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X. PART-I 1. Name of Assessee (Declarant) 2. PAN of the Assessee 3. Age 5. Flat/Door/Block No. 8. Road/Street/Lane 6. Name of Premises 9. Area/Locality 11. Town/City/District 4. Assessment Year (for which is being made) 7. Assessed in which Ward/Circle 10. AO Code(under whom assessed last 12. State Area Code AO Type Range Code AO No. 13. PIN 15. Email 14. Last Assessment Year in which assessed 17. Present Ward/Circle 16. Telephone No. (with STD Code) and Mobile No. 19. Present AO Code.

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