ibemcha

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12/16/24, 11:20 AM about:blank

PAN Application Acknowledgment Receipt For Form 49A


( Physical Application )

Received Rs. 107.00/- (incl of


SMT LAIMUJAM ABEMCHA CHANU
taxes) from
Application No./Coupon No. U-A103007746
Name to be printed on PAN card LAIMUJAM ABEMCHA CHANU
Gender FEMALE
Date of Birth/Incorporation 09/05/1999
Father's Name LAIMUJAM NANAO MEETEI
Aadhaar Number/EID Number xxxx-xxxx-8666 (MENTIONED, MATCHED)*
Name as per Aadhaar LAIMUJAM ABEMCHA CHANU
Applicant's Contact details 9863134260 / wrmeitei67@gmail.com
Communication Address RESIDENCE
Residence State MANIPUR
Proof of Identity AADHAAR Card issued by UIDAI (In Copy)
Proof of Address AADHAAR Card issued by UIDAI (In Copy)
Proof of DOB AADHAAR Card issued by UIDAI (In Copy)
Date of Receipt 12/12/2024 06:45:16
Mode of Pancard Both physical PAN and e-PAN Card
Payment Ref No 4347064020165554 / PY0145214785
Payment Date 12/12/2024 06:40:46
*AADHAAR MATCHED USING DEMOGRAPHIC DETAILS - WILL BE LINKED WITH PAN.

PAN Service Center Code


576723520011
576723520011
PAN Service Center Name (Sign/Stamp)
576723520011 Received for submission to UTIITSL
Centre Contact Details:
wrmeitei22@gmail.com
/9366828299
To know your PAN Application status, you may visit our website: https://www.utiitsl.com.
As per instruction from Income Tax Department, an authorized agency's agent may visit you for your identity and address verification as per
the documents submitted by you with the PAN application form. You are requested to ask authorization letter/ID card from the agent before
verification.Your cooperation is solicited in this regard.

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