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Format for Indemnity Bond Format for PAN card Surrender or Deactivation
I, ________________., S/o ______________. Residing _______________ Contact No +91–______________ do hereby solemnly affirm and declare as under:
1) My PAN is: _____________.
2) I am regularly assessed in your ward/jurisdiction with PAN: _______________.
3) I have only one PAN i.e. ___________ which is used for last many years for filing my income tax returns.
4) I do not have any other PAN (_____________) with me, if any allotted in your records, kindly deactivate the same.
5) I undertake to indemnify the Income Tax Department for any loss that may be caused in the future.
6) Kindly activate my PAN: ____________. & Kindly deactivate my PAN: ______________.
That the above statements are true and correct to the best of my knowledge and belief.
(Deponent)
Place:
Date: —-/—-/20—–
VERIFICATION
Verified at _____________, Mumbai, on this ________day of _________, 20_____. That the contents of the above affidavit are true and correct to the best of my knowledge and belief. No part of it is false and nothing material has been concealed therefrom.
(Deponent)
Place:
Date: ___/___/20____.
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