Territory
Select State
ANDHRA PRADESH
ANDMAN NICOBAR
ARUNACHAL PR
ASSAM
BIHAR
CHANDIGARH
CHHATTISGARH
DADR & NAGAR H
DAMAN AND DIU
DELHI
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU AND KASHMIR
JHARKHAND
KARNATAKA
KERALA
LAKHSWADEEP
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
ODISHA
ORISSA
OTHER
PUDUCHERRY
PUNJAB
RAJASTHAN
SIKKIM
TAMIL NADU
TELANGANA
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
Pincode
Country Name
Select Country
AFGHANISTAN
ALAND ISLANDS
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVARIAN REPUBLIC OF VENEZUELA
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
COOK ISLANDS
COSTA RICA
CÔTE D'IVOIRE
CROATIA
CUBA
CURAÇAO
CYPRUS
CZECH REPUBLIC
DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA(NORTH KOREA)
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FEDERATED STATES OF MICRONESIA
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUERNSEY
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HOLY SEE (VATICAN CITY STATE)
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAQ
IRELAND
ISLAMIC REPUBLIC OF IRAN
ISLE OF MAN
ISRAEL
ITALY
JAMAICA
JAPAN
JERSEY
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KUWAIT
KYRGYZSTAN
LAO PEOPLE'S DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
PLURINATIONAL STATE OF BOLIVIA
POLAND
PORTUGAL
PUERTO RICO
QATAR
REPUBLIC OF KOREA(SOUTH KOREA)
REPUBLIC OF MOLDOVA
RÉUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT BARTHÉLEMY
SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT MARTIN (FRENCH PART)
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA
SEYCHELLES
SIERRA LEONE
SINGAPORE
SINT EUSTATIUS AND SABA BONAIRE
SINT MAARTEN (DUTCH PART)
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SOUTH SUDAN
SPAIN
SRI LANKA
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
THAILAND
THE DEMOCRATIC REPUBLIC OF THE CONGO
THE FORMER YUGOSLAV REPUBLIC OF MACEDONIA
TIMOR-LESTE
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED REPUBLIC OF TANZANIA
UNITED STATES
UNITED STATES MINOR OUTLYING ISLANDS
URUGUAY
UZBEKISTAN
VANUATU
VIET NAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
ZAMBIA
ZIMBABWE
Zip Code
8. If you desire to update your other address also, give required details in additional sheet
Flat/Room/Door/Block No.
Name of Premises/Building/Village
Road/Street/Lane/Post Office
Area/Locality/Taluka/Sub-Division
Town/City/District
State/Union Territory
Select State
ANDHRA PRADESH
ANDMAN NICOBAR
ARUNACHAL PR
ASSAM
BIHAR
CHANDIGARH
CHHATTISGARH
DADR & NAGAR H
DAMAN AND DIU
DELHI
GOA
GUJARAT
HARYANA
HIMACHAL PRADESH
JAMMU AND KASHMIR
JHARKHAND
KARNATAKA
KERALA
LAKHSWADEEP
MADHYA PRADESH
MAHARASHTRA
MANIPUR
MEGHALAYA
MIZORAM
NAGALAND
ODISHA
ORISSA
OTHER
PUDUCHERRY
PUNJAB
RAJASTHAN
SIKKIM
TAMIL NADU
TELANGANA
TRIPURA
UTTAR PRADESH
UTTARAKHAND
WEST BENGAL
Zip code
9. Telephone number
Telephone ISD Code
Select ISD Code
AFGHANISTAN
ALAND ISLANDS
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVARIAN REPUBLIC OF VENEZUELA
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
COOK ISLANDS
COSTA RICA
CÔTE D'IVOIRE
CROATIA
CUBA
CURAÇAO
CYPRUS
CZECH REPUBLIC
DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA(NORTH KOREA)
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FEDERATED STATES OF MICRONESIA
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUERNSEY
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HOLY SEE (VATICAN CITY STATE)
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAQ
IRELAND
ISLAMIC REPUBLIC OF IRAN
ISLE OF MAN
ISRAEL
ITALY
JAMAICA
JAPAN
JERSEY
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KUWAIT
KYRGYZSTAN
LAO PEOPLE'S DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
PLURINATIONAL STATE OF BOLIVIA
POLAND
PORTUGAL
PUERTO RICO
QATAR
REPUBLIC OF KOREA(SOUTH KOREA)
REPUBLIC OF MOLDOVA
RÉUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT BARTHÉLEMY
SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT MARTIN (FRENCH PART)
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA
SEYCHELLES
SIERRA LEONE
SINGAPORE
SINT EUSTATIUS AND SABA BONAIRE
SINT MAARTEN (DUTCH PART)
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SOUTH SUDAN
SPAIN
SRI LANKA
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
THAILAND
THE DEMOCRATIC REPUBLIC OF THE CONGO
THE FORMER YUGOSLAV REPUBLIC OF MACEDONIA
TIMOR-LESTE
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED REPUBLIC OF TANZANIA
UNITED STATES
UNITED STATES MINOR OUTLYING ISLANDS
URUGUAY
UZBEKISTAN
VANUATU
VIET NAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
ZAMBIA
ZIMBABWE
Area/STD Code
Telephone/Mobile number
*
Email ID
10. AADHAAR number(if alloted)
*
11. Mention the Permanent Account Number(PANs) inadvertently alloted to you
*
PAN 1
PAN 2
PAN 3
PAN 4
12.Verification
I/We
the applicant, in the capacity of
Select Capacity
AUTHORIZED SIGNATUREE
DIRECTOR
HIMSELF/HERSELF
KARTA
PARTNER
REPRESENTATIVE ASSESSEE
TRUSTEE
do hereby declare that what is started above is true to the best of my/our information and belief.
I/We have enclosed
Select
1
2
3
4
5
6
7
8
9
10
(number of documents) in support of proposed changes/corrections.
Place
Date
Identity Proof
Select Identity proof
AADHAAR Card issued by UIDAI (In Copy)
Arms License (In Copy)
Bank certificate in original on letter head of the branch ( alongwith name & stamp of issuing officer) containing duly attested photograph and bank A/c no of the Applicant
Central Govt Health Scheme Card or Ex serviceman Contributory Health Scheme photo card (In Copy)
Certificate of identity in original signed by MP or MLA or Municipal Councilor (Annexure-A)
Certificate of identity in original signed from Gazetted Officer
Driving License (In Copy)
Passport (In Copy)
Pensioner Card having photograph of Applicant (In Copy)
Photo ID card issued by Central Govt or State Govt or a Public Sector Undertaking (In Copy)
Ration Card having photograph of the applicant. (In Copy)
Voters ID card (In Copy)
Address Proof
Select Address proof
AADHAAR Card issued by UIDAI (In Copy)
Allotment letter of accomodation issued by Central Govt or State Govt not more than 3 Years old (In Copy)
Bank Account Statement not more than 3 months old (In Copy)
Certificate of address in original signed by MP or MLA or Municipal Councilor (Annexure-A)
Certificate of address in original signed from Gazetted Officer
Consumer Gas connection card or book or piped gas bill not more than 3 months old (In Copy)
Copy Electricity bill not more than 3 months old.
Copy Land Line telephone Bill or Broad band connection bill not more than 3 months old
Credit card statement not more than 3 months old (In Copy)
Depository account statement not more than 3 months old (In Copy)
Domicile certificate issued by Government (In Copy)
Driving License (In Copy)
Employer certificate in ORIGINAL
Latest Property tax assessment order (In Copy)
Passport (In Copy)
Passport of the Spouse (In Copy)
Post office pass book having address of applicant (In Copy)
Property registration document (In Copy)
Voters ID card (In Copy)
Water Bill not more than 3 months old (In Copy)
DOB Proof
Select DOB proof
AADHAAR Card issued by UIDAI (In Copy)
Affidavit sworn before Magistrate stating Date of Birth (In Copy)
Birth Certificate issued by Municipal Authority or any office authorized to issue Birth & Death Certificate by Registrar of Birth and Deaths or the Indian Consulate (In Copy)
Central Govt Health Scheme Card or Ex serviceman Contributory Health Scheme photo card (In Copy)
Domicile certificate issued by Government (In Copy)
Driving License (In Copy)
Marriage Certificate issued by Registrar of Marriages (In Copy)
Matriculation certificate or mark sheet of recognised board (In Copy)
Passport (In Copy)
Pension payment order (In Copy)
Photo ID card issued by Central Govt or State Govt or a Public Sector undertaking or State Public sector undertaking (In Copy)
Voters ID card (In Copy)
PAN Proof
Select PAN proof
Copy of FIR
Copy of PAN Allotment Letter
Copy of PAN Card
No Document