Scribd Logo
Upload

Welcome to Scribd!

  • 41 views

    Application Form PDF

    Uploaded by

    Sai Charan
    This document is a passport application form for Venkata Jagadesh Sai Datta Nandikonda from Visakhapatnam, Andhra Pradesh. The application is for a fresh normal passport. Key details provided include the applicant's personal information like name, date of birth, address, identification marks. Family details of father and mother are also given. Two references with contact information are listed. The applicant declares that the information provided is true and acknowledges legal penalties for providing false information.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Application Form PDF

    Uploaded by

    Sai Charan
    41 views1 page
    This document is a passport application form for Venkata Jagadesh Sai Datta Nandikonda from Visakhapatnam, Andhra Pradesh. The application is for a fresh normal passport. Key details provided include the applicant's personal information like name, date of birth, address, identification marks. Family details of father and mother are also given. Two references with contact information are listed. The applicant declares that the information provided is true and acknowledges legal penalties for providing false information.

    Original Title

    Application Form.pdf

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is a passport application form for Venkata Jagadesh Sai Datta Nandikonda from Visakhapatnam, Andhra Pradesh. The application is for a fresh normal passport. Key details provided include the applicant's personal information like name, date of birth, address, identification marks. Family details of father and mother are also given. Two references with contact information are listed. The applicant declares that the information provided is true and acknowledges legal penalties for providing false information.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    41 views1 page

    Application Form PDF

    Uploaded by

    Sai Charan
    This document is a passport application form for Venkata Jagadesh Sai Datta Nandikonda from Visakhapatnam, Andhra Pradesh. The application is for a fresh normal passport. Key details provided include the applicant's personal information like name, date of birth, address, identification marks. Family details of father and mother are also given. Two references with contact information are listed. The applicant declares that the information provided is true and acknowledges legal penalties for providing false information.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    2/2/2017 Application Form

    PASSPORT APPLICATION FORM

    Government of INDIA, Ministry of External Affairs

    Service Required
    Application Reference Number 17­1001339717
    Applying For FRESH
    Type of Application NORMAL
    Type of Passport Booklet NORMAL
    Applicant Details
    Applicant's Name VENKATA JAGADESH SAI DATTA NANDIKONDA
    Date of Birth (DD/MM/YYYY) 27/04/1993
    Validity Required NA
    Place of Birth (Village/Town/City) VISAKHAPATNAM
    District VISAKHAPATNAM URBAN
    State/UT ANDHRA PRADESH
    Country INDIA
    Gender MALE
    Marital Status SINGLE
    Citizenship of India by BIRTH
    PAN AJFPN8483L
    Employment Type NOT EMPLOYED
    Is either of your parent (in case of
    N
    minor)/spouse, a government servant?
    Educational Qualification GRADUATE AND ABOVE
    Are you eligible for Non­ECR category? Y
    Visible Distinguishing Mark A MOLE ON THE LEFT CHEEK
    Aadhaar Number 380614091803
    Family Details
    Father's Name SATYANARAYANA NANDIKONDA
    Mother's Name ANURADHA NANDIKONDA
    Present Residential Address Details
    Residing Since(MM/YYYY) 07/1993
    D.NO 37­3­87/2,GAJAPATHI NAGAR,KANCHARAPALEM, VISAKHAPATNAM,
    Address
    KANCHARA, VISAKHAPATNAM URBAN, ANDHRA PRADESH
    PIN 530008
    Mobile/Tel No. 9493977473
    E­mail TEJASWI9SAI@GMAIL.COM
    First Reference Name And Address NAMMI MALLESWARA RAO,D.NO 37­3­87/2,HAJAPATHI NAGAR,VISAKHAPATNAM
    Mobile/Tel No. 7032220448
    V V MURALI KRISHNA,D.NO­37­3­87 ,GAJAPATHI
    Second Reference Name And Address
    NAGAR,KANCHARAPALEM,VISAKHAPATNAM­08
    Mobile/Tel No. 9000625565
    Permanent Residential Address
    D.NO 37­3­87/2,GAJAPATHI NAGAR,KANCHARAPALEM, VISAKHAPATNAM,
    Address
    KANCHARA, VISAKHAPATNAM URBAN, ANDHRA PRADESH
    PIN 530008
    Mobile/Tel No. 9493977473
    Emergency Contact Details
    N.SATYANARAYANA,D.NO 37­3­87/2,GAJAPATHI
    Name and Address
    NAGAR,KANCHARAPALEM,VISAKHAPATNAM­08
    Mobile/Tel No. 9866530881
    Mobile/Tel No. 9866530881
    Other Details
    Self Declaration
    I owe allegiance to the sovereignty, unity and integrity of India, and have not voluntarily acquired citizenship or travel document of
    any other country. I have not lost, surrendered or been deprived of the citizenship of India and I affirm that the information given by
    me in this form and the enclosures is true and I am solely responsible for its accuracy, and I am liable to be penalized or prosecuted
    if found otherwise. I am aware that under the Passports Act, 1967 it is a criminal offence to furnish any false information or to
    suppress any material information with a view to obtaining passport or travel document.
    Place VISAKHAPATNAM
    Date 02/02/2017

    https://portal2.passportindia.gov.in/AppOnlineProject/secure/ApplicantSelfDeclarationAction 1/1

    You might also like