APPLICATION FOR INDIAN PASSPORT
1 RE-ISSUE OF PASSPORT
PASTE
DUPLICATE PASSPORT IN LIEU OF LOST,
2 ONE
STOLEN OR DAMAGED PASSPORT
3 CHANGE OF NAME/SURNAME
PHOTO HERE
4 EMERGENCY CERTIFICATE Size (4x4 cm)
5 CHANGE IN APPEARANCE 4 photos
Consulate General of India
Sign in Box only
6 PASSPORT FOR CHILDREN BORN IN UK
17 Rutland Square
Edinburgh EH1 2BB RENEWAL OF SHORT VALIDITY
7
PASSPORTS
Tele:00 44 131 229 2144
Fax: 00 44 131 229 2155 8 MISCELLANEOUS SERVICE
E-mail:
[email protected]
Website: http:// www.cgiedinburgh.org
This application can be used at the Consulate General of India in Edinburgh. (PERSONAL CHEQUES/CREDIT CARDS
NOTE ARE NOT ACCEPTED FOR PAYMENT OF FEES. only CASH and Postal order in favour of “Consulate General of India
Edinburgh” FILL IN WITH BLACK INK ONLY,AND IN BLOCK LETTERS.INCOMPLETE APP WILL NOT BE ACCEPTED.
1. FULL NAME (EXPANDED INITIALS)
________________________ _________________________ _________________________
(GIVEN NAME) (MIDDLE NAME) (SURNAME NAME)
2. IF YOU HAVE EVER CHANGED YOUR NAME, WRITE YOUR PREVIOUS NAME:
3. PLACE OF BIRTH 4. COUNTRY OF BIRTH
5. DATE OF BIRTH 6. SEX
(DD) / (/MM) / (YYYY)
7. FULL NAME OF
NATIONALITY
FATHER
8. FULL NAME OF
NATIONALITY
MOTHER
9. PROFESSION
11. COLOUR OF 12. COLOUR OF
10. HEIGHT
EYES HAIR
13. VISIBLE DISTINGUISHING MARKS, IF ANY
14. FULL NAME OF SPOUSE
15. ADDRESS TO BE PRINTED ON
PASSPORT
E-
TEL. NO. MOB. NO.
MAIL
16. OTHER ADDRESS
17. PARTICULARS OF A PERSON TO BE INTIMATED IN THE EVENT OF DEATH OR ACCIDENT :
a.) NAME b.) Relationship c.) Tel.
d.)
ADDRESS
i) Birth ii) Descent iii) Naturalization Registration
18. ARE YOU A CITIZEN OF INDIA BY
Yes No
19. DID YOU EVER POSSESS ANY OTHER NATIONALITY OR TRAVEL DOCUMENT OF ANY OTHER
COUNTRY? If so, please give details
20. IS THIS APPLICATION FOR A PASSPORT FOR THE
FIRST TIME NEW PASSPORT IN REPLACEMENT OF AN EXPIRED PASSPORT DUPLICATE PASSPORT?
21. IF THIS APPLICATION IS FOR DUPLICATE PASSPORT, WAS THE PREVIOUS PASSPORT LOST DAMAGED
(If damaged, please attach damaged passport)
22. PRESENT PASSPORT NO. OR DAMAGED OR LOST PASSPORT NO.
II) PLACE OF
I) DATE OF ISSUE III) DATE OF EXPIRY
ISSUE
23. a.) WERE YOU EVER REFUSED A PASSPORT? Yes No
b.) WAS YOUR PASSPORT EVER ORDERED TO BE IMPOUNDED OR REVOKED? Yes No
IF ANSWER TO ANY OF THESE QUESTIONS IS “YES,” PLEASE ENCLOSE A COPY OF THE OFFICIAL COMMUNICATION RECEIVED
BY YOU AND GIVE OTHER DETAILS.
24. HAVE YOU EVER APPLIED FOR ASYLUM OR REFUGEE STATUS IN THE UK? IF YES, PLEASE ATTACH Yes No
RELEVANT DOCUMENTS.
25. a.) BRIEFLY STATE CIRCUMSTANCES OF LOSS/THEFT/DAMAGE OF PASSPORT AND ATTACH REPORT LODGED WITH LOCAL
POLICE IN CASE OF LOSS OF PASSPORT. (PLEASE ATTACH YOUR EXPLANATION ON A SEPARATE SHEET OF PAPER)
b.) DETAILS OF RESTRICTION, IF ANY, PUT ON APPLICANT’S DAMAGED/LOST PASSPORT
26. DETAILS OF THE SERVICE REQUIRED:
(IF APPLYING FOR MISC. SERVICE)
SPECIMEN SIGNATURE OF APPLICANT ONLY
(THUMB IMPRESSION, IN CASE OF AN INFANT)
SELF DECLARATION :
I OWE ALLEGIANCE TO THE SOVEREIGNTY & INTEGRITY OF INDIA AND HAVE NOT VOLUNTARILY ACQUIRED THE CITIZENSHIP OR
TRAVEL DOCUMENT OF ANY OTHER COUNTRY. I HAVE NOT LOST, SURRENDERED OR BEEN DEPRIVED OF CITIZENSHIP OF INDIA.
THE INFORMATION GIVEN BY ME IN THIS FORM AND ENCLOSURES IS TRUE AND I AM SOLELY RESPONSIBLE FOR ACCURACY. I AM
AWARE THAT IT IS AN OFFENCE UNDER 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.
I FURTHER DECLARE THAT I HAVE NO OTHER PASSPORT / TRAVEL DOCUMENT.
____________________________________________
(Signature or thumb impression of applicant)
In case of male child left thumb female right thumb
Declaration by Parents/Legal Guardian in case of Minor:
1) Information given above in respect of __________________________________ of whom I am the parent / legal guardian is true.
2) I undertake to be entirely responsible for his / her expenses.
3) I solemnly declare that he / she has not lost, surrendered or been deprived of his/her citizenship of India.
4) I hereby declare that ________________________________ born in UK has not applied for or acquired U.K. citizenship / travel document.
Should I approach the British authorities for such a travel document, I undertake to inform the High Commission of India, London
immediately so that Indian travel document may be withdrawn.
________________________________________________
Signature of both the Parents /legal guardian
Place :_________________________
Date: __________________________
1- Applicants need to give proof of address in Scotland by copy of any utility bill. [e.g. bank statement, electricity, etc]
2 -Applicants are required to give copy of marriage certificate & spouse’s passport in case of change of marital status.
3- Acceptance of applications between 9.30am to 12.30pm only. Collection time 4.00 to 5.00 pm only. [ON ADVICE]
4- Applicants will be informed by phone when Passport is ready for collection, Please ensure that proper contact number is provided.
