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Passport manager

Passport Application Form

Personal Details

Given Name:*
Surname:*
Aliases,if any:*
Previous Name:*
Gender: *
Date of Birth( eg '1984-06-24'):*
Phone: *
Mobile: *
Email: *
Place of Birth:*
Height(in Cm):
Colour of Eyes:
Colour of Hair:
Visible Marks:
Permanent Address (In India):*
Present Address (In Singapore):*

Family Details

Father's Name:*
Father's Birth Country:*
Mother's Name:*
Mother's Birth Country:*
Nationality of Father at the time of Applicant's Birth:*
Nationality of Mother at the time of Applicant's Birth:*
Marital Status: *
Spouse's Name:*
Spouce Nationality:*

Passport & Other ID Details

Passport No:
Date of Issue:*
Place of Issue:
Edu. Qualifications:
When did Applicant first leave India:
When was he/she in India last:
How long has applicant continuously resided abroad:
Present Emigration Status with documentary evidence:
Profession:
Business Address:
Business Phone:
Citizen of India By:
Did applicant ever possess any other nationality or travel document of any other country? If so, please give details? :
Was applicant ever refused an Indian Passport?:
Was applicant's passport ever impounded/revoked? If so, details please:

Name and address of two relatives/friends

Name (In India):
Address:
Phone: *
Name (In Singapore):
Address:
Phone: *
Are any criminal proceedings pending against applicant in a court in India? If so, please give Details:
Has applicant ever been repatriated from abroad to India at the expenses of the Govt. of India? If so, details please:

Lost/Damaged Passport Details

Passport No:
Place of Issue:
Date of Issue:
Valid Until:
Briefly state circumstances of loss/theft/damage of passport on a plain paper and attach copy of report lodged with local police in case of loss/theft:
Give details of restriction, if any, imposed on applicant's damaged/lost passport:
Did applicant avail transfer of residence, foreign travel scheme facility on lost/damaged passport ? if so , details please:

Declaration

Sign Place:
I HAVE READ AND AGREED TO THE FOLLOWING TERMS AND CONDITIONS
 
 
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