(APPLICATION FORM FOR INDIAN

Paste your
PASSPORT AT INDIAN MISSION/POSTS) unsigned
recent Color
photograph
Specimen Signature
Size:2"X2"
WEBFILE NO:- AUSSP0137215

Payment of Fee(to be filled by Applicant)

Amount paid $/E ............................................. by .......................................................... Mode of payment
For delivery by mail $/E ..........extra to be paid as postal charges for each passport
1. (a) Full Name (expanded initials)

Surname , SINGH
Given name SAHAJ
(b) Aliases, if any (Surname)
(c) Applicant ever changed his/her name
Is so, give previous name in full
(d) Email id uk_enterprise@live.com Phone NO 9717401653 MobileNo 9717401653

2. Date of birth 14-APR-2012 Sex MALE

Place of birth NEW DELHI INDIA
District/Country of Birth

Height 25 (cms) Color of eyes FARE Color of Hair BLACK

Visible distinguishing marks, if any FACE

3. Permanent Address :
WZ-93 A GURU NANAK NAGAR
(a) To be printed on passport TILAK NAGAR ND 18

(b) Other Adress:- WZ-93 A GURU NANAK NAGAR

TILAK NAGAR ND 18

4. (i) Name of Father MANJEET SINGH

Country of his birth INDIA

(ii) Name of Mother JYOTI KAUR

Country of her birth INDIA

iii) Nationality of Father at the time of applicant’s birth INDIA
(iv) Nationality of Mother at the time of applicant’s birth INDIA
AUSSP0137215

5.Marital Status SINGLE

6. Name of Spouse

and Nationality
7. Particulars of person to be intimated in the event of death or accident:
Name ………………………………………………………………...
Address ………………………………………………………………
………………………………………………………………
8. Present Passport/ nationality, identity card, if any No. ……………… Date and Place of issue ………………
9. Local car driving Licence No. …………………….… Date and Place of issue ……………………………..
10. Educational qualification BA PASS

(In order to determine emigration status).

11. When did applicant first leave India? When was he/she in India last?
12. How long has applicant continuously resided abroad?
13. Present Emigration Status (ECR or ECNR) ECR ECNR
(With documentary evidence)
14. Profession and business address Telephone
15. Please mention, if citizen of India by birth/descent/Naturalization/Registration.
16. Did applicant ever possess any other nationality or travel document of any other country? If so please give details
17. Was applicant ever refused an Indian Passport? (Yes/No)
18. Was applicant’s passport ever impounded/revoked? If so, details please. (Yes/No)
19. Name and address of two relatives/friends
(1) (2)

20.Is applicant in Govt. Service/Public Undertaking Service/Statutory Bodies Service of India? If so, Please give details and enclose
‘No objection Certificate’ from your employer in original
…………………………………………………………………………………………………
21. (i) Are any criminal proceedings pending against applicant in any court in India? If so, please give details
……………………………………………………………………………….
(ii) Has applicant ever been repatriated from abroad to India at the expenses of the Govt. of India ? If so, details please
…………………………………………………………………….
22. No. of lost/damaged passport …………………................. place of issue ……………….................
Date of issue ……………………………………............... Valid until ………………….................
23. (i) Briefly state circumstances of loss/theft/damage of passport on a plain paper and attach copy of report lodged with local police
in case of loss/theft
(ii) Give details of restriction, if any, put on applicant’s damaged/lost passport.
(iii) Did applicant avail transfer of residence, foreign travel scheme facility on lost/damaged passport? If so ,details please
...................................................................................

24. Is applicant registered with Indian Mission/Post ? If not, is he/she a member of any Indian Organisation ?
25. Particulars of children, if any, to be deleted
Name Place & Date of birth (M/F)

Note : Separate passport will be issued to children of all ages. However, children below
18 years of age will be given a 5-year maximum validity passport

26.DECLARATION :
I owe allegiance to the sovereignty, unity & integrity of India and have not voluntarily acquired the citizenship or travel document of
another country. I have not lost, surrendered or been deprived of citizenship of India.
The information given by me is true and I am solely responsible for its accuracy. I am aware that it is an offence under the Passport
Act,1967 to furnish any false information or to suppress any material information with a view to obtaining passport or any other
travel document.

Signature/Thumb Impression of applicant

(Left Hand T.I. if male and right Hand T.I. if female)
AUSSP0137215

Date…………………/Place……………………

27. In case of minors, following passport particulars of both parents must be given:

Mother Father
(a) Passport No. :

(b) Date of Issue :

(c) Place of Issue: ……………………….. …………………………….

(d) If parents have applied for a passport, please give File No & date
…………………………….. ………………………………….
28 Declaration of Parents or Guardian if passport is for minor : (To be signed by both Parents or Guardian)

We affirm that the particulars given above are in respect of (Name) …………………………..Son / daughter of
Smt………………………………….Sh……………………………………………..of whom we are the Parents / Guardian.
We undertake the entire responsibility for his/her expenses.We solemnly declare that he/she has not lost,surrendered or
been deprived of his/her citizenship of India and that the information given in respect of him/her in this application
is true. It is also certified that the name of the child mentioned is not included in passport of either parent.
………………………………………………..AND…………………………………OR……………….

Mother Father Guardian

Name & Signature/ T.I of both the Parents/Guardian (left hand T.I. if male and Right hand T.I .if female)

Place……………………………….Date……………………………

AUSSP0137215
29. Specimen signature or T.I.within the Space given below :

FOR OFFICE USE ONLY