Fillable Passport Application Form (Page 2 of 2) in pdf

29. (a) NAME OF APPLICANT ELDEST SON OR DAUGHTER (first child)

30. IS APPLICANT IN

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GOVERNMENT SERVICE

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PUBLIC UNDERTAKING SERVICE

(b) NAME OF APPLICANT ELDEST BROTHER OR SISTER

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STATUTORY BODIES SERVICE OF INDIA

(if so, please give details and enclose “No Objection Certificate” from your

employer in original)

31. IS THIS APPLICATION FOR A PASSPORT FOR THE:

32. (a) BRIEFLY STATE CIRCUMSTANCES OF LOSS/THEFT/DAMAGE OF

PASSPORT AND ATTACH REPORT LODGED WITH THE LOCAL POLICE:

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FIRST TIME

(attach explanation on a separate sheet of paper)

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NEW PASSPORT IN REPLACEMENT OF AN EXPIRED/EXPIRING PASSPORT

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DUPLICATE PASSPORT (proceed to item 32)

(b) DETAILS OF RESTRICTION, IF ANY, PUT ON APPLICANTS DAMAGES/LOST

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LOST PASSPORT

PASSPORT.

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DAMAGE PASSPORT (attach damaged passport to this application)

(proceed to item 32)

DECLARATION

(Signature to be notarized by a public notary only in case of application for duplicate or if the application is in lieu of a passport

that expired more than six months ago.)

I solemnly affirm that:

(i) I owe allegiance to the sovereignty and integrity of India, and

(ii) Information given above in respect of myself, my son/daughter/ward is correct and nothing

has been concealed and I am aware that it is an offense under the Passport Act 1967

to knowingly furnish false information or suppress material information, which attract penal

and other punishments under the acts.

(iii) I undertake to be entirely responsible for expenses of my son/daughter/ward.

(iv) I have not lost, surrendered or been deprived of my citizenship of India. I have not voluntarily

PASTE

y acquired the citizenship of another country.

PHOTO HERE

(v) The information furnished by me in this form is correct.

Size: 3.5 X 3.5 cm

(vi) I have neither applied for, nor been granted asylum.

(vii) I have read the passport guidelines, fees and mailing information carefully.

Signature or thumb impression of applicant or his/her

Place ____________________

legal guardian (Left thumb impression of male and Right

Thumb impression of female.

Date ____________________

SOME USEFUL INFORMATION ABOUT YOUR PASSPORT

CHECK LIST FOR PASSPORT APPLICATION

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Passport in Original

i. Please keep a photocopy of your passport in a safe place. Without these

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Completely Filled and Signed Application Form

relevant issuance of a duplicate passport in case of loss/damage/theft

may be delayed.

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Two (2) Most Recent Colored Photograph 3.5cm x 3.5 cm (Pasted on

ii. It is an offence under the Passports Act 1967 to give false information in

the space provided on first and second page of the application).

the Application. Passport facilities can be denied on grounds of

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Photocopy of Front/Back Side of Green Card or Employment

suppression of factual information, submission of false particulars, willful

damage of passport and for making unauthorized changes in the

Authorization Card or Proof of Status such as

I-94, Visa type: B, H, L &

passport.

etc..

iii. Your passport can be impounded or revoked by the Government of India

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Proof of US Address such as

State ID/Drivers License or utility bill

under the provisions of the Passports Act 1967, in the event of which you

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will have to surrender the Passport to the nearest Indian Passport

Sworn Affidavit (Passport that is expired more than six (6) months)

authority.

iv. Indian Citizenship Law Does Not Provide For Dual Citizenship and,

For Passport to a Child:

accordingly, it is illegal for a person to possess an Indian Passport once

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A Notarized

No Objection letter

signed by both the parents

he/she becomes citizen of another country. It may therefore, be noted that

For Entry of Spouse Name in the Passport:

on becoming citizen of any other country (including US), the holder of an

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Indian passport should return the same to the nearest Indian Consular

Notarized Photocopy of Marriage Certificate

post (Embassy/Consulate). The Indian passport will be stamped "acquired

US nationality" and returned to holder. Please send the Indian passport

For Change of Name consequent of Marriage:

with covering letter and a self addressed stamped envelope for this

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Notarized Photocopy of Marriage Certificate

purpose.

v. Please always check the expiry date of your Passport, and get it renewed

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Spouse Passport

well in advance of the expiry. Incase your Passport has expired more than

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Affidavit to change Maiden Name to Married Name

six months back the process of renewal may take longer time.

vi. Passport should not be sent out of any country by post. It should be in

For Duplicate of Passports (in Lieu of Lost/Damage Passport)

the custody of the holder or especially authorized by the holder. It must

not be altered or mutilated in any way. Loss, theft or destruction of

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Additional

Most Recent Colored Photograph 3.5cm x 3.5 cm

Passport should be immediately reported to the nearest passport

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Personal Particulars Proforma

authority in India or Mission abroad and to the local police authorities.

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MAILING INSTRUCTIONS

Police Report about the loss of passport

Each application should have a self addressed USPS EXPRESS MAIL Envelope

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Copy of lost passport

with appropriate stamp (currently $14.40) for returning passport /document.

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Copies of school certificates/ birth certificate/ Indian driving license /

Please note down the tracking number on the USPS envelope for your record.

ration card/ Election Commission I.D./ employment letter/ any other

photo-identification from India (whichever available)

Please note overnight mail only facilitates delays in mail but does not mean

that the application will be processed immediately.

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Letter from school / college, if student

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Mailing Address:

CONSULAR WING – PASSPORT SECTION

Letter explaining the circumstances of loss of passport.

540 Arguello Boulevard San Francisco CA 94118

Page 2 of 2

Passport Application Form Page 2

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