HOW TO FILL THE APPLICATION FORM GUIDE * Use CAPITAL LETTERS only. Particulars given in the form will be printed in the passport. Therefore, please be careful in filling up the form and avoid any mistakes. * Write clearly within the box without touching the boundaries. * While filling the boxes, kindly leave one box blank after each complete word. * Do not write anything outside the box. Avoid over-writing. * Use BLUE/BLACK ball pen only. * Please write all the dates in DD/MM/YYYY format wherever required * Incomplete application will not be accepted. * For any explanations or detailed descriptions refer the Instruction Booklet. EXAMPLE Step 1 : Choose the appropriate box, according to the type of passport to be procured. New Passport : For issuing a fresh passport Re-issue Passport : For re-issuing a passport in case of expiry of the passport Replacement of Lost : For re-issuing a passport in case of lost passport Damaged Passport : For re-issuing in case the passport is damaged Step 2 : Fill in the details asked appropriately according to the sections relevant PERSONAL DETAILS 1 3 2 1. Name of the applicant as it should appear in the Passport (Initials not allowed) Surname COLUMN 1 4 Middle Name First Name Documentary Proof : Details : 5 1 Suggests the braod category under which the questions fall. 2 Suggests Column No. (as in this case ,1) and description of the Column 3 Suggests the column no, where you need to refer for detailed instructions and explanation of the particular column in the Instruction Booklet Column no. and name 1. NAME OF THE APPLICANT The name upto 75 character long name can be given and filled in the form. The full name as it should appear in the Passport should be furnished here. Eg: Name : KARUR VAIKUNTA SUBRAMANIYAN RAMANATHAN PILLAI Write the Surname as “PILLAI” in the boxes provided for Surname and put a comma and write “VAIKUNTA SUBRAMANIYAN RAMANATHAN” as the Given Name in the rest of the columns. In case you do not have a surname, just write the given name. No initials should be written and they should be expanded Details of documents to be attached DOCUMENTS TO BE ATTACHED - Birth certificate issued by a Municipal Authority or district office of the Registrar of Births & Deaths OR - Date of Birth certificate from the school last attended by the applicant or any other recognised educational institution OR - affadavit sworn before a Magistrate / Notary stating date / place of birth as per the specimen in ANNEXURE ‘A’ by illiterate or semi - illeterate applicants OR N.B : In the case of applicants born on or after 26.01.89, only Birth Certificate issued by the Municipal Authority or the Office of hte Registrar of Births & Deaths is acceptable. 4 Details of the parameters to be filled are given 5 Documentry prrof if attached, needs to be verified. Details of the attached proof need to be mentioned. Eg. Documentary Proof : Details : Birth Certificate Passport Application Form (No.1) Government of India Ministry of External Affairs New Passport Replacement of Lost Re-issue Passport Damaged Passport Please read the Passport Information Booklet carefull, before filling the form, in CAPITAL LETTERS in blue/black ball point pen only Paste your unsigned recent colour photograph (CAUTION: PLease furnish correct information. Furnishing of incorrect information would attract penal provisions as presecribed under the Passports Act,1967). Please produce your original documents at the time of submission of the form. Signature /Thumb Impression Male : Left hand Thumb Female : Right Hand Thumb Size: 3.5 * 3.5 cm PERSONAL DETAILS 1. Name of the applicant as it should appear in the Passport (Initials not allowed) COLUMN 1 Surname Middle Name First Name Documentary Proof : Details : 2. In case of change of name/surname (after marriage or otherwise), please indicate the previous name, surname in full COLUMN 2 Surname Middle Name First Name Documentary Proof : 3. Sex Male : Details : COLUMN 3 Female : 4. Date of Birth (dd/mm/yyyy) COLUMN 4 In Words Documentary Proof : Details : 5. Place of Birth COLUMN 5 Village / Town District State Country Documentary Proof : Details : (1) 6. Father / Legal Guardian’s Full Name (Initials not allowed) COLUMN 6 Surname Middle Name First Name 7. Mother’s Full Name (Initials not allowed) COLUMN 7 Surname Middle Name First Name 8 (i) If Married, Full Name of wife / husband (Initials not allowed) COLUMN 8 Surname Middle Name First Name 8 (ii) If Divorced Widow / Widower Documentary Proof : please indicate Details : 9 (i) Current Residential Address (where staying presently) Residing Since COLUMN 9 (dd/mm/yyyy) *Note: for students staying away from their parents, have the option of applying from place of study. in such cases, for proof of address a bonafide certificate from the Principal / Director / Registrar / Dean of educational institute is a must. 9 (i) If you have been residing at your current address for less than one year, please furnish other addresses of your residence during the last one year. From From To To 10. Present Address with PIN code (If address is same as the present address wirite “Same”) Documentary Proof : Details : (2) COLUMN 10 11.Other Details COLUMN 11 (a) Educational Qualifications : Documentary Proof : Details : (b) Visible Distinguishing Marks, if any : (c) Height (cms) : (d) Telephone No : (e) Mobile No : 12. Are you a citizen by Birth COLUMN 12 Descent Registration Naturalisation *Note: If by Registration or Naturalisation, enclose citizenship document. Registration : Naturalisation: If any other citizenship : Documentary Proof : Details : 13. Are you working in Central Government / State Govt. / PSU / Statutory Bodies ? No : Yes : Documentary Proof : COLUMN 13 ( Attach Identity Certificate, Annexure B) Details : 14. “Emmigration Check Not Required” Status? COLUMN 14 *Note: All matriculation and above applicants are eligible for ECNR Status. To check under which category, the applicants falls, please read the instruction manual carefully No : Yes : Documentary Proof : ( Mention eligible criteria, Attach copy of document ) Details : COLUMN 15 15. (a) Have you at any time during the period of Five years immedietly preceding the date of this application been convicted by a court in India for any criminal offence & sentenced to imprisonment for two years or more? No : Yes : ( Attach copy of judgement ) Name of Court : Case Number : Section of Law : Documentary Proof : Details : (b) Are any criminal proceedings pending against you before a court in India? No : Yes : ( Give Details,provide No Objection Certificate ) Case Number : Name of Court : Section of Law : Documentary Proof : Details : (3) 15. (c) Have you been ever refused / denied passport? No : ( Give Details ) Yes : Details : (d) Has your passport ever been impounded / revoked? *Note: Impounded: Revoked: No : Yes : ( Give Details ) Details : (e) Have you ever applied /granted political assylum by any foreign country? No : ( Give Details ) Yes : Details : MINOR’S PASSPORT 16. In case of minor’s (applicant’s below the age of 18), give details and enclose documents COLUMN 16 *Note: If EITHER of the parents hold a valid Indian Passport or has applied for it, give following details. If NOT , read instruction manual (Attach Annexure - H) Passport/File No. Date of Issue Place of Issue Father Mother RE-ISSUE/DAMAGED/LOST PASSPORT 17 (i) Details of latest held / existing Ordinary Diplomatic Official Passport(s) COLUMN 17 *Note: If EITHER of the parents hold a valid Indian Passport or has applied for it, give following details. If NOT , read instruction manual (Attach Annexure - H) (a) Passport Office File No: Passport(s) No: Date of Expiry: (b) Date of Issue: (c) Place of Issue: (d) In case passport was applied for and not issued: Date: File No: (e) Has your passport(s) ever been lost /damaged? No : Yes : Documentary Proof : (Attach FIR , Give details) Details : (4) 17 (ii) If you have returned to India on Emergency Certificate (EC) or were deported or repatriated, give following details (4)applied for it, give following details. If NOT , read instruction *Note: If EITHER of the parents hold a valid Indian Passport or has manual (Attach Annexure - H) (a) Emergency Certificate No : (b) Date of Issue : Place of Issue : Country : (c) Deported / Repatriated from Place : Documentary Proof : Details : In case of ACCIDENTS /DEATH 18. Particulars of person to be intimated in teh event of death or accident COLUMN 18 Name : Address : Mobile No : Telephone No : Email ID : SELF DECLARATION 19. COLUMN 19 I owe allegiance to teh soverignity, unity & integrity of India, and have not voluntarily acquired citizenship or travel documents of any other country. I have not lost, surrendered or been deprived of citizenship of India. the information given by me in this form and enclosures is true and I am solely responsible for its accuracy. I am aware that it is an offence under the Passports Act, 1967 to furnish any false information or to suppress any material information with a view to obtaining a passport or any other travel document. I further declare that i have no other passport / travel document. Signature /Thumb Impression Date : Male : Left hand Thumb Female : Right Hand Thumb Place : ENCLOSURES 20.(i) PERSONAL COLUMN 20 Proof of Date of Birth Proof of Residence Change of Name proof Identity Certificate Educational Qualifications: Citizenship ECNR /ECR (supporting document) Judgement Copy No Objection Certificate (5) (ii) MINOR’S PASSPORT (Annexure(s) ,if applicable) 1. 2. 3. 4. (iii) RE-ISSUE PASSPORT (Annexure(s) ,if applicable) 1. 2. 3. 4. (iv) LOST / DAMAGED PASSPORT Emergency Certificate FIR 2. 1. (v) ANNEXURES ATTACHED Annexure(s) B A C D E F G H I J K FEES Cash D.D Fee Amount Rs. Bank Code Date of Issue of D.D D.D No For OFFICE USE Only File Number Police Verification Required : Yes No ECR/ECNR Name Signature Checked By Granted By Scanned By Dispatched By (6) Date PERSONAL PARTICULARS FORM (In Duplicate) Paste your unsigned recent colour photograph Signature /Thumb Impression For Police Use Only Recommended Passport: Yes Size: 3.5 * 3.5 cm Male : Left hand Thumb Female : Right Hand Thumb No 1. Full Name (Initials not allowed) 2. Has the applicant ever changed name? if yes, previous name (Initials not allowed) 3. (a) Father’s Name (b) Mother’s Name (c) Husband/Wife’s Name 4. Sex: Male : Female: 5. (a) Date of Birth (dd/mm/yyyy) : 5. (b) Place of Birth : 6. Profession : 7. (a) Permanent Address & Telephone No along with Police Station details 7. (b) Present Address & Telephone No along with Police Station details and residing since 8. (b) If you have been residing at your current address for less than one year, please furnish other addresses of your residence during the last one year. From / / (dd/mm/yyyy) To / / (dd/mm/yyyy) From / / (dd/mm/yyyy) To / / (dd/mm/yyyy) 9 . References : Name & Addresses of two responsible persons in the applicant’s locality who can vouch for the applicant Name : Name : Address : Address : Telephone No : Telephone No : 10. Are you a citizen by Birth Descent Registration Naturalisation 11. Furnish details of previous passport/travel document, if any (a) Passport / Travel document No: (b) Date & Place of Issue: (6) PASSPORT INFORMATION BOOKLET (APPLICANT MAY KEEP THIS BOOKLET FOR FUTURE HANDY REFERENCE) CAUTION : Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque tincidunt quam vel mi iaculis condimentum. Curabitur ut quam quis duidictum mattis sit amet quis nisl. Quisque felis augue, blandit rutrum sollicitudin vel, vehicula euismod tellus. Phasellus sollicitudin iaculis euismod. Mauris ornare, eros eu pulvinar iaculis, magna nisl venenatis arcu, quis bibendum massa SECTION I : GENERAL INFORMATION 1. HOW TO APPLY : Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque tincidunt quam vel mi iaculis condimentum. Curabitur ut quam quis duidictum mattis sit amet quis nisl. Quisque felis augue, blandit rutrum sollicitudin vel, vehicula euismod tellus. Phasellus Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque tincidunt quam vel mi iaculis condimentum. Curabitur ut quam quis dui dictum mattis sit amet quis nisl. Quisque felis augue, blandit rutrum sollicitudin vel, vehicula euismod tellus. Phasellus sollicitudin iaculis euismod. Mauris ornare, eros eu pulvinar iaculis, magna nisl venenatis arcu, quis bibendum massa dolor et nunc. Mauris magna nibh, malesuada eget vehicula vitae, elementum et nisl. Mauris quis pharetra mi. Donec luctus lobortis metus vitae suscipit. Donec non dui nec enim sodales congue. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Mauris sed orci in enim mattis semper id in ante. Morbi fringilla sodales facilisis. Cras viverra nisl at augue cursus non rhoncus 2. FEE AND MODE OF PAYMENT : Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque tincidunt quam vel mi iaculis condimentum. Curabitur ut quam quis dui dictum mattis sit amet quis nisl. Quisque felis augue, blandit rutrum sollicitudin vel, vehicula euismod tellus. Phasellus sollicitudin iaculis euismod. Mauris ornare, eros eu pulvinar iaculis, magna nisl venenatis arcu, quis bibendum massa dolor et nunc. Mauris magna nibh, malesuada eget vehicula vitae, elementum et nisl. Mauris quis pharetra mi. Donec luctus lobortis metus vitae suscipit. Donec non Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque tincidunt quam vel mi iaculis condimentum. Curabitur ut quam quis dui dictum mattis sit amet quis nisl. Quisque felis augue, blandit rutrum sollicitudin vel, vehicula euismod tellus. Phasellus sollicitudin iaculis euismod. Mauris ornare, eros eu pulvinar iaculis, magna nisl venenatis arcu, quis bibendum massa dolor et nunc. Mauris magna nibh, malesuada eget vehicula vitae, elementum et nisl. Mauris quis pharetra mi. Donec luctus lobortis metus vitae suscipit. Donec non dui nec enim sodales congue. Cum sociis natoque penatibus et 3. DELIVERY OF PASSPORTS : Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque tincidunt quam vel mi iaculis condimentum. Curabitur ut quam SECTION II : INSTRUCTIONS AND GUIDELINES FOR FILLING UP THE APPLICATION FORM Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque tincidunt quam vel mi iaculis condimentum. Curabitur ut quam Important Note : - All original documents are to be shown at the time of submission of the passport application form. - With the Original Passport Application Form, self-attested copies of all required documents need to be attached. Illiterate applicants should put only thumb impression in the box meant for thumb impression / signature. - In case an applicant has stayed at more than one address during the last one year, he / she should furnish two additional photocopies of the Personal Particulars (PP ) form for each additional place of stay. SECTION III : COLUMN-WISE GUIDELINES & INFORMATION ABOUT DOCUMENTS TO BE ATTACHED At the beginning of the Application Form there are boxes for affixing photogrph, appending signature and thumb impression and giving details of payment of the fee. PHOTOGRAPHS : Recent passport size photographs (three) in colour showing frontal view of full face are required. One photograph is to be pasted on form and two on the PP Forms, which is to be filled in duplicate. Black and white photograph, photograph with colored or dark glasses or in uniform, polaroid printes or computer prints will not be accepted. In the box meant for affixing the photograph, please paste your recent and identical colour photograph of size 3.5 cm * 3.5 cm. Photograph should have a white or a light coloured background. Photograph should fit exactly in the box and in any case not smaller than the box provided in the form. For Jumbo booklets, two additional photographs are required. Signature / thumb impression should be strictly within the box without touching the boundaries. Thumb impression should be of left hand in case of males and right hand in case of females. (a) 1. NAME OF THE APPLICANT The name upto 75 character long name can be given and filled in the form. The full name as it should appear in the Passport should be furnished here. Eg: Name : KARUR VAIKUNTA SUBRAMANIYAN RAMANATHAN PILLAI Write the Surname as “PILLAI” in the boxes provided for Surname and put a comma and write “VAIKUNTA SUBRAMANIYAN RAMANATHAN” as the Given Name in the rest of the columns. In case you do not have a surname, just write the given name. No initials should be written and they should be expanded DOCUMENTS TO BE ATTACHED - Birth certificate issued by a Municipal Authority or district office of the Registrar of Births & Deaths OR - Date of Birth certificate from the school last attended by the applicant or any other recognised educational institution OR - affadavit sworn before a Magistrate / Notary stating date / place of birth as per the specimen in ANNEXURE ‘A’ by illiterate or semi - illeterate applicants OR N.B : In the case of applicants born on or after 26.01.89, only Birth Certificate issued by the Municipal Authority or the Office of hte Registrar of Births & Deaths is acceptable. 2. CHANGE OF NAME DOCUMENTS TO BE ATTACHED (b)
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