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Application Form

This document is a passport application form for Mayank Saini, a 24-year-old Indian citizen applying for a fresh normal passport under the Tatkaal scheme. The application provides Mayank's personal details like date of birth, place of birth, address, family details, employment and educational qualifications. It also includes a self-declaration confirming his identity and citizenship. Required documents like PAN card and caste certificate are listed as enclosures.

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Mayank Saini
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28 views2 pages

Application Form

This document is a passport application form for Mayank Saini, a 24-year-old Indian citizen applying for a fresh normal passport under the Tatkaal scheme. The application provides Mayank's personal details like date of birth, place of birth, address, family details, employment and educational qualifications. It also includes a self-declaration confirming his identity and citizenship. Required documents like PAN card and caste certificate are listed as enclosures.

Uploaded by

Mayank Saini
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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2/1/24, 2:09 PM Application Form

PASSPORT APPLICATION FORM

Government of INDIA, Ministry of External Affairs

Service Required
Application Reference Number 24-0002008022
Applying For FRESH
Type of Application TATKAAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name MAYANK SAINI
Date of Birth (DD/MM/YYYY) 28/01/2000
Validity Required NA
Place of Birth (Village/Town/City) MALAKHERA RAJASTHAN
District ALWAR
State/UT RAJASTHAN
Region/Country INDIA
Gender MALE
Marital Status SINGLE
Citizenship of India by BIRTH
PAN KAPPS6462D
Employment Type STUDENT
Is either of your parent (in case of minor)/spouse, a
N
government servant?
Educational Qualification GRADUATE AND ABOVE
Are you eligible for Non-ECR category? N
Visible Distinguishing Mark YES
Aadhaar Number 343107671259
Family Details
Father's Name BAKSHI RAM SAINI
Mother's Name REKHA SAINI
Present Residential Address Details
314/7 SEC 7 URBAN ESTATE GURGAON, GURGAON, GURGAON,
Address
HARYANA
PIN 122001
Police Station NEW COLONY
Mobile/Tel No. 09354763608 / 09354763608
E-mail [email protected]
Permanent Residential Address
314/7 SEC 7 URBAN ESTATE GURGAON, GURGAON, GURGAON,
Address
HARYANA
PIN 122001
Police Station NEW COLONY
Mobile/Tel No. 09354763608 / 09354763608
Emergency Contact Details
Name and Address RIYA SAINI 314/7 SEC 7 URBAN EASTE GURGAON
Mobile/Tel No. 09354763608
E-mail [email protected]
Other Details
Enclosures
1.PAN Card issued by the Income Tax Department
2.SC/ST/ OBC Certificates
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

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2/1/24, 2:09 PM Application Form
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.
Place GURGAON
Date 01/02/2024
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