PASSPORT APPLICATION FORM

Service Required

Applying for *

Type of application *

  • Type of Passport Booklet *

  • Applicant Details

    Applicant's Given Name (Given Name means First Name followed by middle Name (if any)) *

    Surname

    Gender *

    Are you known by any other names(aliases)? *

  • Have you ever changed your name ? *

  • Date of Birth *

    Place Of Birth

    Is your Place of Birth out of India? *

  • Village or Town or City *

    State *

    District *

    Marital Status *

    Citizenship of India by *

    PAN (If available)

    Voter ID (If available)

    Aadhaar Number

    Employment Type *

    Organistion Name *

    Is either of your parent (in case of minor)/ spouse, a government servant? *

    Educational Qualification *

    Are you eligible for Non-ECR category? *

    I, the holder of above mentioned Aadhaar Number , hereby give my consent to Passport Seva to obtain my Aadhaar Number, Name and Fingerprint/Iris for authentication with UIDAI. I have no objection using my identity and biometric information for validation with Aadhaar (CIDR) database only for the purpose of authentication.

  • Family Details (Father/Mother/Legal Guardian details; at least one is mandatory.)

    Father's Given Name (Given Name means First Name followed by Middle Name (If any))

    Surname

    Mother's Given Name (Given Name means First Name followed by Middle Name (If any))

    Surname

    Spouse's Given Name (if applicable)

    Surname

    Present Residential Address Details (where applicant presently resides)

    Is your present address out of India?

  • House No. and Street Name *

    Village or Town or City *

    Country *

    State/ Province *

    District/ Country *

    ZIP Code *

    Mobile Number*

    Telephone Number

    Email ID

    Is permanent address same as present address?

  • Emergency Contact Details

    Name and Address *

    Mobile Number *

    Telephone Number

    E-mail ID

    Previous Passport/ Application Details

    Details of Previous/Current Diplomatic/Official Passport *

  • Have you ever applied for passport, but not issued? *

  • Other Details

    1) Have you ever been charged with criminal proceedings or any arrest warrant/ summon pending before a court of India?

  • 2) Have you at any time during the period of 5 years immediately preceding the date of this application been convicted by a court in India for any criminal offence and sentenced to imprisonment for two years or more?

  • 3) Have you ever been refused or denied passport?

  • 4) Has your Passport ever been impounded or Revoked?

  • 5) Have you ever applied for/ been granted political asylum to/ by any foreign country?

  • 6) Have you ever returned to India on Emergency Certificate (EC) or were ever deported or repatriated?

  • Self Declaration *

    I owe allegiance to the sovereignty , unity & integrity of India, and have not voluntarily acquired citizenship or travel document of any other country. I have not lost, surrendered or been deprived of the the citizenship of India and I affirm that the information given by me in this form and the enclosures is true and I solely responsible for its accuracy, and I am liable to be penalized or prosecuted if found otherwise. I am aware that under the Passport Act, 1967 it is a criminal offence to furnish any false information or to suppress any material information with a view to obtaining passport or travel document.

    Place *

    Date (DD/MM/YYYY) *

    NOTE : Applicants are required to submit the proof of address of the present address only, irrespective of the date from which he/she has been residing at the given address. However, he/she is required to mention all the places of stay during previous one year (from the date of application filling) in the Passport application form.