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    Application Form

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    AJAS RAJA
    Ajash Raja R P is applying for an Indian passport. He provides details such as his date of birth, place of birth, address, and enclosures including his birth certificate and Aadhaar card. He declares his allegiance to India and affirms that the information provided is true, knowing it is a criminal offense to provide false information to obtain a passport.

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    Application Form

    Uploaded by

    AJAS RAJA
    31 views2 pages
    Ajash Raja R P is applying for an Indian passport. He provides details such as his date of birth, place of birth, address, and enclosures including his birth certificate and Aadhaar card. He declares his allegiance to India and affirms that the information provided is true, knowing it is a criminal offense to provide false information to obtain a passport.

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    Ajash Raja R P is applying for an Indian passport. He provides details such as his date of birth, place of birth, address, and enclosures including his birth certificate and Aadhaar card. He declares his allegiance to India and affirms that the information provided is true, knowing it is a criminal offense to provide false information to obtain a passport.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    31 views2 pages

    Application Form

    Uploaded by

    AJAS RAJA
    Ajash Raja R P is applying for an Indian passport. He provides details such as his date of birth, place of birth, address, and enclosures including his birth certificate and Aadhaar card. He declares his allegiance to India and affirms that the information provided is true, knowing it is a criminal offense to provide false information to obtain a passport.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    8/7/2019 Application Form

    PASSPORT APPLICATION FORM

    Government of INDIA, Ministry of External Affairs

    Service Required
    Application Reference Number 19-1007609125
    Applying For FRESH
    Type of Application NORMAL
    Type of Passport Booklet NORMAL
    Applicant Details
    Applicant's Name AJAS RAJA R P
    Date of Birth (DD/MM/YYYY) 17/12/1996
    Validity Required NA
    Place of Birth (Village/Town/City) VAGAVURRAI ESTATE
    District IDUKKI
    State/UT KERALA
    Country INDIA
    Gender MALE
    Marital Status SINGLE
    Citizenship of India by BIRTH
    Employment Type NOT EMPLOYED
    Is either of your parent (in case of minor)/spouse, a
    Y
    government servant?
    Educational Qualification GRADUATE AND ABOVE
    Are you eligible for Non-ECR category? Y
    Aadhaar Number 597841191819
    Family Details
    Father's Name M RAJAGOPAL
    Mother's Name A PADMINI
    Present Residential Address Details
    KANNIMALAI LOWER, NAYAMAKKAD ESTATE, MUNNAR, KANNAN DEVAN
    Address
    HILLS, MUNNAR, IDUKKI, KERALA
    PIN 685612
    Police Station MUNNAR
    Mobile/Tel No. 9495421224
    E-mail AJASRAJA017@GMAIL.COM
    Permanent Residential Address
    KANNIMALAI LOWER, NAYAMAKKAD ESTATE, MUNNAR, KANNAN DEVAN
    Address
    HILLS, MUNNAR, IDUKKI, KERALA
    PIN 685612
    Police Station MUNNAR
    Mobile/Tel No. 9495421224
    Emergency Contact Details
    Name and Address A PADMINI (H M), ALPS KALAAR, MUNNAR P.O
    Mobile/Tel No. 9495990342
    Other Details
    Enclosures
    1.Birth Certificate issued by the Registrar of Births and Deaths or the Municipal Corporation or any other prescribed authority,whosoever
    has been empowered under the Registration of Birth and Deaths Act, 1969 to register the birth of a child born in India
    2.Aadhaar Card/e-Aadhar containing the 12 digit Aadhaar number issued by the Unique Identification Authority of India(UIDAI)
    Self Declaration
    I owe allegiance to the sovereignty, unity and 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 citizenship of India and I affirm that the information given by me in this
    form and the enclosures is true and I am solely responsible for its accuracy, and I am liable to be penalized or prosecuted if found
    otherwise. I am aware that under the Passports 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 MUNNAR

    https://portal2.passportindia.gov.in/AppOnlineProject/secure/ApplicantSelfDeclarationAction 1/2
    8/7/2019 Application Form
    Date 07/08/2019

    https://portal2.passportindia.gov.in/AppOnlineProject/secure/ApplicantSelfDeclarationAction 2/2

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