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pancard task.html
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pancard task.html
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<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<meta name="description" content="This is an awesome webiste">
<style>
#id5>td>div>span
{
display :none;
}
</style>
<title>
Request For New PAN Card Or/And Changes Or Correction in PAN Data
</title>
</head>
<body bgcolor="#FFFFDD" leftmargin ="0" topmargin="0" onload=""onloading();disablePayment();disableTelNum();disablefieldSMother();checkAadhar();chechDOB();blinkName();blinkCardName();blinkFname();hide();showotherAddr();style>
<div class ="text-box blur">
<table border ="0" width="100%" cellpaddding="0" cellspacing="0" background ="/pan/images/TopHeaderbarYellowpart.gif" bgcolor="#FFCC00">
<tbody>
<tr bgcolor="#660000">
<td colspan="4" align="CENTER" background="/pan/images/RedBar.gif">
<b>
<font color="#FFFFFF">Request For New PAN Card Or/And Changes Or Correction in PAN Data</font>
</b>
<br>
<i>
<font color="#FFFFFF">Fields marked with</font>
<font color="RED">*</font>
<font color="#FFFFFF"> (asterisk are mandatory.</font>
</i>
<i><font color="#FFFFFF">To avoid mistake(s),please refer</font>
<font color="#FF9900">guidelines</font>
<font color="#FFFFF">and</font>
<font color="#FF9900">instructions</font>
</i>
</td>
</tr>
</tbody>
</table>
<form method="POST" action="NewPanCorrectDSC" name="newPanCorrect">
<table border="1" cellpadding="0" cellspacing="0" width="100%">
<tbody>
<tr bgcolor="#e0e0e0">
<td>
<b></b>
</td>
</tr>
<tr>
<td> </td>
<td colspan="2"width="98%">
<b>
<font color="RED">*</font>
"Whether citizen of India"
</b>
" Yes"
<input type="radio" name="PAN_CTZN_FLG" id="PAN_CTZN_FLG_YES" value="Y" onclick="patchDocuments();xhexkAadhar();returnfalse();changeTxt();">
"
No "
<input type="radio" name="PAN_CTZN_FLG" value="N" id="PAN_CTZN_FLG_NO" onclick="patchDocuments();checkAadhar();chechDOB();changeTxt();">
</td>
</tr>
<tr>
<td width="2%"> </td>
<td colspan="2" width="98%">
<b>
<font color="RED">*</font>
"Permanent Account Number (PAN)"
</b>
<input type="text" name="PAN_NUM"value size="20" maxlength="10">
</td>
</tr>
<tr>
<td>
<input type="checkbox" name="PAN_MN_NM_CHK" value="Y">
</td>
<td colspan="2">
<b>
<font color="RED">*</font>
" 1. Name"
</b>
<font color="#0000FF">
<span id="nameInfoTxt" style="color: rgb(0,100,255);"></span>
</font>
</td>
</tr>
<tr>
<td> </td>
<td colspan="2">
<b>Title</b>
"
Shri/Mr"
<input type="radio" name="PAN_MN_TITL" value="1">
"
Smt./Mrs."
<input type="radio" name="PAN_MN_TITL" value="2">
"
Kumari/Ms"
<input type="radio" name="PAN_MN_TITL" value="3">
"
"
<font color="#a0a0a0d0d0d0">
M/s
</font>
</td>
</tr>
<tr>
<td> </td>
<td colspan="2">
<table width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td>
<b>
Last Name/Surname
</b>
<br>
<input type="text" name="PAN_LST_MN_NM" value="15" maxlength="25" onchange="fillFullName()">
</td>
<td>
<b>First Name</b>
<br>
<input type="text" name="PAN_FST_MN_NM" value size="15" maxlength="25" onchange="fillFullName()" onkeyup="fillFullName()">
</td>
<td>
<b>Middle Name</b>
<br>
<input type="text" name="PAN_MDL_MN_NM" value size="15" maxlength="25" onchange="fillFullName()" onkeyup="fillFullName()">
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td> </td>
<td colspan="2">
<font color="RED"><b>*</b>
</font>
<b>Name as you would it printed on the card</b>
<font color="#0000FF">
<span id="cardInfoTxt" style="color: rgb(0,100,255);">
"(Prefix like Shri,Smt,Kumari,Late,Dr,CA,Ms,Mrs,M/s,Alias etc. are not allowed)"
</span>
</font>
</td>
</tr>
<tr>
<td> </td>
<td colspan="2">
<input type="text" name="PAN_CRD_MN_NM" value size="40" maxlength="85">
</td>
</tr>
<tr>
<td> </td>
<td colspan="2">
<b>Details of Parents. </b>
<font color="#0000FF">
<span id="fmnameInfoTxt">
"(Prefix like Shri,Smt,Kumari,Late,Dr,CA,Ms,Mr,Mrs,M/s,Alias etc. are not allowed.)"
</span>
</font>
</tr>
<tr>
<td> </td>
<td>
<b>
"Whether mother is single parent and you wish to apply for PAN ny furnishing the name of your mother only"
</b>
<br>
<font color="#0000FF"></font>
</td>
<td colspan="2">
"Yes
"
<input type="radio" name="PAN_MTHR_NM_TO_PRINT_FLG" value="S" disabled="true" onclick="disablefieldSMother();">
"
No "
<input type="radio" name="PAN_MTHR_NM_TO_PRINT_FLG" value checked _ onclick="disablefieldSMother();">
<br>
</td>
</tr>
<tr>
<td>
<input type="checkbox" name="PAN_FTHR_NM_CHK" value="Y">
</td>
<td colspan="2">
<b id="fname">
<font color="RED">*</font>
"Father's Name"
</b>
<font color ="#0000FF">
<span id="fnameInfoTxt" style="color:rgb(0,100.255);">(Mandatory Field.Even married women should given father's name only.)</span>
</font>
</td>
</tr>
<tr>
<td> </td>
<td colspan="2">
<table width="100%" cellpadding="0" cellspacing="0">
<tbody>
<tr>
<td>
<b>Last Name/Surname</b>
<br>
<input type="text" name="PAN_LST_FTHR_NM" value id="FLName" size="15" maxlength="25">
</td>
<td>
<b>First Name</b>
<br>
<input type="text" name="PAN_FST_FTHR_NM" value id="FFName" size="15" maxlength="25">
</td>
<td>
<b>Middle Name</b>
<br>
<input type="text" name="PAN_MDL_FTHR_NM" size="15" maxlength="25">
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td>
<input type="checkbox" name="PAN_MTHR_NM_CHK" value="Y">
</td>
<td colspan="2">
<b id="mname"></b>
<font color="#0000ff">
<span id="mnameInfoTxt" > Mother's Name(This field is optional.) </span>
</font>
</td>
</tr>
<tr>
<td> </td>
<td colspan="2">
<table width="100% cellpadding=0" cellspacing="0">
<tbody>
<tr>
<td>
<b>Last Nane/Surname</b>
<br>
<input type="text" name="PAN_LST_MTHR_NM" value size="15" maxlength="25">
</td>
<td>
<b>First Name</b>
<br>
<input type="text" name="PAN_FST_MTHR_NM" value size="15" maxlength="25>">
</td>
<td>
<b>Middle Name</b>
<br>
<input type="text" name="PAN_MDL_MTHR_NM" value size="15" maxlength="25">
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td> </td>
<td>
<b>
<font color="RED">*</font>
"4.Select Parent name which is to be printed on the card"
</b>
<br>
<font color="#0000FF">
<span id="pnameInfoTxt">
"(In case no option is provided then PAN card will be issued with father's name)"
</span>
</font>
</td>
<td>
"
Fathers Name "
<input type="radio" name="PAN_MTHR_FTHR_NM_TO_PRINT_FLG" value = "F" checked id="Frname">
"
Mother Name"
<input type="radio" name="PAN_MTHR_FTHR_NM_TO_PRINT_FLG" value="M" id="Mrname">
</td>
</tr>
<tr>
<td valign="TOP">
<input type="checkbox" name="PAN_BRTH_CHK" value="Y" id="PAN_BRTH_CHK">
</td>
<td>
<b>
<font color="RED">*</font>
" 5.Date of Birth/Incorporation/Agreement/Partnership "
<br>
" or Trust Deed/Formation of Body of Individuals/"
<br>
" Association of Persons"
</b>
</td>
<td>
<table cellpadding="0" cellspacing="0" border="0">
<tbody>
<tr>
<td valign="TOP">
<font size="-1">DD</font>
<br>
<select name="PAN_DT_BRTH_DD">
<option value>DD</option>
<option value="01">1</option>
<option value="02">2</option>
<option value="03">3</option>
<option value="04">4</option>
<option value="05">5</option>
<option value="06">6</option>
<option value="07">7</option>
<option value="08">8</option>
<option value="09">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
</td>
<td valign="TOP">
<font size="-1">MM</font>
<br>
<select name="PAN_DT_BRTH_MM">
<option value>MM</option>
<option value="01">JAN</option>
<option value="02">FEB</option>
<option value="03">MAR</option>
<option value="04">APR</option>
<option value="05">MAY</option>
<option value="06">JUN</option>
<option value="07">JUL</option>
<option value="08">AUG</option>
<option value="09">SEP</option>
<option value="10">OCT</option>
<option value="11">NOV</option>
<option value="12">DEC</option>
</select>
</td>
<td valign="TOP">
<font size="-1">YYYY</font>
<br>
<input type="text" name="PAN_DT_BRTH_YYYY" value size="4" maxlength="4">
</td>
</tr>
</tbody>
</table>
</td>
</tr>
<tr>
<td>
<input type="checkbox" name="PAN_SEX_CHK" value="Y">
</td>
<td>
<b>
<font color="RED">*</font>
" 6.Gender"
</b>
</td>
<td>
"
Male "
<input type="radio" name="PAN_SEX" value="M">
"
Female"
<input type="radio" name="PAN_SEX" value="F">
"
Transgender"
<input type="radio" name="PAN_SEX" value="T">
</td>
<td>
</td>
</tr>
<tr>
<td>
<input type="checkbox" name="PAN_PHOTO_MIS_CHK" value="Y">
</td>
<td colspan="2">
<b> 7. Photo Mismatch</b>
</td>
</tr>
<td>
<input type="checkbox" name="PAN_SIG_MIS_CHK" value="Y">
<td colspan="2">
<b> 8. Signature Mismatch</b>
</td>
</tr>
<tr>
<td>
<input type="checkbox" name="PAN_CMNC_ADDR_CHK" value="Y" checked onclick="return false;">
</td>
<td>
<b>
<font color="RED">*</font>
9. Address for Communication
</b>
</td>
<td>
" Residential
"
<input type="radio" name="PAN_CMNC_ADDR_FLG" value="R" onclick="disablefield(this.value);patchAmount();patchDocuments();">
"
Office
"
<input type="radio" name="PAN_CMNC_ADDR_FLG" value="0" onclick="disablefield(this.value);patchAmount();patchDocumnets();">
</td>
</tr>
<tr>
<td> </td>
<td>
<span id="PAN_OFF_STYLE" style>
<b>Office Name</b>
<i>(to be filled only incase of office address)</i>
</span>
</td>
<td>
<input type="text" name="PAN_OFF_NM" value="30" maxlength="64">
</td>
</tr>
<TR>
<TD> </TD>
<TD COLSPAN=2><B>Residence Address</B></TD>
</TR>
<tr>
<td> </td>
<td>
<b>Flat/Door/Block No.</b>
</td>
<td>
<input type="text" name=PAN_R01_ADDR1" value size="25" maxlength="25" >
</td>
</tr>
<tr>
<td> </td>
<td>
<b>Name of Premises/Building/Village</b>
</td>
<td>
<input type="text" name="PAN_RO1_ADDR2" value size="25" maxlength="25">
</td>
</tr>
<tr>
<td> </td>
<td>
<b>Road/Street/Lane/Post Office</b>
</td>
<td>
<input type="text" name="PAN_R01_ADDR3" value size="25" maxlength="25">
</td>
</tr>
<tr>
<td> </td>
<td>
<b>Area/Locality/Taluka/Sub-Division</b>
</td>
<td>
<input type="text" name="PAN_R01_ADDR4" value size="25" maxlength="25">
</td>
</tr>
<tr>
<td> </td>
<td>
<b>Town/City/District</b>
</td>
<td>
<input type="text" name="PAN_RO1_ADDR5" value size="25" maxlength="25">
</td>
</tr>
<tr>
<td> </td>
<td>
<b>State/Union Territory</b>
</td>
<td>
<select name="PAN_R01_STATE" onchange="patchPINcode('Ro1');patchAmount();patchDocuments();">
<option value>--Please Select</option>
<option value="1"> Andaman &Nicobar Islands</option>
<option value="2"> Andhra pradesh</option>
<option value="3"> Arunachal pradesh</option>
<option value="4"> Assam</option>
</select>
</td>
</tr>
<tr>
<td> </td>
<td>
<b>PIN</b>
<i>(Indicating PIN is mandatory)</i>
</td>
<td>
<input type="text" name="PAN_RO1_PIN" value size="6" maxlength="6">
</td>
</tr>
<tr>
<td> </td>
<td>
<b>Country</b>
</td>
<td>
<select name="PAN_RO1_COUNTRY" id="selectPan_R_COUNTRY" disabled>
<option value="-1">--Please select--</option>
<option value="IN">India</option>
</select>
</td>
</tr>
<tr>
<td> </td>
<td>
<input type="text" name="PAN_RO1_ZIP" value size="6" maxlength="6" disabled>
</td>
</tr>
<tr>
<td>
<input type="checkbox" id="otherAddrchk" name="PAN_UPDATE_CHK" value="Y" onclick="showotherAddr()">
</td>
<td colspan="2">
<b>10.If you desire to update other address, give required details &</b>
<b>
<u> Submit proof of others address also
</u>
"
.
"
</b>
</td>
</tr>
<tr>
<td colspan="3" id="tdoffAddr" style="display: none"></td>
</tr>
<!--
<TR>
<TD> </TD>
<TD COLSPAN=2><B>oofice address</B></TD>
</TR>
-->
<tr class="hidetr" style="display: none;">
<td> </td>
<td>
<span id="PAN_OFF1_STYLE" style>
<b>office Name</b>
<i> (to be filled only in the case of office address)</i>
</span>
</td>
<td>
<input type="text" name="PAN_OFF_NM1" value size="64" maxlength="64">
</td>
</tr>
<tr class="hidetr" style="display: none;">
<td> </td>
<td>
<b>Flat/Door/Block No.</b>
</td>
<td>
<input type="text" name="PAN_RO2_ADDR1" value size="25" maxlength="25">
</td>
</tr>
<tr class="hidetr" style="display: none;">
<td> </td>
<td>
<b>Name of premises/Building/Village</b>
</td>
<td>
<input type="text" name="PAN_RO2_ADDR2" value size="25" maxlength="25">
</td>
</tr>
<tr class="hidetr" style="display: none;
">
<td> </td>
<td>
<b>Road/Street/Lane/Post office</b>
</td>
<td>
<input type="text" name="PAN_RO2_ADDR3" value size="25" maxlength="25">
</td>
</tr>
<tr class="hidetr" style="display: none;">
<td> </td>
<td>
<b>Area/Locality/Taluka/Sub-Division</b>
</td>
<td>
<input type="text" name="PAN_RO2_ADDR4" value size="25" maxlength="25">
</td>
</tr>
<tr class="hidetr" style="display: none;">
<td> </td>
<td>
<b>Town/City/District</b>
</td>
<td>
<input type="text" name="PAN_RO2_ADDR5">
</td>
</tr>
<tr class="hidetr" style="display: none;">
<td> </td>
<td>
<b>State/Union Territory</b>
</td>
<td>
<select name="PAN_RO2_STATE" onchange="patchPINcode('RO2');patchAmount();patchDocuments();">
<option value>--please select--</option>
</select>
</td>
</tr>
<tr>
<td>
<input type="checkbox" name="PAN_TEL_CHK" value="Y">
</td>
<td>
<b>
<font color="RED">*</font>
" 11. Telephone."
</b>
<br>
"
(country code is compulsory)"
</td>
<td>
<table border="1">
<tbody>
<tr>
<td width="100%" aligh="left" colspan="3">
<font size="-1">Country code(ISD code)</font>
<tr>
<td colspan="1">
<input type="radio" name="PAN_TEL_NUM_GRP" ID="panmobnum" value="M" onchange="disableTelNum();">
" Mobile No."
</td>
<td colspan="1">
<input type="radio" name="PAN_TEL_NUM_GRP" id="pantelnum" value="T" onchange="disabledTelNum();">
" Telephone No"
</td>
`
</tr>
</tbody>
</tr>
</tbody>
</form>
</body>
</html>