Application Form For Miscellaneous Services On Indian Passports Guangzhou (Page 2 of 4) in pdf

Application Form For Miscellaneous Services On Indian Passports Guangzhou Page 2

5. Is applicant registered with this Consulate or the Embassy in Beijing? If not, is he a

member of any Indian Organisation/Association? Give details?

6. Name of Father _________________________________________________________

Name of Mother ________________________________________________________

Name of Spouse & Nationality_____________________________________________

7. Current Passport No. _________________________

Valid upto _______________

Place of issue ____________________________

Date of issue_________________

8. Particulars of children to be deleted :

Name

Place & Date of Birth

Sex (M/F)

__________________ ____________________ _______________________

9. DECLARATION :

I solemnly affirm that :

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

(ii) Information given above is correct and nothing has been concealed and I am aware that it

is an offence under the Passport Act 1967 and the rules made thereunder to knowingly

furnish wrong/incorrect information or suppress material information; and

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

______________________

Signature of applicant or T.I of his legal

guardian (Left hand thumb impression of

male & right hand thumb impression of female)

Place ________________ Date___________________

10. Two specimen signatures or thumb impressions required for service/for issue of

additional booklet within the space given below

________________________________________________________________________

FOR OFFICE USE

Application Form For Miscellaneous Services On Indian Passports Guangzhou Page 2