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    Application Form

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    Pawan

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    © All Rights Reserved
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    Application Form

    Uploaded by

    Pawan
    4 views1 page

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    © © All Rights Reserved

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    Copyright:

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    4 views1 page

    Application Form

    Uploaded by

    Pawan

    Copyright:

    © All Rights Reserved
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    of 1

    PASSPORT APPLICATION FORM

    Government of INDIA, Ministry of External Affairs

    Service Required
    Application Reference Number 19-0007145308
    Applying For FRESH
    Type of Application NORMAL
    Type of Passport Booklet NORMAL
    Applicant Details
    Applicant's Name VIKRAM SINGH
    Date of Birth (DD/MM/YYYY) 20/10/1986
    Validity Required NA
    Place of Birth (Village/Town/City) RAJPURA
    District PATIALA
    State/UT PUNJAB
    Country INDIA
    Gender MALE
    Marital Status MARRIED
    Citizenship of India by BIRTH
    PAN CSEPS2804L
    Employment Type PRIVATE
    Is either of your parent (in case of minor)/spouse, a government servant? N
    Educational Qualification GRADUATE AND ABOVE
    Are you eligible for Non-ECR category? Y
    Visible Distinguishing Mark A MOLE ON CHEST ON LEFT SIDE
    Aadhaar Number 729696250697
    Family Details
    Father's Name SUGAN PAL
    Mother's Name SHEELA DEVI
    Spouse's Name SHALU DEVI
    Present Residential Address Details
    Address 61, GARDI NAGAR, GHANOUR, PATIALA, PUNJAB
    PIN 140417
    Mobile/Tel No. 8427280002
    E-mail VIKRAM_RANA1986@YAHOO.COM
    Permanent Residential Address
    Address 61, GARDI NAGAR, GHANOUR, PATIALA, PUNJAB
    PIN 140417
    Mobile/Tel No. 8427280002
    Emergency Contact Details
    Name and Address SHALU DEVI & VILL GARDI NAGAR DISTT PATIALA
    Mobile/Tel No. 9877528158
    E-mail SHALURANA190@YAHOO.COM
    Other Details
    Enclosures
    1.Aadhaar Card/E-Aadhaar
    2.Aadhaar Card/e-Aadhar containing the 12 digit Aadhaar number issued by the Unique Identification Authority of India(UIDAI)
    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 BANUR
    Date 23/05/2019

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