Passport Application Form (Page 3 of 6) in pdf

13. Are you working in Central Government/ State Govt/ PSU/ Statutory Bodies (Y)es/ (N)o

If ‘Yes’ attach Identity Certificate (As per Annexure “B” of Passport Information booklet).

14. Are you a citizen of India by: (B)irth/(D)escent/(R)egistration/(N)aturalisation; …………………………

If you have ever possessed any other citizenship, please indicate previous citizenship …………………..

15. “Emigration Check Not Required” status? Yes/No …………………

(Please note that all 10 and above qualified applicants are eligible for ECNR status.)

If yes, mention the eligible category (see Section III of Passport Information Booklet) and enclose copy

of relevant certificate/document__________________________________________________________

16. In case of minors (applicant below the age of 18), if EITHER of the parents hold a Valid Indian

Passport or has applied for it give the following details. Please see and fill up attached Annexure-H.

Passport/ File No.

Date & Place of Issue/ Application

Mother

_______________

_________________________________

Father

_______________

_________________________________

17. (a) Have you at any time during the period of Five years immediately preceding the date of this

application been convicted by a court in India for any criminal offence & sentenced to imprisonment

for two years or more? If so, give name of the court, case number and relevant sections of Law.

(Attach copy of judgement)

…………………………………………………………………………………………………………..

(b) Are any criminal proceedings pending against you before a court in India? If so, give name of court,

case number and relevant sections of Law.

…………………………………………………………………………………………………………..

Passport.

…………………………………………………………………………………………………………

………………………………………………………………………………………………………….

(d) Have you been ever refused/denied passport? If yes, give details:

…………………………………………………………………………………………………………..

(e) Has your passport ever been impounded / revoked? If yes, give details:

…………………………………………………………………………………………………………..

(f) Have you ever applied/granted political asylum by any foreign country? If yes, give details.

…………………………………………………………………………………………………………..

18. Particulars of person to be intimated in the event of death or accident:

Name

………………………………………………………………………………………..

Address

………………………………………………………………………………………..

Mobile / Tel. No. / email ID …………………………………………………………………………

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Passport Application Form Page 3