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    Tarun Bhatnagar
    Ashok Chaudhary is applying for an Indian passport as a married 35-year-old citizen of India by birth. He has submitted his passport application form along with supporting documents including his PAN card, Aadhaar card, and self-declaration affirming his Indian citizenship and the accuracy of the information provided. The application provides his personal details, family details, residential address in New Delhi, employment information, and emergency contact.

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    68 views3 pages
    Ashok Chaudhary is applying for an Indian passport as a married 35-year-old citizen of India by birth. He has submitted his passport application form along with supporting documents including his PAN card, Aadhaar card, and self-declaration affirming his Indian citizenship and the accuracy of the information provided. The application provides his personal details, family details, residential address in New Delhi, employment information, and emergency contact.

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    Ashok Chaudhary is applying for an Indian passport as a married 35-year-old citizen of India by birth. He has submitted his passport application form along with supporting documents including his PAN card, Aadhaar card, and self-declaration affirming his Indian citizenship and the accuracy of the information provided. The application provides his personal details, family details, residential address in New Delhi, employment information, and emergency contact.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    68 views3 pages

    View - Print Submitted Form

    Uploaded by

    Tarun Bhatnagar
    Ashok Chaudhary is applying for an Indian passport as a married 35-year-old citizen of India by birth. He has submitted his passport application form along with supporting documents including his PAN card, Aadhaar card, and self-declaration affirming his Indian citizenship and the accuracy of the information provided. The application provides his personal details, family details, residential address in New Delhi, employment information, and emergency contact.

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    12/26/2020 View/Print Submitted Form

    File Number (For Office Use Only)

    GOVERNMENT OF INDIA, MINISTRY OF EXTERNAL AFFAIRS

    PASSPORT APPLICATION FORM

    Please read the Passport Instruction Booklet carefully before filling the form. Fill this form in CAPITAL LETTERS using
    blue/black ink ball point pen only. Furnishing of incorrect information/ suppression of information would lead to rejection of
    the application and would attract penal provisions as prescribed under the Passports Act, 1967. Please produce your
    original documents at the time of submission of the form.

    Service Required
    Application Reference Number 20-0008473930

    Applying For FRESH

    Type of Application NORMAL

    Type of Passport Booklet NORMAL


    Applicant Details
    Applicant's Name ASHOK CHAUDHARY

    Date of Birth (DD/MM/YYYY) 05/07/1985

    Validity Required NA

    Place of Birth (Village/Town/City) NEW DELHI

    District SOUTH DELHI

    State/UT DELHI

    Country INDIA
    Signature/Left Hand Thumb Impression
    Gender MALE of Illiterate Applicant and Minors who
    Marital Status MARRIED cannot sign.

    Citizenship of India by BIRTH

    PAN AKIPA1632N

    Employment Type PRIVATE

    Is either of your parent (in case of


    N
    minor)/spouse, a government servant?

    Educational Qualification 10TH PASS AND ABOVE

    Are you eligible for Non-ECR category? Y

    Visible Distinguishing Mark A MOLE ON LEFT EAR

    Aadhaar Number 546657017848

    Family Details
    Father's Name SAHAB SINGH

    Mother's Name JAGBIRI DEVI

    Spouse's Name NISHA CHAUDHARY

    https://portal1.passportindia.gov.in/AppOnlineProject/secure/ViewDraftAction?arn=20-0008473930 1/3
    12/26/2020 View/Print Submitted Form
    Present Residential Address Details
    HOUSE NO 454 GALI 01 BLOCK D SANGAM VIHAR, NEW
    Address
    DELHI, SOUTH DELHI, DELHI

    PIN 110062

    Police Station SANGAM VIHAR

    Mobile/Tel No. 9540889991

    E-mail [email protected]
    Permanent Residential Address
    HOUSE NO 454 GALI 01 BLOCK D SANGAM VIHAR, NEW
    Address
    DELHI, SOUTH DELHI, DELHI

    PIN 110062

    Police Station SANGAM VIHAR

    Mobile/Tel No. 9540889991


    Emergency Contact Details
    ASHOK CHAUDHARY HOUSE NO 454 GALI 01 BLOCK D
    Name and Address
    SANGAM VIHAR

    Mobile/Tel No. 9540889991

    E-mail [email protected]
    Other Details
    Fee Details (Not to be filled by applicants submitting the application at Passport Seva Kendra/Passport Office)
    Fee amount in (Rs)

    If paid by Demand Draft(DD), provide the following details

    DD Issue Date (dd/mm/yyyy)

    DD Expiry Date (dd/mm/yyyy)

    Bank Name

    Branch
    Enclosures
    1.PAN Card issued by the Income Tax Department

    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 & 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. I have not contravened any of the
    conditions relating to the possession and use of an Indian passport.
    I affirm that the information and particulars given by me in this form are true and correct. I further state that I am not suppressing
    any material information in this regard. I further affirm that the enclosures and documentary proof submitted in support of my
    application for an Indian passport are authentic and solely pertain to me and I am fully responsible for the accuracy of the same.
    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.
    I have read and understood the contents of the above and by submitting this form certify that all the information submitted by me
    in the form is bonafide.

    Signature/Left Hand Thumb Impression of


    https://portal1.passportindia.gov.in/AppOnlineProject/secure/ViewDraftAction?arn=20-0008473930 2/3
    12/26/2020 View/Print Submitted Form
    Place SOUTH DELHI Applicant (If applicant is minor, either
    parent to sign)
    Date 26/12/2020

    https://portal1.passportindia.gov.in/AppOnlineProject/secure/ViewDraftAction?arn=20-0008473930 3/3

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