Edit, Download, and Sign the Certificate for PAN Card Application by Gazetted Officer or MP MLA

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How do I fill this out?

To fill out this form, you will need to provide personal details such as your name, father's name, date of birth, and addresses. You will also need to have a recent photograph affixed and attested by the issuing authority. Ensure all information is accurate and complete before submission.

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How to fill out the Certificate for PAN Card Application by Gazetted Officer or MP MLA?

  1. 1

    Provide your personal details including name, father's name, and date of birth.

  2. 2

    List your residence and office addresses.

  3. 3

    Affix a recent photograph, the same as on the PAN application form.

  4. 4

    Have the issuing authority sign and stamp the form, including placing a stamp on the photograph.

  5. 5

    Submit the completed certificate as part of your PAN card application.

Who needs the Certificate for PAN Card Application by Gazetted Officer or MP MLA?

  1. 1

    Individuals applying for a PAN card who need attestation from a Member of Parliament.

  2. 2

    Applicants whose PAN applications require a certificate from a Member of Legislative Assembly (MLA).

  3. 3

    People who need their PAN card application certified by a Municipal Councillor.

  4. 4

    Individuals seeking attestation from a Gazetted Officer for their PAN card application.

  5. 5

    Married ladies who need to provide their father's name for the PAN application.

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You can easily edit this PDF on PrintFriendly using our PDF editor. Add or modify text, upload and position your photograph, and insert signatures and stamps where needed. Save and download the edited PDF seamlessly.

  1. 1

    Open the PDF on PrintFriendly.

  2. 2

    Use the text tool to fill in your personal details.

  3. 3

    Upload and position a recent photograph in the designated area.

  4. 4

    Insert the signature and stamp of the issuing authority using the drawing tool.

  5. 5

    Save and download the edited PDF.

What are the important dates for this form in 2024 and 2025?

For the years 2024 and 2025, ensure your form is submitted before December 31st of each year, to avoid any delays in processing your PAN card application.

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What is the purpose of this form?

The purpose of this form is to provide a certification of an individual's personal details by a recognized authority for the issuance of a PAN card. Under the Income-tax Rules, 1962, this certificate helps verify the authenticity of the information provided by the applicant, ensuring a smooth processing of their PAN card application. By obtaining this certification from a Member of Parliament, Member of Legislative Assembly, Municipal Councillor, or Gazetted Officer, the applicant demonstrates that their personal particulars have been verified by a trusted source.

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Tell me about this form and its components and fields line-by-line.

This form contains several fields where the applicant needs to provide their personal details and the issuing authority needs to certify the information.
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  • 1. Name: The full name of the applicant.
  • 2. Father's Name: The full name of the applicant's father, even in the case of married ladies.
  • 3. Date of Birth: The applicant's date of birth.
  • 4. Residence Address: The applicant's current residential address. If the applicant has lived at more than one place in the past year, all addresses should be mentioned with dates.
  • 5. Office Address: The address of the applicant's office.
  • 6. Previous Name: The previous name of the applicant, in case of any name change.
  • 7. Details of issuer of certificate: This section includes the office address and location of the issuing authority.
  • 8. Office Seal: The seal of the office of the issuing authority.
  • 9. Date: The date when the certificate is issued.
  • 10. Place: The place where the certificate is issued.
  • 11. Signature: The signature of the issuing authority.
  • 12. Full Name: The full name of the issuing authority.
  • 13. Designation: The designation of the issuing authority.
  • 14. Department/Organisation/Constituency: The department, organisation, or constituency of the issuing authority.
  • 15. Identity card No: The identity card number of the issuing authority, with a photocopy of the I-card attached.
  • 16. Telephone: The telephone number of the issuing authority.
  • 17. Mobile: The mobile phone number of the issuing authority.

What happens if I fail to submit this form?

Failure to submit this form may result in a delay or rejection of your PAN card application.

  • Application Rejection: Your PAN card application may be rejected if the required certificate is not submitted.
  • Processing Delay: There may be delays in processing your PAN card application without the necessary certification.

How do I know when to use this form?

This form is used when an individual needs their PAN card application attested by a recognized authority under rule 114 of the Income-tax Rules, 1962.
fields
  • 1. New PAN Application: Use this form if you are applying for a new PAN card and need attestation.
  • 2. Name Change: Use this form if you have changed your name and need to update your PAN card details.

Frequently Asked Questions

What is this certificate used for?

This certificate is used to attest an individual's personal details for PAN card application purposes.

Who can issue this certificate?

A Member of Parliament, Member of Legislative Assembly, Municipal Councillor, or Gazetted Officer can issue this certificate.

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What details do I need to provide in this form?

You need to provide your name, father's name, date of birth, residential and office addresses, and affix a recent photograph.

Is it mandatory to have a recent photograph affixed?

Yes, you must affix a recent photograph, the same as on the PAN application form, and have it attested by the issuing authority.

How can I ensure the form is correctly filled out?

Double-check all personal details, ensure the photograph is correctly affixed, and obtain the signature and stamp of the issuing authority.

What if I make a mistake while filling out the form?

You can correct mistakes using PrintFriendly's PDF editor before saving and downloading the final version.

Where can I find more guidance on filling out this form?

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