Ashadip PSC

MOBILE NO *

EMAIL ID *

APPLICANT FULL NAME *

GENDER *

HAVE YOU EVER BEEN KNOWN BY OTHER NAMES? *

Yes No

If Yes, Provied Name

HAVE YOU EVER CHANGED YOUR NAME ? *

Yes No

If Yes, Provied Name

DATE OF BIRTH *
(DD/MM/YYYY)

IS YOUR PLACE OF BIRTH OUT OF INDIA ? *

Yes No

NAME OF THE PLACE OF BIRTH *
( Village/Town/City )

STATE *

DISTRICT *

MARITAL STATUS *

CITIZENSHIP OF INDIA BY *

PAN NO (If Available)

VOTAR ID CARD NO (If Available)

AADHAAR NO (If Available)

EMPLOYMENT TYPE *

IS EITHER OF YOUR PARENT (in case of minor) / SPOUSE , A GOVERNMENT SERVANT ? *

Yes No

EDUCATIONAL QUALIFICATION *

IS APPLICANT ELIGIBLE FOR NON-ECR CATEGORY ? *

Yes No

Name *
Address *
Email *
Phone No *

APPLYING FOR *	Fresh Passport Re-issue of Passport
TYPE OF APPLICATION *	Normal Tatkaal
TYPE OF PASSPORT BOOKLET *	36 Pages 60 Pages

FATHER NAME *
MOTHER NAME *
LEGAL GUARDIAN NAME *
SPOUSE NAME *

HOUSE NO *
STREET NAME *
VILLAGE / TOWN / CITY *
POST OFFICE *
POLICE STATION *
DISTRICT *
STATE *
PIN CODE *
IS PERMANENT ADDRESS SAME AS PRESENT ADDRESS ? *	Yes No
IF YES, GIVE FULL ADDRESS ( Mention House No + Street Name + At/Vill + P.O + P.S + Sub-division + Dist. + State + Pin code )

HAVE YOU EVER HELD / HOLD ANY IDENTITY CERTIFICATE * ( Identity certificate is normally issued to Tibetan/other stateless people residing in India )	Yes No
Details of Previous / Current Diplomatic / Official Passport
Have you ever applied for passport, but not issued ? *	Yes No

GOVT.VARIOUS APPLICATION & REGISTRATION

Form - Application for Passport

Total Expenses : Rs 1736/-

:: Contact Person Details ::

RPO DETAIL

PASSPORT TYPE

APPLICANT DETAILS

FAMILY DETAILS

PRESENT RESIDENTIAL ADDRESS

EMERGENCY CONTACT

IDENTITY CERTIFICATE / PASSPORT DETAILS

OTHER DETAILS

DOCUMENTS

(scan all documents in 300 dpi color jpeg / pdf format)(maximum size-1MB)

Our Team

DEBIKA SUBBA

ANINDITA ROY

Gopal Bera

PRIYA BISWAKARMA

Nisha Sarki

Kiran Bala Dey

Mousumi Pal

ARPITA CHAKRABORTY BANERJEE

JHARNA MALLICK

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ASHADIP PSC

Have you ever been charged with criminal proceesings or is any arrest warrant/summon pending before a court in India ?	Yes No
Have you at any time during the period of 5 years immediately preceding the date of this application been convicted by the court in India for any criminal offence and sentenced to imprisonment for two year or more ?	Yes No
Have you ever been refused/denied passport ?	Yes No
Has you passport ever been impounded or revoked ?	Yes No
Have you ever applied for or been granted political asylum to/by any foreign country ?	Yes No
Have you ever returned to India on Emergency Certificate (EC) or were ever deported or repatriated ?	Yes No
If any of this option yes , Give the details

Applicant Aadhaar Card *
Applicant PAN Card
NON-ECR Catagory Proof , If any
Other if Any
Final Submission *