If born before 15/08/1947 in a place now in Pakistan or Bangladesh, select "Undivided India".
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.
Impounded/Revoked Passport Details
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.
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.
No.963 Crescent Court,
Periyar E.V.R. High Road,
India - 600 084.
+91 (044) 2641 3126 / 27