Income tax Department Government of___________________ [Mention the country who has issued the card]
[Photo of the candidate]
_______________ [name of the candidate]
_______________ [father’s or husband’s name of the candidate]
Date of birth: _____________
Permanent Account Number: _______________
If this card is lost or someone’s lost card is found, please return or inform to:
________________________ [address of the government office where the card needs to be returned]
_________________ [telephone number of the government office]
_____________ [fax number of the government office]
________________
Signature