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2)
Government of India Paste your recent
Ministry of External Affairs colour photograph
Application for Miscellaneous Services on Indian Size: 3.5 X 3.5 cm
Passports
(For use in India)
Please read the instructions carefully before filling the form. FILE NUMBER
Please fill in BLOCK LETTERS
Fee Amount Rs. Cash /D.D Bank Code D.D No. Date of Issue of D.D
s
1. Name of applicant as appear in the Passport (Initials not allowed)
Surname,
Given
name
2. Father's Full Name/ Legal Guardian's Full Name (including surname, if any): (Initials not allowed)
4. If married, Full Name of Spouse (including surname, if any). (Initials not allowed)
6. Permanent Address with PIN code (if the permanent address is same as the present address write
“Same” only)
Passport No
Place of Issue
10. Information required under Section 10(3) of the Passport Act, 1967
Are any criminal proceedings pending against the applicant before a Court in India? YES NO
................................................................
ii) ...............................................................
iii) ...............................................................
Proforma for Emigration Check
1. Name:
2. Profession:
5. Educational Qualifications:
2. Name of Father/Husband/Guardian:
3. Profession of Father/Husband/Guardian:
Place:
Date:
Signature of applicant