India Application For The Issue Of A Diplomatic / Official Passport Form (Page 3 of 4) in pdf

India Application For The Issue Of A Diplomatic / Official Passport Form Page 3

10. Details of previous passport(s) held or applied for (if any). Attach extra sheet for more than one

passport)

Passport No.

Date of Issue DD MM

YYYY

Place of Issue

11.

Countries to be visited on official Duty Countries to be

Purpose and duration of visit

transited

Date ………….

(Signature of the applicant

Place …………

or parent in case of minor)

CERTIFICATE

12. (a) I hereby certify that Shri/Smt./Kumari

___________________________________________________ is proceeding abroad on official duty as

indicated in item 12 above.

(b) I hereby certify that, Shri/Smt./Kumari

___________________________________________________ is Wife/ Son/ Daughter/Parent/Domestic

Help of ___________________________________________________ who is going abroad on official

duty as indicated in item 12 above.

13. Are you working in PSU/ Autonomous Bodies (Yes) / (No)

Strike out whichever is not applicable

14. Pay scale & grade pay of the officer is Rs.

[Signature of Head of Office]

Instructions:-

All entries should be in Block letters written with black ball point pen. Only one application is required with two

photographs. Child above 5 years of age or above is required to sign. It is mandatory to fill each item. Incomplete form will not be

accepted.

Please enclose original safe custody Certificate of Valid Ordinary Passport (if held) from your office. If Diplomatic/official

passport previously held by the applicant was kept in the safe custody of the Ministry of External Affairs, the original certificate

should be enclosed.

Official/Diplomatic/Ordinary passport which is around 10 years old or more (from the date of issue) must be submitted

with the application for cancellation.

Official retiring in less than six months from the date of application, is required to give an undertaking from his/her office that

he/she will surrender dip./off. passport to his/her office immediately after return.

India Application For The Issue Of A Diplomatic / Official Passport Form Page 3