12/29/24, 2:20 PM Ack_R010740786

PAN Application Acknowledgment Receipt For Form 49A

( Physical Application )
Received Rs. 107.00/- (incl of taxes) from SHRI AVDHESH KUSHRAM
Application No./Coupon No. U-R010740786
Name to be printed on PAN card AVDHESH KUSHRAM
Gender MALE
Date of Birth/Incorporation 11/01/2006
Father's Name BRAJLAL MASRAM
Aadhaar Number/EID Number xxxx-xxxx-5113 (MENTIONED, MATCHED)*
Name as per Aadhaar AVDHESH KUSHRAM
Applicant's Contact details 6268057432 / yuvrajmponlineanjaniya@gmail.com
Communication Address RESIDENCE
Residence State MADHYA PRADESH
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 29/12/2024 02:20:46
Mode of Pancard Both physical PAN and e-PAN Card
Payment Ref No PY0016706434
Payment Date 29/12/2024 02:01:20
*AADHAAR MATCHED USING DEMOGRAPHIC DETAILS - WILL BE LINKED WITH PAN.

PAN Service Center Code SRAVAQX-A99932047825800 YESH MP ONLINE

(Sign/Stamp)
PAN Service Center Name YESH MP ONLINE Received for submission to UTIITSL
Centre Contact Details:
/YESHMPONLINEMANDLA@GMAIL.COM
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.

PAN Collection Centre Copy

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PAN Application Acknowledgment Receipt For Form 49A

( Physical Application )
Received Rs. 107.00/- (incl of taxes) from SHRI AVDHESH KUSHRAM
Application No./Coupon No. U-R010740786
Name to be printed on PAN card AVDHESH KUSHRAM
Gender MALE
Date of Birth/Incorporation 11/01/2006
Father's Name BRAJLAL MASRAM
Aadhaar Number/EID Number xxxx-xxxx-5113 (MENTIONED, MATCHED)*
Name as per Aadhaar AVDHESH KUSHRAM
Applicant's Contact details 6268057432 / yuvrajmponlineanjaniya@gmail.com
Communication Address RESIDENCE
Residence State MADHYA PRADESH
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 29/12/2024 02:20:46
Mode of Pancard Both physical PAN and e-PAN Card
Payment Ref No PY0016706434
Payment Date 29/12/2024 02:01:20
*AADHAAR MATCHED USING DEMOGRAPHIC DETAILS - WILL BE LINKED WITH PAN.

PAN Service Center Code SRAVAQX-A99932047825800 YESH MP ONLINE

(Sign/Stamp)
PAN Service Center Name YESH MP ONLINE Received for submission to UTIITSL
Centre Contact Details:
/YESHMPONLINEMANDLA@GMAIL.COM
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.

Applicant's Copy

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