Fillable Form O - Pio Card Application/renewal (Page 2 of 3) in pdf

Form O - Pio Card Application/renewal Page 2

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City _________________ State ________________ Post Code ____________ Tel. No. _______________

City _________________ State _________________ Pin Code ____________ Tel. No. _____________

4. Profession or occupation ________________________________________________________________

5. Business/Office address ________________________________________________________________

City _________________ State _________________ Post Code ___________ Tel. No. _____________

6. Male/Female __________________ 7. Marital status: Married/Unmarried ________________________

8. Nationality (at the time of birth) __________________________________________________________

9. Present nationality (if different) _____________________ Date on which acquired _________________

(Day-Month-Year)

10. (a) Passport No._______________ (b) Date of issue ______________(c) Date of expiry ____________

(Day-Month-Year)

(d) Country, which issued the Passport ____________________ (e) Place of issue ____________________

11. Does the applicant hold dual nationality? __________________________________________________

(if so, please give details including the details of all the passports held etc.)

12. Did the applicant at any time hold the nationality of any country other than the present nationality, if so,

please give details including the period ______________________________________________________

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 ________________________

(Day-Month-Year)

(b) Place of issue __________________________________(d) Date of expiry ____________________

(Enclose photocopy of relevant documents)

(Day-Month-Year)

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 permanently resident in India as defined in the Government of India Act, 1935 at any

time, if so, following details may be indicated:

(a) Date of birth ___________________ (b) Place of Birth _______________________________________

(Day-Month-Year)

documents)

(Note: if applicant is the spouse of a citizen of India or a person of Indian origin, his/her particulars should

be indicated).

15. Has the applicant ever been refused Indian passport/travel document or visa for visiting India? If so,

give complete details: (i.e. place & date of application, purpose, reasons for refusal etc.)

____________________________________________________________________________________

16. Details of previous PIO Card (wherever applicable):

F/AUS/IND/05

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PIO Card Form

Form O - Pio Card Application/renewal Page 2

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