Application Form For The Grant Renewal Of Pio Card (Page 2 of 3) in pdf

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10.

Passport particulars of applicant:

a) Passport Number:

__________________________________________________________

b) Date of issue:

__________________________________________________________

c) Date of expiry:

__________________________________________________________

d) Country which issued the Passport:

_____________________________________________

e) Place of issue:

__________________________________________________________

10(a).

Mark of Identification: __________________________________________________________

11.

Does the applicant hold dual nationality? (If so, please

give details including details of all passports held, etc.):____________________________________

______________________________________________________________________________

12.

Did the applicant at any time hold the nationality of any country

other than the present nationality? If so, give details thereof: _______________________________

______________________________________________________________________________

13.

Whether the applicant or either of his/her parents or grand parents or great grand parents held an

Indian Passport at any time. If so, details thereof:

a) Passport Number:

__________________________________________________________

b) Date of Issue:

__________________________________________________________

c) Place of Issue:

__________________________________________________________

d) Date of expiry:

__________________________________________________________

(enclose photocopy of relevant documents)

14.

Whether the applicant or either of his/her parents or any of his/her grand parents or great grand

parents was born and was a permanent resident in territories falling in present day India, Pakistan and

Bangladesh, as on notification of the Scheme, i.e. 30.3.1999, if so, indicate the following details:

i) Date and place of birth:

____________________________________________________

ii) Proof of residence, etc.:

____________________________________________________

(enclose photocopy of relevant documents)

[Note: If the applicant is the spouse of a citizen of India or of a person who or either of whose

parents, grand parents or great grand parents was born and was a permanent resident in territories

falling in present day India, Pakistan and Bangladesh, his/her full particulars including date and place

of birth, proof of residence, nationalities held and passport details (previous and present) may be

given]

15.

Has the applicant ever been refused Indian Passport/Travel Document or visa for visiting India? If

so, give complete details (i.e. Place and date of application, purpose, reason for refusal, etc.)

____________________________________________________________________________

Application Form For The Grant Renewal Of Pio Card Page 2

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