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Passport Application Form
Reason of applying for passport:
1. Name of applicant as it should appear in the Passport (Initials not allowed)
Surname:
 
Given Name:
 
2. In case of change of name/surname
(after marriage or otherwise with documentary proof), please indicate the previous name/surname in full:
3. Sex:  
4. Date of Birth:
5. Place of Birth: Village / Town, District, State, Country (with Documentary Proof)
 
6. Father/Legal Guardian's Full Name (including surname, if any): (Initials not allowed)
 
7. Mother’s Full Name (including surname, if any): (Initials not allowed)
 
8. If married, Full Name of wife/husband (including surname, if any). (Initials not allowed).
8 (i) If divorced/widow/widower, Please indicate the category with documentary proof.
 
9. Current Residential Address (where staying presently), (In case of students, please see Section III of Passport Information Booklet)
 
Residing since:
PIN:  
Telephone No.
Mobile No.
9 (a) If you have been resident at your current address for less than one year, please furnish other addresses
From:
To:
From:

To:
10. Permanent Address with PIN code (if the permanent address is same as the present address write “Same”
 
PIN:  
11. Details of latest held/existing Ordinary/Diplomatic/Official passport(s):
Passport Office File No:  
Passport(s) No  
Date Of Issue:
   
Place Of Issue:  
Date of Expiry
(iii) In case passport was applied for and not issued, please give File No. & Date      
File No.
Date:
(iv) Has your passport(s) ever been lost / damaged (if so attach FIR and give details)
11. (a) If you have returned to India on Emergency Certificate (EC) or were ever deported or repatriated, please furnish details:
EC No., date and place of issue & attach seizure memo in original
Place & Country from where deported / repatriated and reason thereof:
12. Other Details:
a) Educational Qualifications
 
b) Visible Distinguishing Mark, if any
c) Height
cm  
d) Occupation
 
e) Address of Employer
 
 13.Are you working in Central Government/ State Govt/ PSU/ Statutory Bodies ?
14. Are you a citizen of India by:
If you have ever possessed any other citizenship, please indicate previous citizenship
15. “Emigration Check Not Required” status 
If yes, mention the eligible category (see Section III of Passport Information Booklet) and enclose copy of relevant certificate/document
 
16. In case of minors (applicant below the age of 18), if EITHER of the parents hold a Valid Indian Passport or has applied for it give the following details. Please see and fill up attached Annexure-H.
Mother                                  
Passport/ File No.
Date Of Issue:
/Place Of Issue:
Father                                  
Passport/ File No.
Date Of Issue:
/Place Of Issue:
17. (a) Have you at any time during the period of Five years immediately 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? If so, give name of the court, case number and relevant sections of Law. (Attach copy of judgement)
(b) Are any criminal proceedings pending against you before a court in India? If so, give name of court, case number and relevant sections of Law.
(c) If answer at (b) is (Y)es, please furnish No Objection Certificate from competent court for grant of
(d) Have you been ever refused/denied passport? If yes, give details:
(e) Has your passport ever been impounded / revoked? If yes, give details:
(f) Have you ever applied/granted political asylum by any foreign country? If yes, give details.
18. Particulars of person to be intimated in the event of death or accident:
Name:  
Address:  
Mobile / Tel. No. / email ID  
 
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