Application Form For The Grant Renewal Of Pio Card
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1
2
3High Commission of India
Maputo
PIO CARD
APPLICATION FORM FOR THE GRANT / RENEWAL OF
(To be filled in duplicate)
Affix one
Recent
passport-size
photo here
1.
a) Name of the applicant:
____________________________________________________
b) Surname at birth (if any):
____________________________________________________
c) Other names (wherever applicable):
_____________________________________________
d) Date of Birth:
____________________________________________________
e) Place of birth (Town, City, Country):
_____________________________________________
2.
Father’s/Mother’s/Spouse's name and nationality:
a) Father:
__________________________________________________________
b) Mother:
__________________________________________________________
c) Spouse (where applicable): _______________________________________________________
3.
Address: a) Present:
__________________________________________________________
__________________________________________________________
b) Permanent: __________________________________________________________
__________________________________________________________
c) Address in India (verifiable): ______________________________________________
__________________________________________________________
4.
Profession or occupation:
____________________________________________________
5.
Business/Office Address:
____________________________________________________
____________________________________________________
6.
Male/Female:
__________________________________________________________
7.
Marital Status: Married/Unmarried:
_____________________________________________
8.
Nationality (at time of birth):
____________________________________________________
9.
a) Present nationality (if different):
_____________________________________________
b) Date on which acquired:
_____________________________________________
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