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Form of application for registration as authorised income-tax practitioner under section 515

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.... Female (iii) Transgender 3. Permanent Account Number (PAN)   4. Name of *Father/Husband (Refer Note 1) 5. Permanent Residential Address (Refer Note 2) 6. Present Residential Address (Refer Note 2) 7. Contact Details (i) Mobile Number Country Code Number     (ii) Email ID   8. Principal Place of Profession in India   9. (i) Whether partner in a firm,    (Select One) (i) Yes (ii) No   (ii) If the answer to row 9(i) is yes, then provide following details of the firm: (a) Name   (Refer Note 1) (b) PAN     (Repeat, if required) Part B: Declaration ....

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.... (Signature)  Verification I, _____________ [name in block letters], do declare that what is stated in the above application is true to the best of my information and belief.  Place:   Date: _________________  (Signature) *Delete whichever is not applicable   Notes: 1. First, middle and last name shall be provided in full without any abbreviations. 2. The address shall contain (i) Country/Region, (ii) Flat/Door/Building, (iii) Road/Street/Block/Sector, (iv) PIN/ZIP Code, (v) Post Office, (vi) Area/locality, (vii) District, and (viii) State. The address may also contain DIGIPIN. 3. With respect to row 10, following documents shall be provided as an....

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....ii) No (B) If the answer to row 9(A) is yes, then provide following details: (i) Name of firm (Refer Note 1) (ii) Names of other partners (Refer Note 1) (C)   (Repeat, if required) Part B: Declaration by Applicant 10. (i) (a) I certify that I have passed the accountancy examination of   (b) Attach true copy of the certificate mentioned in row 10(i)(a). (Refer Note 3) (ii) (a) I certify that I have acquired the educational qualifications of   (b) Attach true copy of the certificate mentioned in row 10(ii)(a). (Refer Note 3) (iii) Whether you were disqualified under section 515(4). (Select One) (i) Yes (ii) No (iv) Were you an ....