1. No category

Embassy of the People's Republic of Bangladesh
Dovestr. 1, 10587 Berlin
Tel. : (004930) 39897-s0
Fax: (004930) 39897510
E-mai l : [email protected]
APPLICATION FOR PASSPORT
(Tb be filled in English)
Reeeipt No.
&
Date:
PART _
I
Please paite photographs of father,'mother or legal
guardian if the applicant is below l5 years
(size 30x30mm)
Please paste a
Photograph (ofthe
applicant) here
(Size 40.x50mm)
2
12. Mother's name and
nationality:-....-.-.
--.----........-:
. 13. Mother's profession and voter identification number
(if
any):..".....-...-.....-..--...-..-.-'.--....----.-.
14- Husbandlwile'S name and natibnality (as is applicable),:....-"........-.....-.......:I
5. Legal guardian's name and national ity:-....---...--..:..-..-----
16- Relation
with legal guardian:.,....-.--.-
-r...-.-----...-'
[7. Nationality of applicant:
by birth D
'
by naturalisation
fl
by any other means D
I8. Marital statusl
Married
fl
Unmarried
2l . Number of passport pages
E
Widow/Widower
requested:
48 pages
fl
D
Divorcee fJ
64 pages D
22- Particulars of the children (under l2 years of age) to be endorsed in the passport
(upto'2 children)
SerialNo.
t.
2.
:i
Photo
Name
Date of Birth
Place of
Birth
Sex
l.
2.
).
c)
e)
3.
Endbrsernent of children:
please fill out item22
I do solemnl; declare
(a) that the ab,lve statements made by me are true;.
that I am not in possession,of anY other passgrorts except the one mentioned at seriali
No.23;
of return, for myself'and'my
(b)
' ' that I or my legal hqir wili be responsible to pay for the costdeportation
journey
case
of
compulsory
or unfoitunate'
in
to"Bangladesh,
dependanti'
death.
Signature/Thumb.impression of the appli'-
rvill
cant Applicant should alsei.sign insidc.thc
bc.all'ixcd on the passport
,
'
lnn
r^'hich.
u'il[ bc.al'tixed on the passporl'
--:--------------*--:------:-------------