PART A – Personal InformationFirst NameMiddle NameLast Name *Date of Birth *Day *Month *Year *Aadhaar Number0 / 12Gender (select one) *–Select Gender–MaleFemaleTransgenderCommunication AddressResidence AddressRepresentative Assessee AddressOffice AddressResidence AddressFlat/Door/BuildingRoad/Street/Block/SectorPost OfficeArea/Locality/Town/CityDistrictPIN / ZIP CODE0 / 6State/Union Territory *–Select–Andhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest BengalAndaman and Nicobar IslandsChandigarhDadra and Nagar Haveli and Daman and DiuDelhiJammu and KashmirLadakhLakshadweepPuducherryContact Details *0 / 10Email ID *Office AddressResidence AddressFlat/Door/BuildingRoad/Street/Block/SectorPost OfficeArea/Locality/Town/CityDistrictPIN / ZIP CODE0 / 6State/Union Territory *–Select–Andhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest BengalAndaman and Nicobar IslandsChandigarhDadra and Nagar Haveli and Daman and DiuDelhiJammu and KashmirLadakhLakshadweepPuducherryPART B- Source of IncomeSource of Income (select one or more) *SalaryIncome from Business/ProfessionIncome from House PropertyCapital GainsIncome from Other SourcesNo IncomePART C – Details of ParentsWhether mother/father is a single parent? (select one)YesNoFather’s First NameFather’s Middle NameFather’s Last Name *Mother’s First NameMother’s Middle NameMother’s Last Name *Name of parent to be printed on Permanent Account Number card (select one)FatherMotherPART D – Assessing Officer (AO Code)Assessing Officer (AO Code)(i) Area Code *0 / 3(ii) AO Type *0 / 2(iii) Range Code *0 / 3(iv) AO No *0 / 2PART E- Representative Assessee, if applicableRA’s First NameRA’s Middle NameRA’s Last NamePermanent Account Number0 / 10Aadhaar Number0 / 12Representative Assessee AddressFlat/Door/BuildingRoad/Street/Block/SectorPost OfficeArea/Locality/Town/CityDistrictPIN / ZIP CODE0 / 6State/Union Territory *–Select–Andhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest BengalAndaman and Nicobar IslandsChandigarhDadra and Nagar Haveli and Daman and DiuDelhiJammu and KashmirLadakhLakshadweepPuducherryContact Details0 / 10Email IDDateCapacitySelfRADownload
