Passport (Amendment) Rules, 1995… Bare Act

The source publishes this enactment as a single document rather than provision by provision, so the whole text is below and there are no per-section pages for it. Nothing has been shortened.

Long title	Under Section 24 of the Passport Act, 1967 (15 of 1967)
Type	Rules
Year	1967
Jurisdiction	Central
Ministry	Ministry of External Affairs
Status	In force as published by the source
Text	Published as one document, as the source published it
Subjects	transport

REGD. NO. D.L.—33004/95 The Gazette Of India EXTRAORDINARY

PART II --Section 3—Sub-section (i) PUBLISHED BY AUTHORITY No. 343] NEW DELHI, MONDAY, AUGUST 21,1995/SRAVANA 30,1917 2044 GI/95 (1) 2 THE GAZETTE OF INDIA : EXTRAORDINARY [Part II—SEC.3(i)l MINISTRY OF EXTERNAL AFFAIRS NOTIFICATION New Delhi, the 7th August, 1995 G.S.R. 592 (E).—In exercise of the powers conferred by section 24 of the Passports Act, 1967 (15 of 1967), the Central Government hereby makes the following rules further to amend the Passports Rules, 1980, namely ;— 3

1. (1) These rules may be called the Passports (Amendment) Rules, 1995.

(2) They shall come into force on the date of their publication in the Official Gazette.

2. In the Passport Rules, 1980,—

(1) in Part I of Schedule III, for Part I of Forms "EAP-1" and "EAP-2" and the items relating thereto the following Forms and items shall be substituted, namely :-—

(2) for Schedule III-A, the following Schedule shall be substituted, namely :— "Schedule III-A" [see sub-rule (2) of rule 5] >l. No.

(1)

2. 3,

6. Description of Passport application forms

(2) Form No. 1 for issue of fresh passport (printed in black ink and available at all Passport Offices in India) Form No. 1 for issue of fresh passport (Printed in blue ink available at Post Offices in India) Form No. 2 for miscellaneous services on passport (printed in brown/chocolate ink) Form No. 3 for passport to be issued in lieu of lost/damaged Forms No. EAP-1 Ext. for issue of fresh passport and EAP-2 Ext for miscellaneous services on passport Form No. EAP-5 for issue of Cei tificate of Identity Cost in India

(3) Free Rs. 3.00 Free Free Not applicable Free Abroad

(4) Not applicable Not applicable Not applicable Not applicable Free Not applicabe [No. VIII/8 87/22/95] B. K. MITRA, Jt. Secy. (CPV) -oar NOTE :—Principal rules were published vide No. GSR 691 (E) dated 11th December, 1980, Gazette of India, 1980 (Extraordinary) Part II, Section 3, Sub-section (i) subsequently amended by :—

(i) Number GSR 50 (E) dated 7-2-1981

(ii) Number GSR 469 (E) dated 24-6-1932

(iii) Number GSR 325 (E) dated 12-4-1983

(iv) Number GSR 494 (E) dated 16-6-1983

(v) Number GSR 345 (E) dated 29-3-1985

(vi) Number GSR 860 (E) dated 1-11-1985 (VH) Number GSR 857 (E) dated 13-10-1987

(viii) Number GSR 84 (E) dated 11-2-1988

(ix) Number GSR 1155 (E) dated 21-11-1988

(x) Number GSR 622 (E) dated 27-7-1990

(xi) Number GSR 653 (E) dated 2-7-1990

(xii) Number GSR 100 (E) dated 4-3-1991

(xiii) Number GSR 275 (E) dated 20-3-1991

(xiv) Number GSR 586 (E) dated 21-6-1991

(xv) Number GSR 111 (E) dated 22-1-1992

(xvi) Number GSR 684 (E) dated 15-6-1992

(xvii) Number GSR 721 (E) dated 7-8-1992

(xviii) Number GSR 477 (E) dated 16-6-1993

(xix) Number GSR 485 (E) dated 1-7-1993

(xx) Number GSR 503 (E) dated 10-7-1993

(xxi) Number GSR 83 3 (E) dated 2-12-1994 THE GAZETTE OF TNDIA : EXTRAORDINARY [Part II—SEC. 3(i) GOVERNMENT OF INDIA fjNta wrid .̂rafcrar/REGIONAL PASSPORT OFFICE writ ^/ACKNOWLEDGEMENT s n w sn^cR ""7?, ?p=F T ^ ftHfciRsfti SFQ <«ii3*iT % "̂ rr*? 'SITO fSTT i <HIM+1 ̂ fc*f "?T©TT. fî TRT. Is I ̂ R T "i»cil» ^R% WW fft ^ t °Ft '5Fnr«T cTÎ f 3T«Î I " ^ '?f?*f «OHI #I^f I Received your application form alongwith fee and other documents mentioned below. Your reference Is No.* Dated Please bring this card or quote this reference for enquiries. TF^TTSR/Signature f>% ?Nfa HWl\i srf^iRt/For Regional Passport Office UP<T diWÎ Î iflf̂ T fc(c(<*J! .'/Details of documents received :

1. ^Nr ̂ |TC/Bank Draft : TlftT/Amount •fl^/Number f^fiWDate [

2. **i)<iljip+> "SFl" tlteMI/No. of photographs i '•

3. "ŜFTT m^Mi'i, Tf? "^i ft/Old Passport, if attached ^ '"*|i|ld^ SPlt7! ̂ f^/For Official Use I O.I.G.S. Sh./Smt./Kum House No. & Street TTFf t^'cfrK V.P.O Town & State PIN Code 5 ^J^f TO/INDEX CARD To be filled by applicant in BLOCK LETTERS

1. ""JCT TO ( gft/ttiHdl/S'Hlfl) Full Name (Mr./Mrs./Miss.) i. 3f l^W Applicant. ii. ftm/Father iii. "RRn/Mother iv. ^Tftt/̂ TMt/Spouse

2. TTFft ^/Permanent address

3. Hp-qn "̂ iT f^/Visible distinguishing marks

4. ^pq^-WH/Place of birth

5. 'SPT ftftT/Datc of birth

6. 'fan/Profession

7. T̂HT MIWMli ̂ "/Previous Passport No

8. ^nft ^ j ^ yft ni(l<a/Date of Issue

9. H ^ ÊT TWTOT/Specimen Signature For Official Use Only Ref/FileNo

2. f̂rft mfi T& dlO<9

1. MWMi<f -& Date of Issue Passport No

3. "5TPft ̂ ^\ ipT TO Place of Issue Observation/Remarks Subsequent services P.A.C. T.O.R. F.T.S. 6 THE GAZKTTE OF INDIA : EXTRAORDINARY [PMU II -SEC. 3(i)J Serial No. PPT I /95 FORM NO. 1 GOVERNMENT OF INDIA MINISTRY OF EXTERNAL AFFAIRS PASSPORT APPLICATION FORM (Read Instructions Carefully Before Filling The Form) (Please Fill In BLOCK LETTERS) Amount of fee Paid Rs. 300/- I I I I n i r̂ ix i i C a s h Bank Draft Bank Draft No Bank's Name

1.. Full name (Expanded initials, surname to be written first).

(i) Applicant L (II) Father

(iii) Mother

(iv) Spouse ., , — • D Male Female

3. Date of birth Date Month Year

4. Place of birth

5. Visible distinguishing mark:

6. Present address: Distt State PIN code Applicant must past* (35 x 45 mm) on« photograph here with half the signature on the photograph and half on the application. 7

7. If the applicant has not resided at the address given aganlst para (6) continuously for the last two years, please furnish the offer address(es) with duration where he/she has resided during the period. From to (date) Distt State PIN code

8. (I) Applicant Is a citizen of India by : Birth Descent Registration Naturalisation

(ii) If the applicant ever possessed citizenship of any other country, give details : ). If the applicant ever changed his/her name, give details : (see para 7 for instructions)

10. Particulars of children to be included in applicant's passport: Name Sex (D

(2) Place of birth Date (D

(2)

11. The details of passport/travel document held/ applied for, If any : (I) Passport Office File Number:

(il) Passport/Travel Document Number

(iii) Date of Issue/Application

(iv) Place of Issue/Application

12. Is applicant entitled for "Emigration Check Y e s Not Required (F.CNR) ?" If Yes, attach attested copy of the document (see para 4 for No instructions)

113. Whether the passport contains valid visas? Yes No s THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 3(i)] [Yes 14. Please Indicate whether :

(i) A passport/travel document was refused/ Mo impounded at any time or restored conditionally. 1 Yes i, (ii) The applicant was repatriated at Government I cost. ]Yes

(iii) The applicant was ever deported to India. No

15. Information required under section 6 of the Passport Act, 1967 I Yes (i) Has the applicant at any time during the period of five years immediately preceding the date of this application been convicted i ° by a Court in India for any criminal offence and sentenced to imprisonment ? 1 Yes

(ii) Are any criminal proceedings pending against the applicant before a court in India? No zz== y e s (iii) Has a wai rant or summons for appearance or warrant for arrest or an order prohibiting the applicant's departure from India been N° issued by a court ? NOTE: If answer to any of the questions in 14-15 is 'yes', furnish details in a separate sheet duly signed.

16. DECLARATION OF APPLICANT: I owe allegiance to the sovereignty, unity & integrity of India and have not voluntarily acquired the citizenship or travel document of another country. I have not lost, surrendered or been deprived of citizenship of India. The information given by me is true and I am solely responsible for its accuracy. I am aware that it is an offence under the Passports Act 1967 to furnish any false information or to suppress any material information with a view to obtaining passport or any other travel document. Signature/Thumb Impression of applicant Date Place 9

17. Declaration U Parent or Guardian if passport Is for minor: I affirm that the particulars given above are JM respect of (Name) Son/daughter of of whom I am the Parent/Guardian. I undertake the entire responsibility fc/< his/her expenses. I sofemnly declare that he/sr ie has not. lost, surrendered or been deprived of his/her citizenship of India and that the information given in respect of him/her in this application is true. Name & Signature/T.I, of Parent/Guardian (Left hand T,l. if male and Right hand T.I. if female) Place Date

18. Enclosures: Government/PSU empl oyeo attach original NOC For Office Use

19. Specimen signatures or Thumb Improsslons of applicant In the boxes given below AND on two stickers. 10 THE GAZETTE OF INDIA: EXTRAORDINARY [PART I I -SEC. 3(i)] PERSONAL PARTICULARS FORM (In Duplicate)

1. «0T *nq (antrrwtf v r JTOW *r 1$) Full name (Expanded initials)

2. ffo/Sex: (1) J^Male (2) *sft/Female

3. (*;) vn an^n* % q** v*ft vmi -=m *swr I ?

(a) Has the applicant ever changed his/her name ? if/Y«s *nflt/No

(w) ^ ^ ^ I F H T ' n ' i :

(b) If yes, previous name: i

4. 3P*r filOr/Dato of birth HlfiWDato »Wf/Month ^/Year

5. tjpq w 7 f ..n e of birth «m/ToViij ftlWDIatt TNH/State RFT ̂ I /PIN code

6. (T/a) ftai * I ^W/ Father's name (TST/b) Him^TIR/ Mother's name (*T/c) 'rt^/'TFftTFI^rni/ Spouse's (husband/wife) name

7. 'ffiT/Addreso:

(1) W « wnft mi Permanent address In India: <2) **** ^I/Present address: W^ Tf T^l ? / Residing since (tow/date) ti>j^Wt^m/ii. /Housename/No *Wr^^T^T^/^. /Housename/No iffa/isft/Vill./Street *fhr / 1?ft /Vill./Street IWTO /Post Off ico OTPIT/Post Office JjffrfUPIT/ Police Station.: jRre^I^T/Police Station fSnn/Distt Prat/Distt TW/State TW/State ft^^I/PIN code I ftn^T/PIN code ~ ^ M<Bhfl./Tel,No fcfolfcuf./Tel.No ~ 11 If the applicant has not resided at the address given against para (7) continuously for the last two years, please furnish the other address (es) with duration where he/she has resided during the period. Applicant should furnish an additional set of Personal particulars form (in duplicate with photograph) for each additional place of stay during the last two years. PP form may be photocopied for this purpose. $ / R c m <TO/to (fore/date) 'WR^T^TH/^./House name/No *fff/TRft/Vill./Street *W*T /Post Office gfiraiTO/ Police Station fcrar/Distt iml State ,... PR * fa / PIN code £tfli£i«H*t/Tel. No Reference* :- Names and addresses oi t*/o responsible persons in the applicant's locality who can vouch for the applicant.

(1) •d/From We/to (fafa/date) *CTWW1W/^, /House Name/No *fi</*rcft/VillVStreet IWTC /Post Office flim/Distt jmi State ftff*fa/PIN code %tfWtail / Tel. No

(2) t /Lrorn WK/to (ft^W/date) M*H W^TR/^. / HouseName/No. 'fa/itf/Vill./Street IWHT/Post Office Prar/Distt TT*T/ State Pr t^ I /PIN code WWlffl. /Tel. No

10. wftfalf tTO* i/PHYSICAL PARTICULARS: (^/a) wail Height *ftw/m i4/cm. (TI) strafwr^i (n) ^raf»n<n

(b) Colour of eyes (c) Colour of hair (*l) 'WinTWWsft f

(d) Visible distinguishing mark

11. Is applicant a citizen of India by : Birth Descent Registration Naturalisation

12. («F) *tf% 'W& V[ MIU>W /*ITOT *«H^Jt t Of ̂ *i*n Mti*k wftn i i

(a) Furnish details of previous passportAravel document, If any:

(i) irfrftiTWn/Passport number

2. 'Stlftift ^ f l r f h l /Da te of issue

3. i l l t t i f t *T Wm/ Place of issue Signature or Thumb Impression of the applicant (Left hand T.I. of male and Right hand T.I. of female) 12 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(0] PERSONAL PARTICULARS FORM (In Duplicate) 1 . "JTT ̂ W (3TTOTWff Wl W ^ ^ Vt) Full namo (Expandod Initials)

2. fat/Sex: (1) 5^/Male I I (2) ^/Female

3. (ap) 1PTT AU^Mi % TJ^ ^ f t 3TOHT 'inTI *4HI t 7

(a) Has the applicant ever changed his/her name ? tf/Ye» t # N o (TI) ^< t , *ftirarira:

(b) If yes, previous name:

4. 5R» ftrf*r/Dat«i of birth fllffel/Date »ITF/Month vWear

5. v^vm/Place of birth STFVTown.... flrcn/Dlstt Tpq/Stato ,,. far ifa/PIN coda

6. (*F/a) ft^IVI^TH/ Father's name (W/b) ^raim^nV Mother's name (n/c) <rf^/^?ft W^ini/ Spouse's (husband/wife) name

7. TOT/Address:

(1) T̂OT *( W ^ 'TOT/ Permanent address in India: tWHWIR/H . / House name/No iftf/»rtft/Viliystreet W*m /Post Office gftra^nt/'PolIca Station faWT/Dlstt TT«T/State Pm^tJ/PIN code WWlPnt/TeLNo..,

(2) ^m^TO/Present address: *»^7I7fc$?y Residing since (ft»ite/date) IWHW^W/' t i / House name/No %/T*ft/Vilk/Street IWVT/Post Office j f tn i inn/Police Station fam/Distt TT*I/State ft****/PIN code 4#Kh l i . /TeLNo 13 If the applicant has not resided at the address given against para (7) continuously for the last two years, please furnish the other address (es) with duration where he/she has resided during the period. Applicant should furnish an additional set of Personal particulars form (in duplicate with photograph) for each additional place of stay during the last two years. PP form may be photocopied for this purpose. Tl/From d* / l o (ftRW/date) ' W R W I W / i / H w s e name/No ^ff»/n*ft/Vill7Street .-. 1WR/Post Office gflnnpn/Police Station frrm/Distt TF**I State frufa/ PIN code fcsfafoTL / Tel. No References :- Names and addresses of two responsible persons in the applicant's locality who can vouch for the applicant.

(1) ^/From 7TO/to (f^W/date) tWlfW^/^T. / House Name/No •nw/^ft/VIIL/Street Vim /Post Office ftraT/Distt TT«T/State „ foiwta/ PIN code ^#E^I^./Tel. No

(2) t / F rom • WS/to (ft^FF/date) *WTWTOTtni/^. /HouseName/No %/*Kft/Vill./Street ITOTC /Post Office ." ftrar/Distt imi Slate ftr^fa/PIN code i*f)*l i^. /Tel. No

10. STtftfop forciT : / PHYSICAL PARTICULARS: (T/a) ffmi/ Height '«ft^/m &*ft./cm. (TI) mHv\v\ (i) W f ^ T T

(b) Colour of eyes (c) Cciour of hair

(tl) ^j?WTVtH*cft*

(d) Vtsible distinguishing mark

11. Is applicant a citizen of India by : ?:rth Descent Registration Naturalisation

12. fa) f̂t <w f̂iT'nwftrf/̂ raT <ren^rI # f n n ^ w f t n ? :

(a) Furnish details of previous passport/travel document, if any:

(i) tiwfti ^TWT/Passport number ?. i r f t Ft% tih n<fl*l / Date of issue , onft ?ft^FTWPT/ Place of issue Signature or Thumb Impression of the applicant (Left hand T.I. of male and Right hand T I of female) 14 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3 (i)] 15 16 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(1)] PASSPORT INFORMATION BOOKLET (APPLICANT MAY REMOVE & KEEP. THIS BOOKLET FOR FUTURE HANDY REFERENCE) ^ CAUTION : S A passport is issued under the Passports Act, 1967. It is an offence to knowingly furnish false information OR suppress material information which attracts penal and other action under relevant sections of the said Act. Passport is a valuable document. All holders are required to take due care that it does not get damaged, mutilated or lost. Passports should not be sent out to any country by post. Loss of passport should be immediately reported to the nearest Police Station and to the nearest Passport Office/Indian Mission. Passport holder shall be responsible for misuse of passport, due to non-intimation of loss to the concerned Passport Office/Indian Mission. Passport is a Govt. property and should be surrendered when demanded in writing, by any Passport Issuing authority V )

1. HOW TO APPLY : An application for a passport may be submitted personally OR through a representative OR by registered post.

2. MODE OF PAYMENT An all inclusive fee of Rs.300 for a fresh passport is to be paid along with the application form either by bank draft drawn in favour of the Passport Officer or in cash."In case of Bank Draft full name of the applicant and application No. should be written on the reverse of bank draft.

3. DELIVERY OF PASSPORTS Passport shall be delivered only to the applicant or despatched by registered post acknowledgement due to the address given in the application form.

4. PERSONS ENTITLED TO EMIGRATION CHECK NOT REQUIRED STAMP (ECNR) Holders of B.A. OR equivalent degrees including professional degrees; their dependents. Gazetted Government Servants. Income-Tax payers and their dependents, subject to proof of actual payrrrent of income tax for last three years. Persons living abroad for more than three years and their spouse and children upto the age of 24 years. Seamen in possession of CDC and Sea Cadets. Nurses possessing qualifications recognised under the Indian Nursing Council Act, 1947. Persons above the age of 60 years. NO EMIGRATION CLEARANCE IS REQUIRED FOR VISITING BANGLADESH, PAKISTAN AND ALL COUNTRIES IN EUROPE AND NORTH AMERICA. NOTE : Protector Of Emigrants will also grant emigration clearance to certain categories of skilled/semi-skilled workers for a period of s4x months when they apply through authorised recruiting agents with passport containing valid employment visa.

5. PHOTOGRAPHS 6 photographs in black and white or in colour of 35 mm x 45 mm showing frontal view of full face against a light background are required. Four of the photographs should be pasted on the application in the boxes provided. Photographs should not be stapled. Applicant should sign across the pasted photographs in such a way that half the signature appears on the photograph and the remaining on the application form. The signature across the photographs should be the same as the specimen signature given by the applicant in the form. The applicant's name should be written on the back of the remaining two unpasted photographs. There should be no marking or, the front of the unpasted.photographs. Photos taken with coloured or dark glasses and in uniform wiil not be accepted.

6. DOCUMENTS (Originals shouid be produced for verification and same will be returned after verification).

(i) While applying for a fresh passport attach :

(a) A photocopy of applicant's ration card OR appointment letter of reputed companies on letterhead/water tax/ telephone bill/electricity bill/running bank account etc./Income Tax Assessment Order of last three year OR Election Commission I.D. card. 17

(b) Attested copy of citizenship document If applicant is a citizen of India by Registration or Naturalisation.

(c) If tho applicant has not continuously stayed at the present address for the last two years, please photocopy the "Personal Particulars Form" and enclosa an additional set (in duplicate with photographs) for each additional place of residence.

(d) If nome(s) of chlld(ren) is (are) to be included In tho passport applied for, enclose;

(i) Birth Certificate/School certificate in respect of each child bearing names of both parents an;

(ii) Passport, if any, of both the parents. (For Inclusion of children's name In parents' existing passport apply on EA(P)2 form)

(e) Govt./Public Sector/Statutory body employeas should submit "No Objection" Certificate In original (Annexure E).

(f) If the applicant is eligible for "ECNR" attach attested copy of supporting document (see para 4).

(g) If tho applicant was repatriated at Govt. cost, enclose documents to show that expenditure incurred by the Govt. on his/her repatriation has been fully refunded to the Govt. of India, Ministry of External Affairs,

(h) If the applicant was deported to India, give details of Emergency Certificate/Passport. (II) When applying for a passport after 10 years ottach: Old passport and photocopy of first four and last four pages.

(iii) When applying for a minor's passport attach:

(a) Affidavit by legal guardian (Annexure C).

(b) Affidavit by 2 persons who know the legal guardian as well as minor (Annexure D).

(iv) For change of name of child :

(a) Deed poll/sworn affidavit by legal guardian (Annexure A) and (V) PROOF OF DATE OF BIRTH (Attach one of the following):

(i) Birth certificate issued by a Municipal Authority or district office of the Registrar of Births & Deaths;

(ii) Date of birth certificate or nationality certificate from the school last attended by the applicant or any other recognised educational institution;

(iii) Old Pa3spori;

(iv) Affidavit sworn before a Magistraie stating nationality and date/place of birth, as per specimen in Annexure 'F'

7. CHANGE OF NAME I. FOLLOWING MARRIAGE, REMARRIAGE OR DIVORCE

(a) A woman applying for first time for a passport in her married name for change of name/surname In existing passport on account of marriage OR for substitution of father's name with husband's name, must furnish an attested copy of marriage certificate issued by Registrar of Marriages OR en affidavit from the husband and wife. . (b) Divorcees applying for change of name OR for substitution of husband's name with father's name in existing passport must furnish :

(i) Divorce deed duly authenticated by court: OR

(ii) Deed poll/sworn affidavit (Annexure 'A')

(i) Divorce deed/death certificate as the case may be in respect of her first husband, and

(ii) Documents as at (a)above relating to second marriage. II IN OTHER CIRCUMSTANCES: Please see Annexure 'A'

8. OUT OF TURN ISSUE OF PASSPORT An applicant desiring to obtain his passport out of turn in view of any emergency should submit necessary documentation substantiating the urgency. In case the applicant wishes to obtain his passport In less than four weeks from the date of submission of the application form, a verification certificate as per the specimen at Annexure fi should also be submitted along with the documentation of urgency. The Passport Officer shall retain the right to verify in writing the authenticity of the Verification Certificate from the official who has Issued it. All applicants seeking a passport out of turn are advised to meet the Passport Officer concerned after submitting their applications with the documentation as specified. Police verification shall be dona In all cases of issue of passport. 18 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II- -SEC. 3(0] 19 20 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. :M ; J 21 ANNEXURE "A" SPECIMEN AFFIDAVIT FOR CHANGE IN NAME/DEED POLL/SWORN AFFIDAVIT (on Non-Judicial stamp paper) By this deed I, the undersigned (New Name) of etc. called (Old name), doing (give profession or avocation) and resident of (address)solemnly declare:-

1. That for and on behalf of myself and my wife and children and remitter issue wholly renounce/relinquish and abandon the use of my former name/surname of and in place thereof I do hereby assume from this date the name/ surname and so that I and my wife and children remitter issue may hereafter be called, known and distinguished not by my former name/surname, but assumed name/surname of.

2. That for the purpose of evidencing ouch my determination declare that I shall at all times hereafter in all records, deeds and writings and in all proceedings, dealings and transactions, private as well as upon all occasions whatsoever use and sign the name of as my name/surname in place and in substitution of my former name/surname.

3. That I expressly authorise and request all persons in general relatives and friends in particular at all times hereafter to designate and address me, my wife, my children, remitter issue by such assumed name/surname of accordingly.

4. Jn witness whereof I have here unto subscribed my former and adopted name/surname of and affix my signature and seal, if any this day of... Date : Signed sealed and delivered by the above name former name In the presence oi : Name Address Name Address (This deed poll/affidavit may be signed and attested in presence of a magistrate or Consular Officer In an Indian Mission abroad) Note: In case of change of name, applicant should insert advertisements in two reputed newspapers (one local newspaper of the area in which he/she is residing and 2nd in Newspaper of the area of permanent address) and submit original newspapers at time of applying for passport in his/her new name 22 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(0] ANNEXURE"C" SPECIMEN AFFIDAVIT TO BE DECLARED/AFFIRMED BY LEGAL GUARDIAN OF THE MINOR (To be executed on non-judicial stamp paper) I (name of guardian) solemnly declare and affirm as follows: 1 That I am the legal guardian of. (nameofmmor) whoisaminorandon whosebehalf Ihavemadean application fora passport.

2. That (name of the minor) has been living in India under my guardianship.

3. That I have no interest adverse to that said (name of minor)

4. That I have applied for a passport for (name and address of minor) under the instructions of (name and address of minor's parent and his full address abroad) This affidavit may be sworn in the presence of of Magistrate Signature and address of Deponent: Date. ANNEXURE"B" SPECIMEN AFFIDAVIT TO BE DECLARED/AFFIRMED BY TWO RESPONSIBLE PERSONS WHO KNOW THE LEGAL GUARDIAN AS WELL AS THE MINOR (To be executed ^n non-judicial stamp paper) I (name of deponent) s/o/d/o do solemnly declare and affirm as follows:

1. That I know both Shn/Smt (name of guardian) s/o/d/o and (name of minor) s/o/d/o .and name of guardian is the legal guardian of (name of minor)

2. That (name of guardian) has applied fora passport in favour of (name of minor) under tha instructions of his/her (name and address of minor's parents residing abroad).

3. That (name of guardian) has no interest adverse to that of said .(name of minor).

4.That (namsof guardian)is (relationship)of (nameofminor) This affidavit may be sworn in the presence of Magistrate. Signature & address and designation of Deponent. Date : ANNEXURE"&" All Central Government employees, State Government employees, Employees of Statutory Bodies and Public Sector Undertakings are required to produce a NO OBJECTION CERTIFICATE (on Official Stationed CertiiiodthatShn/Smt/Kum is a temporary/permanent employee of this from (date) and is at present holding the post of This Ministry/Department/Organisation has no objection to his acquiring Indian passport. The undersigned is duly authorised to sign this No Objection Certificate. Name & Designation Tel.NoDate : A1M1MPYIIRF "P." SPECIMEN AFFIDAVIT TO BE SUBMITTED BY ILLITERATE APPLICANTS AS PROOF OF DATE OF BIRTH IN CASE NO OTHER DOCUMENT MENTIONED AT PARA 6(V) OF THE INSTRUCTION BOOKLET IS AVAILABLE (To be axecuted on non-judicial stamp paper) I S/o/W/o/D/o hereby state as follows: I was bom on at situated in the Distt in the state of I have no documentary proof in support of my place and date of birth. I do not possess any educational qualification and I am an illiterate person. I take oath and solemnly declare/affirm that the particulars furnished by me above are correct and that I have not concealed or misrepresented any facts. Place Date Deponent Verified on this day of of the year One Thousand Nine Hundred and A.D. that the contents of my above affidavit are true and correct to the best of my knowledge and belief and nothing in material has been concealed therefrom. Deponent The contents of the affidavit has boon read out to me. Deponent Attested Note : Affidavit to be attested, by a Magistrate. Signature and Official seal erf attesting authority 23 ANNEXURE «fi SPECIMEN VERIFICATION CERTIFICATE (on official stationary of verifying authority) This is to certify that Mr/Miss/Mrs son of/daughter of/wife of resident of has good moral character and reputation and that after.havlng read the provisions of section 6 (2) of the Passports Act, 1967 (Printed below), I certify that these provisions are not attracted in case of this applicant and I, therefore, recommend Issue of an Indian Passport to him. Applicant has boon staying at his address continuously for the last two years. ^i/innti StaPlace; Date: (Complete name with designation) Tel. No. Office /Residence Note:

1. This verification certificate may be got signed by any of following •

(i) A Deputy Secretary/Director/Joint Secretary/Add Secy./Spl. Secy./Secy./Cab.Socy. to Govt. of India,

(it) A Joint Secretary/Add.Secy./Spl.Secy./Secy./Chief Secy, to a Stale Govt.

(iii) A Sub-Divisional Magistrate/Additional DM/District Magistrate of the district of residence of applicant,

(iv) A District Supdt. of Police/Range, DIG/1G/DGP of district ol residence ofapplicant.

2. Anyone who issues incorrect verification certificate may be prosecuted under section 12(2) of the Passports Act, 1967.

3. SECTION 6(2) OF THE PASSPORTS ACT, 1967 "Subject to the other provisions of this Act, the passport authority shall refuse to issue a passport or travel document for visiting any foreign country under clause (c) sub-section (2) of section 5 on any ono or more of the following grounds, and on no other grounds namely:- a. that the npplicant is not a citizen of India. b. that the applicant may. or is likely to engage outside India in activities prejudicial to the sovereignty and integrity of India. c. that the departure of the applicant from India may, or is likely to, be deterimental to the security of India. d. that the presence of the applicant outside India may, or Is likely to prejudice the friendly relations of India with any lorelgn country. e. that the applicant has, at any time during the period of five years immediately preceding the date of his application been convicted by a court in India for any offence Involving morel turpitude and sentenced in respect the roof to imprisonment for not less than two years. f. that criminal proceedings in respect of an offence alleged to have been committed by the applicant are pending before a court in India. g. that a warrant or summons for the appearance, or a warrant for the arrest, of the aplicant has been issued by a court under any law for the time being in force or that an order prohibiting the departure from India of tho applicant hc i been made by any such court. h. that the applicant has been repatriated and has not reimbursed the expenditure incurred in connection with such repatriation. 24 THE GAZETTE OF INDfA : EXTRAORDINARY [PART II—SEC. 3(i)] POST OFFICE SAi / P-.JCE F . FORM NO. 1 Applicant must paste (35 x 46 mm) on* photograph hero with half the signature on the photograph and half on the application. Serial No. PPT I /95'' GOVERNMENT OF INDIA MINISTRY OF EXTERNAL AFFAIRS PASSPORT APPLICATION FORM (Read Instructions Carefully Before Filling The Form) (Please Fill In BLOCK LETTERS) Amount of fee Paid Rs. 300/- I I I I _ . _ a . . Cash Bank Draft Bank Draft No Bank's Name

1.. Full name (Expanded initials, surname to be written first).

(i) Applicant

(il) Father (Ill) Mother (Iv) Spouso

2. I I I Male Female

3. Date of birth Date Month Year

4. Place of birth

5. Visible distinguishing mark:

6. Present address: Dlstt State PIN code I I

7. If the applicant has not rosidod at the address given aganist para (6) continuously for Uie last two years, please furnish the rffier address(es) with duration whefa he/sht.- !i«s resided during the period. From to (dale) Distt State PIN code ~|

8. (I) Applicant Is a citizen of India by ; p a n D Birth Descorrt Rfegr-.tr cton Natural. -_.r.viof.

(ii) If the applicant over possessed citirenship of any other country, give details :

9. If tha applicant evor changed his/her name, give details : (see para 7 for instructions)

10. Particulars of children to b» Included In applicant's passport; Name Sox (D

(2) Place of birth Date 0)

(2)

11. The details of passport/travel document held/ applied for, if any :

(i) Passport Office File Number:

(ii) Passport/Travel Document Number

(iii) Date of Issue/Application

(iv) Place of Issue/Application .

12. Is applicant entitled for "Emigration Check Y e s Not Required (ECNR) T If Yos, attach attested C°py of the document (see p,ara 4 for No Instructions)

113. Whether the passport contains valid visas? Yes No 26 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(i)] I Yes 14. Please Indicate whether :

(i) A passport/travel document was refused/ No impounded at any time or restored conditionally. 1 Yes No ^ The applicant was repatriated at Government 1 cost. lYes

(iii) The applicant was ever deported to India No

15. Information required under section 6 of the Passport Act, 1967 I Yes (i) Has the applicant at any time during t h ! ' period of five years immediately preceding JSJO the date of this appl icat ion been conv ic ted ' by a Court in India for any cr iminal of fence and sen tenced to impr isonment ? I l Y e s ,-x A (II) Are any criminal proceedings pending against the applicant before a court in India? No :::=^-\ Yes (''"') Has a warrant or summons for appearance or warrant for arrest or an order prohibiting the applicant's departure from India been | N o issued by a court ? NOTE: If answer to any of the questions in 14-15 is 'yes', furnish details in a separate sheet duly signed.

16. DECLARATION OF APPLICANT: I owe allegiance to the sovereignty, unity & integrity of India and have not voluntarily acquired the citizenship or travel document of another country. I have not lost, surrendered or been deprived of citizenship of India. The information given by me is true and I am solely responsible for its accuracy. I am aware that it is an offence under the Passports Act 1967 to furnish any false information or to suppress any material information with a view to obtaining passport or any other travej document. Signature/Thumb Impression of applicant Date Place 27

17. Declaration of Parent or Guardian if passport is for minor: I affirm that the particulars given above are in respect of (Name) Son/daughter of of whom I am the Parent/Guardian. I undertake the entire responsibility for his/her expenses. I solemnly declare that he/she has not. lost, surrendered or been deprived of his/her citizenship of India and that the information given in respect of him/her in this application is true Name & Signature/T.I, of Parent/Guardian (Left hand T.I. if male and Right hand T.I. if female) Place Date

18. Enclosures : GovernmGnt/PSU employee attach original NOC For Office Uso

19. Specimen signatures or Thumb Impressions of applicant In the boxes given below AND on two stickers. 28 _ THE GAZE'lTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(i)j PERSONAL PARTICULARS FORM (In Duplicate) Applicant must paste (35 x 45 mm) one photograph hare with half the signature on the photograph and halt on tha application.

1. 1JT THT (wwnrcf in jpfrr i >$) Full name (Expanded Initials)

2. ^Pi/Sex: (1) g^tftoato I (2) ifl/Female

3. (*) jpn m%m % ̂ ^ft mm *m TOIT i ?

(a) Has th« applicant over changed hla/her name 7 A / Y O B ^ f /No

(u) ^ftf l, TftiWIIW:

(b) If yos,previous name: ^

4. op«I ftrf*T/Dnte of birth WffhVDate *OT/Month W / o a r

5. ^rwiWPl/Place of birth W o w n ftrWDiatt TT /̂State fltt Wte/PIN coda C (f/a) ftw ^ ^ 1 / Father's name for/b) ^moVT^ni/Mother's name , (*I/c) qfi^ / qrft ^T ̂ w»/ Spouse's (hU3band/wif e) name ,

7. 'JHT/Addreao:

(1) *ITTW ̂ t Twft TW/ Permanent address in India: WHWWT/ ' f . / House nanw/No ^/Tr5ft/Vill./Street 1WSR /Post Oft ice gf̂ T?T8»mi/Police Station Fwn/Distt TW/Stoto faTlto/ PIN code M ^ A / T e l . N o

(2) ??f«nT 'nn/Present address: 'CTftW^I"? /Residingsince (PWw/d.̂ te) n«M«i W^W / •*}, / House name/No *fa/*TC&/Viliystreet IWJT/PostOffice gflni'fnT/Police Station faranr/Distt W«T/Stale fon?ft/ PIN code WtuftTK./Tel. No ?9 If the applicant has not resided at the address given against para (7) continuously for the last two years, please furnish ttie other address (es) with duration where he/she has resided during the period. Applicant should furnish an additional set of Personal particulars form (in duplicate with photograph) lor each additional place of stay during the last two years. PP form may bo photocopied for this purpose. •3/Frcm WP/to Cfcw/dato) *WP( *7 ̂ TR/1^. /Houst; name/No *fa/*Rft/Vill./Streot jraTCT /Post Office gftffl WIT/Police Station fon/Distt TTW/Stata .,,,.. : I 1 — I 1 —... •— . . . I ̂ -J teft<FRrt/Tul. No Reference* :• Names and addresses of two responsible persona in the applicant's locality who can vouch for the applicant. 1) 'ft/From ?W/to ... (fclW/datol WTOWIR/4. / House Name/No.... •>fN7*nft/viiiystraet J[*m /Post Office flrar/Distt .• TP<T/StatB , fcl^I/ PIN code W^fa^./Tel. No ) ^/From TO/to (falTO/date) TOmtR^/^./HousoName/No 'flr/'Rft/Vill./Streot ire^T/PostOffice forar/Distt TT*T/State ft^^I/ PIN code ~| T "1 1 W^T^i./Tel. No

10. Wrftffa: ft^^ : / PHYSICAL PARTICULARS: !*/a) W^rf/Height fajjrn i*,/cra

(n) ^raK^iri (n) wffwrT

(b) Colour of eyes.. (c) Colour of hair

(tl) vraJIWIwkcA'-v

(d) Visible distinguishing mark

11. Is applicant a citizen of India by : z\ • • • Birth Descent Riscjistrtiiior) cjrf!urr-i!i^ Uijfi

(a) Funi'-'h dotails of previous passport/travel documf.nt, if ^>.ny,

(i) ^ w f t i WW/Passport rtumljer

2. ^rrft ¥t% & Hrtte/Date of issue

3. <Utft S^ îT WR/ Place of issue , Signature or Thumb impression oi the applicant (Left hand T.I of male and Right hand T.I. of female) ID THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(0] PERSONAL PARTICULARS FORM (In Duplicate) <£ti Hm (arrorsm ^r mv\ ^ fS) Pi l l name (Exp4nd»d Init ials)

2. fWSex: (1) 5^/Male I (2) ^ /Female

3. (<s) WT o n t ^ ^ ^ j f ;^ 3 ^ ^ *m ^ ra i t ?

(a) Haa the applicant ever changed his/her name ? jt/Yee *nff/No

(a) ^ ^ , (TtMSdHIM:

(b) If yee, previous name:

1. =Hl fafa/Date of birth Hlfha/Date »nF/Mcnth W«i/Year ^*IWH/Place of birth STTOTown ftnn/Dlstt TTKl/Stato $R vltS/PlN code (f/a) ftWPI^W/ Father's name (7j/b) *iraT'EI1I«l/ Mother's name (T/c) <rf?T/IPft WT^TW/Spouse's (husband/wife) name , . . THT/Addrees:

(1) MTOl *f WT<ft Tm/ Permanent address in India: ^ ^ T ^ I ^ W / ^ . /Housename/No,. »fi*/»Rft/Vill./Street SW^T/Post Office gRra^jmt Police Station ftrar/Distt rrml State P H ^ T / P I N code ^frpfa^. /Tel. No..{

(2) l?fqpr im/Present address: l ^ f ^ I T ^ I ? /Residingsince (R^k/date) *TOFTWlTnT/*t / House name/No »frr/»rtft/Vill./Street H i m /Post Office gRra ITU/Police Station faWT/Dlstt TF**I State ft*nfa/ PIN code frfoihtf. /Tel. No 31 If the applicant has not resided at the address given against para (7) continuously forthe last two years, please furnish the other address (es) with duration where he/she has resided during the period. Applicant should furnish an additional set of Personal particulars form (in duplicate with photograph) for each additional place of stay during the last two years. PP form may be photocopied for this purpose. •ft/From HT/to (fa^fo/date) "ffiH VI^ni/4./House name/No Tfa/*Kft/Vilk/Street nfHT /Post Office yRtfl •TPTf / Police Station ftrar/Distt TW/State Qmtiai PIN code • fcsfr&Ht/Tel.No References:- Names and addresses of two responsible persons In the applicant's locality who can vouch forthe applicant,

(1) ^/From WH/to (f i t^/date) • W i #4 ̂ IH1$. I House Name/No ^/»nft/Vill7Street imm /Post office ftrar/Distt TF*T/State , foT^I/ PIN code fcetafa^t/Tel.No

(2) ^/From TTO/to (fcVuUdate •WiWHIW/ i /HouseName/No nfa/*nft/Viliystreet 1TCTT/Post Office flrar/Distt TWl State fcT Wte/ PIN code Wta^i*}. /Tel. No

10. W WWT: / PHYSICAL PARTICULARS: (^/a) W^/Height 'ftw/m î /cm.

(w) siHtvif' i (T) ^rafiFTtn

(b) Colour ot eyes (c) Colour of hair

(u) »nwi!*m>cft'*

(d) Visible distinguishing mark

11. Is applicant a citizen of India by : Birth Descent Registration Naturalisatior

12. (^J) ^ft <rc% v[ m«<ftif / I T W TOtrtf I Hi ̂ p n u w i *ftrr ?(:

(a) Furnish details of previous passportAravel document, if any: (I) ^tnriW (imi / Passport number

2. n̂ft ift ^Hlftw/Date of issue

3. **lft ift Vt WI*/ Place of issue Signature or Thumb Impression of the applicant (Left hat T.I. of male and Right hand T.I. of femal 32 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SKC. 3(i)l 33 34 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(i)] PASSPORT INFORMATION BOOKLET (APPLICANT MAY REMOVE & KEEP THIS BOOKLET FOR FUTURE HANDY REFERENCE) CAUTION"-"] ^ A passport is issued under the Passports Act, 1967. It is an offence to knowingly furnish false information OR suppress material Information which attracts penal and other action under relevant sections of the said Act. Passport is a valuable document. Ail holders are required to take due care that it does not got damaged, mutilated or lost. Passports should not be sent out to any country by post. Loss of passport should be immediately reported to the nearest Police Station and to the nearest Passport Office/Indian Mission. Passport holder shall be responsible for misuse of passport, due to non-intimation of loss to the concerned Passport Office/Indian Mission. Passport is a Govt. property and should be surrendered when demanded In writing, by any Passport Issuing authority J

1. HOW TO APPLY : An application for a passport may be submitted personally OR through a representative OR by registered post.

3. DELIVERY OF PASSPORTS Passport shall be delivered only to the applicant or despatched by registered post acknowledgement due tc the address given in the application form.

4. PERSONS ENTITLED TO EMIGRATION CHECK NOT REQUIRED STAMP (ECNR) Holders of B.A. OR equivalent degrees including professional degrees; their dependents. Gazetted Government Servants, Income-Tax payers and their dependents, subject to proof of actual payment of income tax for last three years. Persons living abroad for more than three years and their spouse and children upto the age of 24 years. Seamen in possession of CDC and Sea Cadets. Nurses possessing qualifications recognised under the Indian Nursing Council Act, 1947. Persons above the age of 60 years. NO EMIGRATION CLEARANCE IS REQUIRED FOR VISITING BANGLADESH, PAKISTAN AND ALL COUNTRIES IN EUROPE AND NORTH AMERICA. NOTE : Protector Of Emigrants will also grant emigration clearance to certain categories of skilled/semi-skilled workers for a period of six months when they apply through authorised recruiting agents with passport containing valid employment visa,

5. PHOTOGRAPHS 6 photographs in black and white or in colour of 35 mm x 45 mm showing frontal view of full face against a light background are required. Four of the photographs should be pasted on the application in the Doxes provided. Photographs should not be stapled Applicant should sign acrossthe pasted photographs in sucn a way that half the signature appears on the photograph and the remaining on the application form. The signature across the photographs should be the same as the specimen signature given by the applicant in the form. The applicant's name should be written on the back of the remaining two unpasted photographs, There should be no marking on the front of the impasted photographs. Photos taken with coloured or dark glasses and In uniform will not be accepted.

6. DOCUMENTS (Originals should be produced for verification and same will be returned after verification).

(i) While applying for a fresh passport attach : i'a) A photocopy of applicant's ration card OR appointment letter of reputed companies on letterhead/water tax/ telephone bill/electricity bill/running bank account etc /Income Tax Assessment Order of last three year OR Election Commission I.D. card 35

(b) Attested copy of citizenship document if applicant is a citizen of India by Registration or Naturalisation,

(c) If the applicant has not continuously stayed at the present address for the IEISI two years, please photocopy the "Personal Particulars Form" and enclose an additional set (in duplicate with photographs) for each additional place of residence.

(d) If narne(s) of child(ren) is (are) to be included In the passport applied for, enclose:

(i) Birth Certificate/School certificate in respect of each child bearing names of both parents an;

(li) Passport, if any, of both the parents. (For inclusion of children's name in parents' existing passport apply on EA(P)2 form)

(e) Govt./Public Sector/Statutory body employees should submit "No Objection" Certificate in original (Annexure E)

(f) If the applicant is eligible for "ECNR" attach attested copy of supporting document (see Dara 4).

(g) If the applicant was repatriated at Govt. cost, enclose documents to show that expenditure incurred by the Govt. on his/her repatriation has been fully refunded to the Govt. of India, Ministry of External Affairs.

(h) If the applicant was deported to India, give details of Emergency Certificate/Hasspon. (II) When applying tor a passport after 10 years attach. Old passport and photocopy of first four and last four pages.

(iii) When applying for a minor's passport attach:

(a) Affidavit by legal guardian (Annexure C).

(b) Affidavit by 2 persons who know the legal guardian as well as minor (Annexure D).

(iv) For change of name of chi ld :

(a) Deed poll/sworn affidavit by legal guardian (Annexure A) and (V) PROOF OF DATE OF BIRTH (Attach one of the following):

(i) Birth certificate issued by a Municipal Authority or district office of the Registrar of Births & Deaths;

(n) Date of birth certificate or nationality certificate from the school last attended by the applicant or any other recognised educational institution;

(iii) Old Pa3sport;

(iv) Affidavit sworn before a Magistrate stating nationality and date/place of birth, as per specimen in Annexure 'F'.

7. CHANGE OF NAME I. FOLLOWING MARRIAGE, REMARRIAGE OR DIVORCE

(a) A woman applying for first time for a passport in her married name for change of name/surname in existing passport on account of marriage OR for substitution of father's name with husband's name, must furnish an attested copy of marriage certificate issued by Registrar of Marriages OR an affidavit from the husband and wife.

(b) Divorcees applying for change of name OR for substitution of husband's name with father's name in existing passport must furnish :

(i) Divorce deed duly authenticated rjy court: OR

(ii) Deed poll/sworn affidavit (Annexure 'A')

(i) Divorce deed/death certificate as the case may be in respect of her first husband, and

(ii) Documents as at (a)above relating to second marriage. II IN OTHER CIRCUMSTANCES: Please see Annexure 'A1

8. OUT OF TURN ISSUE OF PASSPORT An appl icant desi r ing to obtain his passport out of turn in view of any emergency should submit necessary documenta t ion substant ia t ing the urgency. In case the appl icant wishes to obtain his passport in less than four weeks f rom the date of submiss ion of the appl icat ion fo rm, a ver i f icat ion cert i f icate as per the specimen at Annexure G should also be submi t ted along with the document at ion of urgency. The Passport Off icer shall retain the right to veri fy in wr i t ing the authent ic i ty of the Ver i f icat ion Cert i f icate f rom the off icial who has issued it. All appl icants seeking a passport out of turn are adv ised to meet the Passport Off icer concerned after submit t ing their appl icat ions with the documentat ion as spec i f ied. Police verification shall be done In all cases of Issue of passport. 36 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 3(i)] 37 38 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 3(i)] 39 ANNEXURE"A" SPECIMEN AFFIDAVIT FOR CHANGE IN NAME/DEED POLL/SWORN AFFIDAVIT (on Non-Judicial stamp paper) By this deed I, the undersigned (New Name) of etc. called (Old name), doing (give profession or avocation) and resident of (address)solemnly declare:-

2. That for the purpose of evidencing such my determination declare that I shall at all times hereafter in all records, deeds and writings and in all proceedings, dealings and transactions, private as well as upon all occasions whatsoever use and sign the name of as my name/surname in place and in substitution of my former name/surname.

4. ,ln witness whereof I have here unto subscribed my former and adopted name/surname of and affix my signature and seal, if any this day of Signed sealed and delivered by the above name former nameDate : In the presence of: Name Address Name Address (This deed poll/affidavit may be signed and attested in presence of a magistrate or Consular Officer in an Indian Mission abroad) Note: In cage of change of name, applicant should insert advertisements in two reputed newspapers (one local newspaper of the area in which he/she is residing and 2nd in Newspaper of the area of permanent address) and submit original newspapers at time of applying for passport in his/her new name 40 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 3(i)l ANNEXURE"C" SPECIMEN AFFIDAVIT TO BE DECLARED/AFFIRMED BY LEGAL GUARDIAN OF THE MINOR (To be executed on non-judicial stamp paper) I (name of guardian) solemnly declare and affirm as follows:

1. That I am the legal guardian of (name of minor) who isaminorand on whose behalf I have made an application fora passport.

2. That, (name of the minor) has been living in India under my guardianship.

3. That I have no interest adverse to that said (namo of minor) 4 That I have applied for a passport for (name and address of minor) under the instructions of (name and address of minor's parent and hio^ull address abroad) This affidavit may be sworn in the presence of of Magistrate. " Signature and address of Deponent: Date: ANNEXURE "*)" SPECIMEN AFFIDAVIT TO BE DECLARED/AFFIRMED BY TWO RESPONSIBLE PERSONS WHO KNOW THE LEGAL GUARDIAN AS WELL AS THE MINOR (To be executed "n non-judicial stamp paper) I (name of deponent) s/o/d/o do solemnly declare and affirm as follows:

1. That I know both Shri/Smt ..(namo of guardian) s/o/d/o , and (name of minor) s/o/d/o and name of guardian is the legal guardian of (name of minor)

2. That (name of guardian) has applied for a passport in favour of (namo of minor) under the instructions of his/her , (name and address of minor's parents residing abroad),

3. That (name of guardian) has no interest adverse to that of said ..(name of minor).

4. That (name of guardian) Is (relationship) of (name of minor) This affidavit may be awom in the presence of Magistrate. Signature & address and designation of Deponent. Date. ANNEXURE"fi" All Central Government employees, State Government employees, Employees of Statutory Bodies and Public Sector Undertakings are required to produce a NO OBJECTION CERTIFICATE (on Official Stationery) Certified that Shn/Smt/Kum is a temporary/permanent employee of this from (date) and Is at present holding the post of This Ministry/Department/Organisation has no objection to his acquiring Indian passport. The undersigned is duly authorised to sign this No Objection Certificate. Name & Designation Tel.NoData • ANNEXURE "E-" SPECIMEN AFFIDAVIT TO BE SUBMITTED BY ILLITERATE APPLICANTS AS PROOF OF DATE OF BIRTH IN CASE NO OTHER DOCUMENT MENTIONED AT PARA 6(V) OF THE INSTRUCTION BOOKLET IS AVAILABLE (To be executed on non-judicial stamp paper) I S/o/W/o/D/o hereby state as follows: I was bom on at. situated in the Distt in the state of I have no documentary proof in support of my plaoe and date of birth. I do not possess any educational qualification and I am an illiterate person, I take oath and solemnly declare/affirm that the particulars furnished by me above are correct and that I have not concealador misrepresented any facts. Place Data Deponent Venfied on this day of of tho year One Thousand Nine Hundred and A.D. that tho contents of my above affidavit are true and correct to the best of my knowledge and belief and nothing in material has been concealed therefrom. Deponent The contents of the affidavit has been read out to me. Deponent Attested Note Affidavit to be attested, by a Magistrate. Signature and Official seal of attesting authority 41 ANNEXURE"£" SPECIMEN VERIFICATION CERTIFICATE (on official stationery of verifying authority) This Is to certify thot Mr/Mis»/Mrs son of/daughter of/wifo of resident of has good morn] character and [reputation and that after.having read the provisions of section 6 (2) of the Passports Act, 1967 (Printed below), I certify that these provisions are not attracted in case of this applicant and I, therefore, recommend Issue of an Indian Passport to him Applicant has been staying at his address continuously for the last two years. Place: Date: Signature (Complete name with designation) Tel. No. Ofice /Residence Note: " 1 . This verification certificate may be got signed by any of following : (I) A Deputy Secretan/Orector/Joint Secretary/Add Secy /Spl. Secy./Secy./Cab.Sacy to Qovt of India,

(ii) A Joint Secrelary/Add.Secy./Spl,Secy./Secy./Chlef Secy, to a State Govt.

(iii) A Sub-Divisional Magistrate/Additional DM/District Magistrate of the district of residence of applicant

(iv) A District Supdt. of Police/Range, DIG/IG/DGP of district of residence of applicant.

2. Anyone who Issues Incorrect verification certificate may be prosecuted under section 12(2) of the Passports Act, 1967.

3. SECTION 6(2) OF THE PASSPORTS ACT, 1967 "Subject to the other provisions of this Act, the passport authority shall refuse to issue a passport or travel document for visiting any foreign country under clause (c) sub-section (2) ol section S on any one or more of the following grounds, and on no other grounds namely:- a.. that tho applicant is not a citizen of India b. that the applicant may, or is likely to engage outside India in activities prejudicial to the sovereignty and integrity of India. c. that the departure of the applicant from India may, or is likoly to, be deterimental to the security of India, d. that the presence of the applicant outside India may, or is likely to prejudice the friendly relations of India with any foreign country. e. that the applicant has, at any time during the period of five years immediately preceding the date of his application been convicted by • court In India for any offence involving moral turpitude and sentenced In respect thereof to imprisonment for not less than two years. f. that criminal proceedings in respect of an offence alleged to have been committed by the applicant are pending before a court in Inifie. g. that a warrant or summons for the appearance, or a warrant (or the arrest, of the aplicant has been issued by a court under any law for the time being in force or that an order prohibiting the departure from India ol the applicant has been made by any such court. h. that Hie applicant has been repatriated and has not reimbursed the expenditure incurred in connection with such repatnation. 42 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 3(i)l FREE OF CHARGE FORM NO. 2 Applicant must paste (35 x 45 mm) one photograph her* with half the signature on the photograph and half on the application. GOVERNMENT OF INDIA MINISTRY OF EXTERNAL AFFAIRS Application Form for Miscellaneous Services on Indian Passports (For use in India) (Please Fill In BLOCK LETTERS) Service required (See instructions on page 4): Amount of fee Paid Rs I I I I n i r> « M C a a n Bank Draft Bank Draft No Bank's Name

1.. Full name (Expanded initials, surname to be written first).

(i) Applicant

(ii) Father

(ill) Mother

(iv) Spouse

2. Present address: Distt State : PIN code I

3. Permanent address in India : Distt State PIN code 43

4. Details of Passport : i) Passport Ofiice File No.: ii) Passport No iii) Date of Issue iv) Place of Issue v) Valid upto |Y&s w vi) Wheather the passport contains valid visas?

5. Particulars of childorn to be includgd/deleted in applicant's passport: Name Sex

(1)

(2) Place of birth Date

(1)

(2)

6. Information required under section 10(3) of the Passport Act, 1967 |Yes Are any criminal proceedings pending No against the applicant before a Court in India? NOTE: If answer to above is 'yes', furnish details in a separate sheet.

7. DECLARATION OF APPLICANT: I solemnly affirm that: i) I owe allegiance to the sovereignty, unity & integrity of India and have not voluntarily acquired the citizenship or travel document of another country. ii) I have not lost, surrendered or been deprived of citiznship of India. iii) The information given by me is true and I am solely responsible for its accuracy. I am aware that it is an offence under the 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.

(iv) I undertake to be entirely responsible for expenses of my son/daughter/ward, and 44 THE GAZETTE OF INDIA : EXTRAORDINARY [PART 11—SEC. 3(i)l

(v) I declare that I have not lost or surrendered my citizenship of India since the above passport or travel document was issued to me. I further declare that I have no other passport. Name & Signature/T.I, of Applicant/Parent Legal Guardian (Left band T.I. if male anc Right hand T.I. if female) Place Date

8. Enclosures : 0 ii) iii) For Office Use

9. Please put two specimen signature or Thumb Impression in the boxes given below. 45 INSTRUCTIONS FOR FILLING UP FORM-2 This form is to be used for Miscellaneous Services on ordinary Passport for. i. Renewal ii. Issue of Visa Sheet. iii. Issue of additional Booklet on used up pages, including/deleting names of children, change of name and date of birth. iv. Change of address. v. Police Clearance Certificate (indicate the name of country for which PCC required and purpose). vi. Additional Endorsement vii. Addition/Deletion of particulars of children. viii. Any other services. ix. In case of fresh inclusion of name (s) of children please enclose (i) birth certificate (s) giving name of both parent? [\i\ Passports i;tthen ],-•:.•.>!'!••. '•;£->'•• (rr.,.. ..jsf'. or apply for separate passport. Children above 15 year must apply for separate passport. 46 THE GAZETTE OF INDIA : EXTRAORDINARY [PARI II—SEC. 3(i)] FREE OF CHARGE FORM NO. 3 GOVERNMENT OF INDIA MINISTRY OF EXTERNAL AFFAIRS APPLICATION FORM FORPASSPORT IN LIEU OF LOST/DAMAGED PASSPORT (Read Instructions Carefully Before Filling The Form) (Please Fill In BLOCK LETTERS) Amount of fee Paid Rs. I I I I n i n u KI C a s h B a n k D r a f t Bank Draft No Bank's Name

1. Full name (Expanded initials, surname to be written first). (I) Applicant

(li) Father (HI) Mother (Iv) Spouse

2. I I I Male Female

3. Date of birth Date Month Year

4. Place of birth

5. Visible Distinguishing mark : 6a. The details of passport/travel document held

(i) Passport Office File number: (II) Passport/Travel Document number (III) Date of Issue (Iv) Placeof Issue

(b) Details of restrictions, If any, on Lost/Damaged passport

7. Is applicant entitled for "Emigration Check Not Required (ECNR) ?" If Yes, attach documents (see para 4 for instructions)

8. Whether the passport contained valid visas? If yes, give details

9. Present address: • Distt State PIN code " I

10. If the applicant has not resided at tha above address continuously for the last two years, furnish tha other address(es) with duration where he/she has resided during the period. From to (date) Dlstt State PIN code I I I T I I

11. (I) Applicant Is a citizen of India by : Birth Descent Registration Naturalisation

(ii) If the applicant ever possessed citizenship of any other country, give details :

12. If the applicant ever changed his/her name, give details : (sea para 7 for instructions)

13. Particulars of children to be included In applicant's passport: Name Sex

(2) Place of birth Date

(1)

(2) d » T H E G A 7 E T T E O F I N D I A • E X T R A O R D I N A R Y [ P A R T I I - - S E C 3 ( i ) ] ~]Yes 14. Please indicate whether:

(i) A passport/travel document was refused/ , No impounded at any time or restored conditionally. 1 Yes N (ii) The applicant was repatriated at Government I cost. [Yes

(iii) The applicant was ever deported to India. No

15. Information required under section G of the Passport Act, 1967 I Yes (i) Has the applicant at any time during the period of five years immediately preceding _. the date of this application been convicted I by a Court in India for any criminal offence and sentenced to imprisonment ? 1 Yes

(ii) Are any criminal proceedings pending against the applicant before a court in India? No ^ ^ Yes ("') ^ a s a w a r r a n ' o r summons for appearance or warrant for arrest or an order prohibiting the applicant's departure from India been N° issued by a court ? NOTE: If answer to any of the questions in 14-15 is 'yes', furnish details in a separate sheet duly signed.

16. DECLARATION OF APPLICANT: I owe allegiance to the sovereignty, unity & integrity of India and have not voluntarily acquired the citizenship or travel document of another country. - I have not lost, surrendered or been deprived of citizenship of India. The information given by me is true and I am solely responsible for its accuracy, I am aware that it is an offence under the Passports Act 1967 to furnish any false information or to suppress any material information with a view tc obtaining passport or any other t;^-.o( document. Signature/Thumb Impression of applicant Date Place 49

17. Declaration of Parent or Guardian if passport i3 for minor: I affirm that the particulars given above are in respect of (Name) Son/daughter of of whom I am the Parent/Guardian. I undertake the entire responsibility for his/her expenses. I solemnly declare that he/she has not. lost, surrendered or been deprived of his/her citizenship of India and that the information given in respect of him/her in this application is true. Name & Signature/T.I, of Parent/Guardian (Left hand T,l. if male and Right hand T.I. if female) Place Date

18. Enclosures : Government/PSU employee attach original NOC For Office Use

19. Specimen signatures or Thumb Improssions of applicant in the boxes given below AND on two stickers. 50 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 3(i)] PERSONAL PARTICULARS FORM (In Duplicate)

1. *$p wi (ximnil TT inrK H *f ) Full name (Expanded initiala)

2. ftmlSex: (1) j ^Ma le I I (2) #>/Female

3. (v) <WI an̂ CTf % 11^ inft TO T̂T UTOt t ?

(a) Haa the applicant ever changed his/her name ? vt/Y«« ^ft/No

(w) ^iftlt, Hi Wfll 'TW:

(b) If yes, previous name:

4. "P*? filft/Dete of birth fllfoa/Date »IIF/Month ^/Year

5. OF»I WWIace of birth mx/Town faren/Distt TTai/State ft^I *fa/PIN coda

6. ('(f/a) ftw W T̂TRY Father's name (7J/b) i ra i^ f l^R/ Mother's name (*T/c) i f ^ / 1?ft * l ÎT*?/ Spouse's (husband/wife) name

7. traT/Addres«:

(1) TTC7T fli w f t THI/ Permanent address in India: q^R^r^TT/'T. /Housename/No nrT/*reft/Vill./Street ITOTC /Post Office gflra«tHT/Police Station fann/Distt TRI/State fcr^fa/PINcodG ^##T7T./Tel.No

(2) vfaff ^/Present address: l^ l^7 f#¥? /Residingsince (frihr/date) W m i l B l T̂. / House name/No *fi*/*ltf/Vill./Street im^T /Post Office gRrnim/Police Station NIWI/ Distt TW/State ftn ^ 1 / PIN code : îfaEfaTi. /Tel. No SI If the applicant has not resided at the address given against para (7) continuously for the last two years, please furnish the other address (es) with duration whore he/she has resided during the period. Applicant should furnish an additional set of Persona! particulars form (in duplicate with photograph) for each additional place of stay during the last two years. PP form may be photocopied for this purpose. ^/From WP/to (Ril*-'.date] *WH VI^TO/'t./House name/No *fa/*itft/Vill./Street *WH /Post Office Jjfira *!I*II /Police Station ftrar/Distt TW/Slate ftH^if?/ P)N code itSWiTt /Tel. No References :- Names and addressee of two responsible persona in the applicant's locality who can vouch for the applicant.

(1) ^ /From TW/to (ft'-ii* / date) » W W * I W I / i / House Name/No %/^ft/Vil iyStreot ITOW /Post Office fam/Distt TW/State Pm lite/PIN code fcsfafa t̂. / Tel. No

(2) t/From IW/to (fcri*/date) M+HW^IW/H. /HouseName/No TO/^/Vill./Street ¥HW/Post Office ftrat/Distt..., TW/State PH Vt l /PIN code fctftafait /Tel. No

10. VUflft* frlTT i / PHYSICAL PARTICULARS: (*/a) W*tf/Helght iftcT/m ^ A / c m . (TS) wmKvrin (n) wrffv\in

(b) Cofour of eyes... (c) Colour of hair (*l) IWR^IJWiEfaf r

(d) Visible distinguishing mark ..../

11. Is applicant a citizen of India by : Birth Descent Registration Naturalisatioi

(a) Furnish details of previous passportAravel document, if any:

(i) MMriU WWt/Passport number

2. <snft Fl^ «ft m f ^ / Date of issue

3. 'Jnfttftt VT W i t / Place of issue Signature or Thumb Impression of the applicant (Loft hand T.I. of male and Right hand T.I. of female) 52 THE GAZETTE OF INDIA : EXTRAORDINARY IPART II—SEC. 3(i)J PERSONAL PARTICULARS FORM (In Duplicate)

1. TJI ITO (snwwrilf vr smt*T T I S ) Full name (Expanded Initials) ,

2. fan/Sex: (1) g*N/Male I I (2) ^/Female

3. (w?) vn z\ihi<b % qrc^ qnft am^r =TTO nzxi $ ?

(a) Has the applicant ever changed his/her name ? IT/Yes ^nff/No

(w) ifitlft, ??lMgdHIH:

(b) If yes, previous name:

4. "J^l fafa/Date of birth «lfh«/Date *HF/Month v4/Year

5. op»» WTVPIace of birth mi/Town firat/Dlstt Tiwi/State for^fa/PIN code

6. (^/a) ftw f *"1'/ Father's name (W/b) >TOI^nTO/Mother's name (*!/c) iRf / I r f t W1TR/ Spouse's (husband/wife) name

7. iflT/Address:

(1) ^RW ̂ WPft 1?(T/ Permanent address in India: H*WWIP?/^f, /Housename/No 1frf/ilft/Vill./StreBt 1W¥T/Post Office gRra«n*ft A Police Station ftlW/Distt TW/State , ftlT ^ 1 / PIN code WWlT^t/TeLNo

(2) flrfnn tin/Present address: ^JT^TF^f?/Residingsince (fN*/date) • w n W i n / ' i , /Housename/No ifrr/T5ft/Vill./Street IW^T/Posi Office gftraim/Police Station foaT/Distt WQI State ft^^tt/PIN code WWfaH./Tel.No 53

8. ^ wfc^ ftffl # fa (») *i fi& *rt ̂ r̂c *PTOTC *ra ̂ t irf wfti ^ ifRiT TO it I w in* i $ H^B *ifaR*n w n $ ftnj wft ift nfii) T IT *nrt i XH ̂ tw % ftrci 1*4 Rh* ft*u"i «ni ift If the applicant has not resided at the address given against para (7) continuously forthe last two years, please furnish the other address (es) with duration where he/she has resided during the period. Applicant should furnish an additional set of Personal particulars form (in duplicate with photograph) for each additional place of stay during the last two years. PP form may be photocopied for this purpose. •^/From TO/to (foifaj/date) 1 W VI^ml^. lHouse name/No ^ *frt/i*ft/Vill./Street WWW/Post Office 3?ira •inn/Police Station ftrat/Distt Tml State ftT * fa / PIN code itfttiHTt /Tel. No References :- Names and addresses of two responsible persons In the applicant's locality who can vouch for the applicant.

(1) ^/From Wtf/to (fcritf/date) W J f U I R / i / House Name/No %/T«ft/ViliyStreet *WMT/Post Office ftrat/Dlstt TTO/State , PR * & / PIN code fctflWfaTt /Tel. No

(2) ^/Frorn fTO/to (ft^TC/date) W T O ^ / t / House Name/No »fra/Trcft/VIII./Stre6t IR^T/Post Office PraT/Distt rmi state Pfa^ll/PIN code MWit'ni. /Tel. No

10. Hlftita W W : / PHYSICAL PARTICULARS: (n/a) W^il Height "ftctym i4/cm. {is) wfoafTifT (n) ^raf^iT1!

(b) Colour of eyes (c) Colour of hair (*l) MJHI1 w H*t ft-<

(d) Visible distinguishing mark

11. Is applicant a citizen of India by : Birth Descent Registration Naturalisation

(a) Furnish details of previous passport/travel document, if any.

(i) 'nwfti^WT/Passport number

2. ÎTft i t^^?rr f tn/Date of issue

3. trf t fft WlVfRlPlace of issue Signature or Thumb Impression of the applicant (Left hand T.I. of male and Right hand T.L of female) 54 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 3(i)l 8-A FORM NO 3-A (0 (All the copies to be filled in by applicant)

1. Full name (Expanded initials)

(i) Applicant

(ii) Father

(iii) Mother

(iv) Spouse

2. Date of birth Date Month Year

3. Place of birth

4. Applicant is citizen of India by : Birth Descent Registration Naturalisation

5. Present address: Distt State PIN code I

6. Permanent address In India Distt State PIN code I T I

7. Details of the LOST passport :

(i) Passport number

(ii) Date of Issue

(iii) Place of Issure

(iv) Date of expiry 51, 8a-2 8a. Details of restrictions, if any, Lost/Damaged passport

(b) Details of transfer of residence/Foreign Travel scheme facility on lost/damaged passport:

9. Copy of FIR

10. If NRI, date from which the applicant residing abroad. Signatures of applicant. Date For Office Use To The Director, C.P.V. Division, Patila House, Ministry of External Affairs, New Delhi-110001 It is requested that clearance for Issue of a duplicate passport in lieu of lost/damaged (strike out what is not applicable) passport be sent to us at the earliest in respect of individual whose particulars are given above. Signatures of R.P.O. / P.O. Ministry of External Affairs (CPV) Division. DateFile No Copy forwarded for necessary action to:

3. Signatures of Director (PV) 56 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 3(i)] 8-A FORM NO 3-A

(i) (All the copies to be filled in by applicant)

1. Full name (Expanded initials)

(i) Applicant

(ii) Father

(iii) Mother

(iv) Spouse

2. Date of birth Date Month Year

3. Place of birth

4. Applicant Is citizen of India by : Birth Descent Registration Naturalisation

5. Present address: Distt State PIN code P I I I I I

6. Permanent address in India Distt State PIN code I f~~l I I I

7. Details of the LOST passport:

(i) Passport number

(ii) Date of Issue

(iii) Placeofissure

(iv) Date of expiry 57 8a-2 8a. Details of restrictions, if any, Lost/Damaged passport

(b) Details oftranster of residence/Foreign Travel scheme facility on lost/damaged passport:

0. Copy at FIR

10. If NRI. date from which the applicant residing abroad. Signatures of applicant. Date For Office Use To The Director, C.P.V. Division, Patila House, Ministry of External Affairs, New DelhM 10001 It it requested that cledrnnca for issue of a duplicate passport in lieu of lost/damaged (strike out what is not applicable) passport be sent to us at the earliest in respect of individual whose particulars are given above. Signatures of P.P.O. / P.O. Ministry of External Affairs (CPV) Division, DateFile No Copy forwarded for necessary action to:

3. Signatures of Director (PV) 58 THE GAZETTE OF INDJA: EXTRAORDINARY [PART II—SEC. 3(i)] 8-A FORM NO 3-A

(i) (All the copies to be filled In by applicant) Applicant must paste (36 x 45 mm) one photograph here with half tha signature on the photograph and half on the application.

1. Full name (Expanded initials)

(i) Applicant (II) Father (Hi) Mother

(iv) Spouse

2. Data of birth Date Month Year

3. Place of birth

4. Applicant Is citizen of India by : Birth Descent Registration Naturalisation

5. Present address: Dlstt Stato PIN code

6. Permanent address In India , T * . 1 J . . . , i i < I . * . , Dlstt Stato PIN codo I 1 1 I 1 [

7. Details oj the LOST passport:

(i) Passport number

(ii) Date of Issue

(iii) Place of Issure

(iv) Dale of expiry 59 8a-2 8a. Details of restrictions, if any, Lost/Damaged passport

(b) Detailsoftransferof residence/Foreign Travel scheme facility on lost/damaged passport:

9. Copy of FIR

10. If NRI, date from which the applicant residing abroad. Signatures of applicant. Date For Office Use To The Director, C.P.V. Division, Patlla House, Ministry of ExtQrnal Affairs, New Delhi-110001 It is requested that clearance for Issue of a duplicate passport in lieu of lost/damaged (strike out what is not applicable) passport be sent to us at the earliest in respect of individual whose particulars are given above. Signatures of R.P.O. / P.O. Ministry of External Affairs (CPV) Division. DateFile No Copy forwarded for necessary action to

3. Signatures of Director (PV) 60 THE GAZETTE OF INDIA : EXTRAORDINARY [PART II—SEC. 3(i)] 8-A FORM NO 3-A

(i) (All the copies to be filled in by applicant)

1. Full name (Expanded initials)

(i) Applicant

(ii) Father (Mi) Mother

(iv) Spouse

2. Date of birth Date Month Year

3. Place of birth

4. Applicant is citizen of India by : Birth Descent Registration Naturalisation 5, Present address: Distt State PIN code ~1 6 Permanent address in India Distt State PIN code [ I ~~

7. Details of the LOST passport:

(i) Passport number

(ii) Oats of Ibsue

(iii) Place of Ksure

(tv) Date of expiry

6.1 8a-2 8a. Details OT restrictions, IT any, Lost/Damaged passport :

(b) Details of transfer of residence/Foreign Travel scheme facility on lost/damaged passport:

9. Copy of FIR

10. If NRI, date from which the applicant residing abroad. Signatures of applicant. Date For Office Use To The Director, C.P.V. Division, Patlla Housa, Ministry of External Affairs, New Dulhl-110001 it is requeued that clearance for issue of a duplicate passport In lieu of lost/damaged (strike out what is not applicable) passport be sent to us at the earliest in respect of Individual who's?particulars are given above. Signatures of R.P.O. / P.O. Ministry of External Affairs (CPV) Division. DataFile No Copy forwarded for necessary action to:

1. 2-

3. Signatures of Director (P'. 62 THE GAZETTE.OF INDIA : EXTRAORDINARY [PART II—SEC. 3(i)] 9(L/D) 63 64 THE GAZETTE OF INDJA : EXTRAORDINARY [PART II—SEC. 3(i)] 11 (L/D) PASSPORT INFORMATION BOOKLET (APPLICANT MAY REMOVE & KEEP" THIS BOOKLET FOB FUTURE HANDY REFERENCE) f' • I CAUTION H ^ A passport Is seued under the Passports Act, 1967. It Is an offence to knowingly furnish false Information OR suppress material information which attracts penal and other action under relevant sections of the anld Act. Passport is a valuable document. All holder* are required to take due care that I does not get damaged, mutilated or lost. Passports should not be sent out to any country by po:;t. Loss of passport should be immediately reported to the nearest Police Station and to the nearest Passport Office/Indian Mission. Passport holder shall be responsible for misuse of passport, due to non-intimation of loss to the concerned Passport Office/Indian Mission. Passport Is a Govt. property and should he surrendered when demanded In writing, by any Passport Issuing authority V I s

1. HOW TO APPLY : An application or a passport may_ be submitted personally OR through a representative OR by registered post.

2. MODE OFPAYMEN" • Mn an incmsivo fee of Rs 2500/- is to be paid along with the application form either by-bank draft drawn in favour of l ie Fasspor Officer or in cash "In case of Bank Draft full name of that applicant and application No. should be written o-n the reverse of bank draft. „

3. DELIVERY OF PASJiPORTS! Passport shall he delivered only to the applicant or despatched by registered post acknowledgement due to the address gi^/en in the application form.

4. PERSONS ENTITLED TO EMIGRATION CHECK NOT REQUIRED STAMP (ECNR) Holders of B.A OR equivalant degrees including professional degrees; their dependents. Gazetted Government Servants. Income-Tex papers and their dependents, subject to proof of actual payment of Income tax for last three years. Persons living abroad 'or more than three years and their spouse and children upto the age of 24 years. Seamen in possession of CDC and Sea Cadets. Nurses possessing qualifications recognised under the Indian Nursing Council Act. 1947. Persons aaovo the age of 60 years. NO EMIGRATION CLEARANCE IS REQUIRED FOR VISITING BANGLADESH. PAKISfTAN AND ALL COUNTRIES IN EUROPE AND NORTH AMERICA. NOTE : Protector Of E :nigrant; will also grant emigration clearance to certain categories of skill«d/semi-skilled workers for a period of six months when they apply through authorised recruiting agents with passport containing vaUl employment visa. B. PHOTOGRAPHS 6 photographs in blac< and white or in colour of 35 mm x 45 mm showing frontal view of full face against a light backg-dund are required. Four of the photographs should be pasted on the application In the boxes provided. Photographs should not be stapled. Applicant should sign across the pasted photcgraphs in such •a1 way thai half the signature appears on the photograph and the remaining on the application form. The signature across the photographs should be the same as the specimen signature given by the applicant in the form. The applicant's name should be written on the back of the remaining two unpastad photographs. There should bs no rrmrklng on the front of the unpasted photographs. Photos taken vith coloured or dark glasses and In uniform will not be accepted. 65 12 (UD)

6. DOCUMENTS REQUIRED FOR REPLACEMENT OF LOST/DAMAGED PASSPORT (Originals shouk be'produced for verification and same will be returned after verification).

(a) IF PASSPORT IS LOSTr '{i) Attach cepy of First information Report (F.i.R.) *rom the police station where theioss has been reported

(ii) Affidavit es per specimen appended (Annexure 'B') and

(iii) A signed statement (on plain paper) describing circumstances leading to loss of passport,

(iv) A copy ol letter written by applicant to concerned PO(s)/indian Mission(s) informing loss of passport (See ."CAUTION" on page n ) .

(v) NRls shojld submit 4 additional photographs,

(b) IF PASSPORT IS DAMAGED;

(i) Attach passport

(ii) Affidavit as per specimen appended at Annexure 'B', and

(iii) A statement (on plain paper) describing circumstances leading to damage.

(i) A photocopy of applicant's ratior» card OR appointment letter of reputed companies on letterhead/water tax/ telephone t ill/electricity bill/running bank account etc/income Tax Assessment Order of last three year OR Election Commission I.D. card.

(ii) Attested capy of citizenship document if applicant is a citizen of India by Registration or Naturalisation.

(iii) If the applic ant has not continuousty stayed at the present address for the last two years, please photocopy the "Personal. Particulars Form" and en.ciosa an additional set (in duplicate with photographs) for each additional place of residence.

(iv) if narre(s) of child(ren) s (are) to be included in the passport applied for, enclose:

(i) Birth Certificate/School certificate in respect of each child bearing names of both parents an;

(ii) Passpart, if any, of both the parents. (For inclusion of children's name in parents' existing passport apply on EA(P)2 form)

(v) Govt./Pub ic Seclor/Statutory body employees should submit "No Objection" Certificate in original (Ann«!xur>3 E).

(vi) If the appl cant is eligible for "ECNR" attach attested copy of supporting document (see para 4).

(vii) If the appl cant WJIS repatriated at Govt: cost, enclose documents to show that expenditure incurred by the Govt. on his/her repatriation has been fully refunded to the Govt. of India, Ministry of External Affairs,

(viii) If the applicant was deported to India, give details of Emergency Certificate/Passport.

(d) WHEN AF PLYING FOR A MINOR'S PASSPORT ATTACH:

(i) Affidavit cy legal guardian (Annexure C).

(ii) Affidavit ty 2 persons who know the legal guardian as well as minor (Annexure D).

(e) PROOF C F DATE OF BIRTH (Attach one of the following):

(i) Birth-cerificate issued by a Municipal Authority or district office of the Registrar of Births & Deaths;

(ii) Date of birth cert ficate or nationality certificate from the school last attended by the applicant or any other recognised educational institution;

(iii) Old 3as:>>a*t;

(iv) Affidavit ;;wom bafore a.Magistrate slating nationality and date/place of bjrth, as..per specimen in Annexure 66 THE GAZETTE OF INDIA: EXTRAORDINARY [PART II—SEC. 3(i)] o7 68 THE GAZETTE OF TNDIA : EXTRAORDINARY [PART II—SEC. 3(i)] 69 ANNEXURE"A" SPECIMEN AFFIDAVIT FOR CHANGE IN NAME/DEED POLUSWORN AFFIDAVIT ' (on Non-Judicial stamp paper) By this deec '•, the undersigned. (New Name) of etc. called ^ I d name), doing (g'wie profession cr avocaiipn) and resident of (addrass)solemnly declare:-

1. Thai for ;nd on behalf of myself and my wife and children and remitter Issue wholly renounce/relinquish and abandon the use of m|/ former name/surname of and in place thereof I do hereby assume from this date the name/ surname :... and so that I and my wife and children remitter Issue may hereafter be called, known and distingumed not by my former name/surname, but assumed name/surname of.

2. Thai for the purpose of evidencing such my determination declare that I shall at all times hereafter in all records, deeda and writings and h all proceedings, dealings andtiansactions, private as well as upon all occasions whatsoever use and sign the rame of as my name/sjrname in place and in substitution of my former name/surname.

3. Thai I oxpressly authorise and request * l ! pprs^ns in general relatives and friends in particular at all times hereafter to, design.ite and address me, my wifei my c^'ldren, remitter issue by such assumed name/surname of accordingly.

4. In wit lie;;!; whereof I have here unto subscribed my former and adopted name/surname of and atfix my signature and seal, if any this day of Signed sealed and delivered by the above name former nameDate : In the presence* of: Name Address Name Address (Trusteed poll/affidavit may bo signed and attested in presence of a magistrate or Consular Officer in an Indian Mission abroad) Note: . In case of change of namo, applicant should Insert advertisements in two reputed newspapers (one local newspaper of the area in which he';the is residing and 2nd In Newspaper of the.area of permanent address) and submit original newspapers at time of applying for passport in his/her new name ANNEXURE"B" SPECIMEN OF AFFIDAVIT TO BE SUBMITTED WITH THE APPLICATION FOR A PASSPORT IN LIEU OF LOST/DAMAGED PASSPORT (To be executed on non-iudlclal stamp paper) (This affidavit I3ta t s axecutiKJ on non-judicial stamp paper of appropriate value In the presence of Magistrate First Class on the following points) I . .. . .s/o/d/oAv/o residing at sol&mnly affirm as lollowa

1. State how and vtien the pussport was lost/damaged & how many passports were lost/damaged aariier?

2. State wh©their yiyj travailed on trui lost/damaged passport If so, state flight No. last data and port of entry into India ?

3. State whether yoj availed Df any TR concesstons/FTS allowance and il so details thereof ?

4. Stale whether no vrosidon; Indian and if resident abroad, the dtttails o( the residence as follows: _ ^ _ _ _ _ _ _ _ _ _ _ SL No. i

3. Name of (he countiy Length of From Residence To Page Nos. of passport bearing departure & arrival stamps (details if available) I further affirm That I will take jtmost care ot my passport it issued and the government will be at liberty to take any legal action under the Passport Act, 13fi7, if tha lap:;e is reaeatod. 'Deponent, Affirmed befora Magistrate First Class Date 70 THEGAi iiH^Ui-1 LuAifc^lK. 17 ANNEXURE"C" SPECIMIEN AFFIDAVIT TO BE DECLARED/AFFIRMED BY LEGAL GUARDIAN OF THE MINOR (To tw executed on non-judicial stamp paper) I (lemeof(iuardlan)...., '. solemnly declare end affirm a* follows:

1. That I am the legal guard en of _ .,.(r»meof minor) who isa mine-rend on whose behalf I have made en application for a passport.

2. That (niMne of the minor) ha* been living In India under my guardianship.

3. That I have no infaireitt idvenw to that said (name of minor)

4./That I hive applied for l passport for (name and address of minor) under the instructions of (name and address of minor's parent and his full address abroad) This .affidavit may bei swon in the presence of of Magistrate. Signature end address of Deponent: DaW: ANNEXURE"D" SPECIMEN AFFIDAVIT TO BE DECLARED/AFFIRMED BY TWO RESPONSIBLE PERSONS! WHO KNOW THE LEGAL GUARDIAN AS WELL AS THE MINOR (To b« executed on non-judkiol stamp paper) I (name of depoMmt) a/a/do d ^ solemnly declare and affirm a> follows:

1. That I know both Shii/3mt,.,.. (name of guardian) «/©/d/o and (name of minor) s/o/d/o and name of guardian is the legal guardian of (riam* of minor) 2 -Th«t (rmm«o(ouardian)hMappN»dferapa*aportinfavourof (name of minor) under the Instructions of hlsjrer. (name and address of minor's parents residing Mjroad). ' • " r t 1 ^ (name ol guerdon) has no Interest adverse to that of said (name of minor). 4-Tbal. (nama of guardian) It (relationship) of (name of minor) Thisaffidavrtmaybesw3)Tviolh«|>rs«anMol Magistrate. Signature & actoVess and designation of Deponent Date; . ANNEXURE "E" AH i~i mrai bovwnment amptoytes, State Government employees, Employees of Statutory Bodies and Public Sector Undertakings are required to produce a NO OBJECTION CERTIFICATE (on Official Stationery) CarttiedthatShri/Smt/Kij* b a temporary/permsnent employe© of Ws from (eaki) and la at present holding the post of This Ministry/OepartrnBii /Organisation has no objection to his acquiring Indian passport, The undersigned is duly authorised to sign this'No Objection Certificate. Nam* & Designation Td.NoPate; ANNEXURE "F" SPECI 3. BE SUBMITTED BY ILLITERATE APPLICANTS AS PROOF OF DATE OF BIRTH IN CASE NO OTHER DOCUWIENT MENTIONED AT PARA 6(V) OF THE INSTRUCTION BOOKLET IS AVAILABLE (To be executed on non-judicial stamp paper) 1 S/o/VWo/D/o hereby state as follows: Iwasbomon at situated In the Distt in the state of I have no documentary proof in support of my place and date of blrthi I do not possess aiy itckicationai i]uejifoitk>n and I am an illiterate person. I take oath end soUimrrly Jeciare/afimi thut the particulars furnished by me above are correct and that I have not concealed or mierepreeented any facts. v - Place ° » t o - -: Deponent - Verified on this ,.. .day of of the year One Thousand Nine Hundred and A D . that the oontents of my .above affidavit^ are true and correct to t <e best of my knowledge and belisf and nothing in material has been concealed therefrom. Deponent The contents of the affidavit has t«en read out to me. Deponent Attested Note: Affidavit to ln< sttested by a Magistrate. Signature and Official seal of attesting authority 71 ANNEXURE'G" SPECIMEN VERIFICATION CERTIFICATE (on official stationery of verifying authority) This ia to car&fy thm Mr/Miss/Wra son of/deughter of/wife of resident of ha* good moral oharncter and reputation and that titi€ r having mad thu provision* of section 6 (2) of the Passports Act, 1967 (Printed below), I certify that these provisions are not attracted in CUM ct thi» applicant ard I, therefore, recommend I U I M of an Indian Passport to him. Applicant has been staying at his address continuously for the lint two years Place: Datoj. Signature (Complete name with designation) Tel. No, Office : /Residence Note:

1. This verification certificate may tie got sighed by any of following :

(i) A Ouputy 3ecretery/Director/Joint Secretary/Add Secy./Spl. 3ecy./Secy./Cab.Secy. to Qovt. of India,

(li) A Joint Secretary/Add.Sec/./Spl.S#cy./Se«y./Chief Seoy. to • State Qovt. (Hi) A Sub-Divisional M.iQi»tmto/Additional"PM/Di»trict Magistrate of the district of residence of applicant. (Iv) A District :3updt, of Police/flange, DIQ/1Q/0GP of district of residence of applicant.

2. TKnyon* who lseu«» Incotract varlfloaBon cariiftcate may b« prosecuted under section 12(2) of the Passports Act, 1967

3. SECTION 6(2; DF THE PASSPORTS ACT, 1967 "Subject to tt-* other provisiont of thi* Act, the paaaport authority shall refute to laaue a passport or travel document for visiting any foreign country uridtr clause (c) sub-«e3tion (2) of section e pn any one or more of the following grounds, and on no other grounds namely:- a, that tho ti|>plioant ii not a tatizen of India. - b: that tho applicant may, or s likely to engage outside India in activities prejudicial to the sovereignty and Integrity of India. c. that thci dtpartura of the applicant from India may, or is likely to, be deterimental to the security of India. d. thai tho p lesenc* of the applicant outside India may, or Is likely to prejudice the friendly relations of India with any fo/elgn-country. e. thai thu applicant h-is, at any time during the period of ftve years immediatary preceding the date of his application bean convicted by a court In rtdta Tor tny offence Involving moral turpitude and sentenced In respect thereof to Imprisonment for not less than two yean. f. thai criminal proceedings i i respect of an offence alleged to have been committed by the applicant are pending before a court in Indie. g. that a wit rant or summon i for the appearance, or a warrant for the arrest, of the aplicant has been issued by a court under any law for the time being in force or that an order prohibiting the departure from India of the applicant has been made by any such court. h. tha: tho applicant has been repatriated and has not reimbursed the expenditure incurred In connection with such repatriation! Printed by the Manager, Qovt of India Press, Ring Road, Mayapuri, New Delhi-110064 and Published by the Controller of Publications, Delhi-110054 199J

The Passport (Amendment) Rules, 1995 (07.08.1995)

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