Name (as per PAN Card)*

Father's Name (as per PAN Card)*

Residential Address*

City*

Pin Code

Date of Birth (as per PAN Card)* (Format DD-MM-YYYY)

PAN No*

AADHAR No*

Contact Number (Mobile)*

E-mail Address*

Bank Account Detail
Bank Name*

Bank A/C No.*

IFSC Code*

Detail of income other than salary (If Any)
House Property

Business/Profession

Capital Gain
Short-term

Long-term

Bank Interest*

Any Other Income

Detail of AIR Reported Transactions If any

Documents Required for ITR:
Form 16 / 16A




Comment if any

Fee Payment Receipt ( For salaried person Rs. 500/- and For Business & Professional Person Rs. 1000/-)


I hereby declare that the above information, which I am Providing to JHA FINANCIAL SERVICES is true & correct.