Application Form For Miscellaneous Certificates printable pdf download

Application Form For Miscellaneous Certificates

EMBASSY OF INDIA

Lisbon

EAP II

EMBASSY OF INDIA

Lisbon

APPLICATION FORM FOR MISCELLANEOUS CERTIFICATES

Please specify the certificate applied for: _____________________________________

(Relevant supporting documents for the certificate should be submitted)

*Column 2 is to be filled if the application is for Driving License Declaration.

Applicant

must paste

(35 x 45 mm) one

photograph here

with half the

signature on the

photograph and

half on the

application

(To be filled in by the applicant)

Amount of fee: ____________________ / Mode of Payment ____________________________

For Delivery by mail Euro 2.50 to be paid as postal charges

1. Full Name __________________________________________ Sex (Tick Mark): Male/Female

2. *Applicant’s Car Driving Licence No ____________________________________________

Date & Place of Issue ___________________________________________________________

3. Residential Address :

(I) In India

(II) In country of domicile

___________________________

_____________________________

___________________________

_____________________________

___________________________

_____________________________

Tel.//Fax/E-Mail___________

Tel./Fax/E-Mail _________________

___________________________

_____________________________

4. Profession and business address*________________________________________________

______________________________________Tel./Fax/E-Mail___________________________

_____________________________________________________________________________

Application Form For Miscellaneous Certificates