Application Form For The Grant/renewal Of Pio Card - Embassy Of India (Page 2 of 3) in pdf

Profession or Occupation : ....................................................................................................

Male / Female : ....................................................................................................................

Marital status : Married/Unmarried : .......................................................................................

Nationality (at the time of birth) : ............................................................................................

Present Nationality (if different) : ...................................................................................

Date on which acquired : ...............................................................................................

Passport particulars of applicant :

Passport Number : ........................................................................................................

Date of issue : ...............................................................................................................

Date of expiry: ..............................................................................................................

Country which issued the passport : ................................................................................

Place of issue : ..............................................................................................................

10. Does the applicant hold dual nationality :

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

11. Did the applicant at any time held the nationality of any country other than the present nationality,

if so, please give details including the period :

12. 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:

Passport Number : ........................................................................................................

Date of issue : ...............................................................................................................

Please of issue : ............................................................................................................

(enclose photocopy of relevant documents)

13. 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 :

Date & Place of birth : ...................................................................................................

ii)

Proof of residence etc : ..................................................................................................

(Enclose photocopy of relevant documents)

(Note : If applicant is the spouse of a citizen of India or a person of Indian origin, his/ .........

her particulars should be indicated).

Application Form For The Grant/renewal Of Pio Card - Embassy Of India Page 2