UG,UTmuID No. D. III ~-QPiT ~he <Sox.ette of ~t1diO EXTRAORDINARY "TIT -wq ~(Iq (i)
PART II--8ection 3-Sub·Section (I) ~ ~ A •• hlt! PUBLISHED BY AUTHORITY Uo 82] No. 8:1] q mc;f\', !'«l,", qf 10, 1967/~ 20, 1889 NEW DELHI, WEDNESDAY, MAY 10, 1961/VAISAKHA 20, .188, tQ ltA ti f~ 'l~~~fM~ '3fT~i\'~ f~ f~ lf~ ~ ~~;r ..r \Iq' i~ lIlT ri I Separate partnl' is given to this Part in order that It may b. lIed as a meparate compUatlon. - MINISTRY OF EXTERNAL AFFAIRS NOTIFICATION New Delhi, the 10th May 1967 G.S.R. 709.-In exercise of the _powers conferred by section 23 of the Passports Ordinance, 1967 (4 of 1967), the Central Government hereby makes the followint rules, name]y:-
1. (1) Short title and eommeueemeat.c-- These rules may be called the Passports Rules, 1967.
(2) They shall come into force at once.
2. DefblitloM.-In these rules, unless the context otherwise requires.-
(a) "Form" means a form set out in the Schedule;
(b) "miscellaneous service" in relation to a passport or travel document includes-
(1) varying the entries in a passport or travel document; (H) making fresh endorsement on a passport or travel document in respect of additional foreign countries;
(ill) issue of a duplicate passport or travel document in lieu of a passport . or. travel document which has been lost. stolen or damaged; (Iv) any other service in respect of a passport or travel document which . the holder thereof may require;
(c) "Ordinance" means the Passports Ordinance. 1967; ( 2II ) 212 THE GAZE'lTE OF INDIA EXTRAORDINARY [P.AP.T 11-
(d) "Schedule" means a Schedule appended to these rules;
(e) "section" means a section of the Ordinance.
3. Passport authorlties.-(l) In addition to the Central Government the officers specified in column 2 of Schedule I shall, subject to the provisions of sub-rule (2) be the passport authorities for all purposes of the Ordinance and these rules. ' . (2) Nothwithatanding anything contained ill sub-rule (1) an offlcer referred to ID column (2) of Schedule I shall. for the purpose of issue of a passport or travel document, exercise jurisdiction in respect of applications 101' such issue made by persons ordinarUy resldlng in the States specified in the corresponding entries in column 3 of the said Schedule: Provi.ded that in exceptional and urgent cases the said officer may entertain an application for the issue of a passport or travel document from a person residing in any other State and may issue a passport or travel document for a period not exceeding six months.
4. Vlasses of persons to whom the classes of passports and travel documents may be mued.--.!fhe classes of persons to whom the classes of passports and travel documents referred to respectively in sub-section (1) and sub-section (2) of section 4 may be issued shall be as specified respectively in Part I and Part Il of Schedule n.
5. Forms of appllc.a.t!Ons.-An application for the issue of a passport or travel document or for the renewal thereof or for any miscellaneous service shall be made in the Form set out for the purpose in Schedule III and in accordance with the procedure and instructions set out therein.
6. FInancW guarantee.-An application for the issue of a passport or travel document shall be accompanied by a guarantee executed in the Form set out in Schedule IV:
Provided that no such guarantee shall be necessary ill respect 01' an applicant in the following cases, when he,- (I) :furnishes a certificate from a Stipendiary Magistrate of the First Class or trom an officer not below the rank of Deputy Secretary to the Government; (Ii) pays income tax or property tax;
(iii) furnishes an entry permit issued by a foreign Government in his favour;
(iv) proceeds out of India under the Indian Emigration Act, 1922 (1 of 1922) and the employer has furnished the required security deposit;
(v) proceeds to the United Kingdom on an employment voucher;
(vi) proceeds on scholarship or :fellowship;
(vii) proceeds on pilgrimage or for other purpose to neighbouring foreign countries;
(viii) :furnishes a tiCket in proof of the journey to a foreign country and return ther~trom. 7 Fee payabieon f.lpplications.-Thc fee payable on every application made under rule 5 shall be at the rates specified in Schedule V. a CoJleetiOn. of lees.-All fees parable in respect of such applications shall be remitted by money order to, or paid m cash .at the coun~er of, the passport Qutl;0- rity concern~d, stating in the coupon or receipt the partIculars in respect ot whIch such fees have been remitted or paid. F' of passports or travel docume1lts.-A passport or travel document iss:~d~~I:. the Ordinance shall be in the Form set out for the purpose in Schedule yI. . 10 Duration of passports 01' travel documents.-(1) An ordinar)l' passport shall conunue in force t.or a period d ';hn~e years from the date of Issue. . szc, 3(1») THE GAZETTE OF INDIA EXTRAORDlNAlty 213
(2) An emergency certificate shall continue in force for a period of six months tram the dane of issue.
(3) An identity certificate shall continue in force for a period of one year from the date of ~
11. Issue of additional paSSports or travel dOCUlllents In special etreumsteneea-« A person holding a passport or travel document shall not be entitled to another passport or travel document unless he surrenders to the passport authority the passport or travel document already held by him:
Provided that separate passports or travel documents may be issued to the same person in respect of different countries if it is necessary 80 to do for facilitating his visits to such countries.
12. Appellate authorltles.-For the purposes of the Ordinance and these rules, the appellate authority to whom an aEpeal shall lie from an order specified in column 1 of the Table below Shall be that specified in the corresponding entry of column 2 thereof:- OrJcrs appealed against Appellate authority I 2. I. An orJcr of the passport authority other than ~l the Central Government under- Ca) clause (b) or clause Cc) of sub-section (;!) of section 5' or . The Chief Passport Officer" Ministry ot
(b) clause (b) ol the Proviso to section 7 j ~ EXt~l oLll Affairs.•New Delhi. Or I
(c) sub-section (1) or sub-section (3) of sec- J tron la. :1.. An order under sub-sectron (6) of section 10 of the authority to whom the passport authority j'l subo-dinate. -} Secretary, Ministry of External Affairs) >- New D~lhi.
13. Fee payable in respect of appeal.--Ev€:ty petition for appeal shall be accompanied by a fee of twenty-five rupees which shall be paid in cash at the treasury and a copy of the receipted challan shall be enclosed with such petition.
14. Procedure to be followed by appellate authorlty.-On receipt of an appeal, the appellate authority may call for the records of the case from the authority who passed the order appealed against and after frlVillg the appellant a reasonable opportunity of representing his case pass final orders . .:.i(..HBDtrLE I Serial No. Jurisdiction ---,--~---,----~--------..--.--~-----. ,------
(r) (2) t (a) Regional Passport Officer, Bombay, The States of Maharashtra and Gujarat, (Regional Passport and Emigration 'Otficx, Bombay)
(rb) Assistant Passport Officer, BOUlbay, Do. (Regional Passport and Emigration Office, Bombay). THE GAZETn. OF INDIA EXTRAORDINARY [PART 11-
(1) (2) -----------------------~-------------, Cc) Public Relatlons Officer, Bombay, (Re The States of Maharashtra and GuJarat. gronal Passport and EmigratJOn Office, Bombay). 2 (a) Regional Passport Officer, Calcutta, (Regional Passport and Emigration Office, Calcutta). The State~ ot West Bengal, Bihar, OrlSSa~ Assam (includrng North East FrOntIer Tract) and Nagaland and the Unron terrrtortes of 'Trrpura and Manipur,
(b) Public Relattons Officer, Calcutta, (Re~ gionel Passport and Enugr ation Office, Calcutta). Do. 3 (a) Regional Pa~BPOtt OfliC::-I, Dclh-, CRegional Paseport :lnd E"fl:~·!"C.tton Office, New Delhi). The UnIOn terrItorIes of Delhi, Himachak Pradcsh and Chandrgajh and the State~ of Punjab, Haryana, Jarnmu and Kashmll'lll and Rajasthan. • Cb) Assrstant Passport Officer, Delhi, (Regional Passport and Emigrution Oin.ce, NeW Delhi). Do. Cc) Puhlrc ReI..ltI011" Officc-, Delhi, (Rcgio nal Passport and Emig':-,tu·tl, Office, New DelhI) Do. 4 (c) Regional Passport Officer, Lucknow, The States of Madhya Pr.ldC~h and Uttar (Regional Passport Office, Lucxnow), Pradesh, Cb)Public Relations Officer, Lucknow, (RegIonal Passport Office, Luck.now). Do. 5 Ca) Regional Pasaport Officer, Madras, (Regional Passport and Emigratton Office, Madras). The State'! of Madras, Andhra Pradesh7 Mysore, Kerala and the Union terrrtones of Laccadrve, Minicoy and Arrundlvs Islands and Pondrcherry Cb) As-ustant Passport Officer, Madras, (Regional Passport and Emigrat.on Office, Madras). Do
(c) Public Relations Offlcer, Mcdras, (Regronal Passport and Emnrranon Office, Mlldra~)., I .,,,,. Do 6 Chief Secretary, Union tcr rttorv of Goa, The UntOll terrItorIes of Goa, Darnan and Daman and Diu, Pan,l). Diu nnd Dadra and Nagar Tlaveli, 7 Chief COtnull',Sloner, U:'lO~l terrlt01 y ot The Union terrttory of Andaman and NIce- Andamsn and Nicob.., Islal.~~ bar Islands 8 Consular Officer in IJn Indian MI'lSI011/Po!lt The area WIttun the Consular rurisdicton 0 . outside Indra. the Indian MiSSIOn or post concerned. M ill!c. 8(1)] THE GAlETTE OF INDIA EXTRAORDINARY 2IS ~C}fEDtJJ F Il i s« rtlle: 4)
PART I-PASSPORTS Classes of Pa-sports Clas~e~ of pej sons to whom Issuable 1 I 0 rdinary Passports 11 ) ficial Passports Ctnzcns of India,
(1) Government officials and non-officrals when their passages are paid by the Government and the members of their familIes i when such members also proceed out of ndia at the expense of Government;
(2) officials of the Reserve Bank of India, the State Bank of India, Corporatrons and Undertakmgs owned or controlled by the State, proceeding out of India for technical tr81l1Ing;
(3) permanent Government officials on deputation to foreign Governments, the UnIted NatIOns Organrsatron and Its specialised Agencies and the members of their farnihes, Provided such deputation l~ arranged through the Government of India,
(4) Government oft1clals sponsored by the Mrrustncs In the Goverllment of India and their departmellts~ for attending mternanonal conferences, semina-a and -neenngs Or for undergoing trammg either independently Or under an) of the scholar- "hJPS schemes tOt the time being in force ,,,here the deputauon out of InJ1H 18 treated <;Iq duty and they are allowed to draw their cutv pRy and ellowances m India; CS') 'in immediate relatrve of an officer be- 'lc.ustitl!~ to the IndJaI1 Foreign Service such MWidowed mother, Widowed motherm-law, dependant Sister, dependant brotner :End not a distant relative such as ~vUElU, uncle or aunt, subject to the condrt.on that the relative 1<; dependant cm the Ofl1~("I and )<; proceeding out of India \v\~-h Et vieW to reside wnh the officer m the place to which he IS deputed. {t)tr.--The following persons shall not be cnutled to the issue of official passports namely '- r .•\ ernpk.> ecs of the Indian Alrl1l1es SOrP"l"atlon and the Air- Indla IntcrnatHmal CorporatlOn, persons sponsored by Government d~f\.ltlment tor attcndlnft inte-natloo.11 confcj-ences, seminars and :r.ectlllgs or for studies or training ourmde India either mdependcntly :u6 'THE GAZETTE OF INDIA EXTRAORDINARY LPA:R.TIl- 1 2 or under any of the scholarship scherns for the time being in force when such persons go on study leave or leave of any other kind; Cc) persons Proceeding- outside India at their own expense on commercial' and other pui PO~C& although a department 01 the Government certifies That such purpose would be to GOVcrnment interest. IlI. Diplomatic Passports (1) Officers of the Indian Foreign Service;
(2) A person having diplomatic status either because of the nature of his foreign nussion or because of the position he holds i
(3) Followmg members of the family of an officer of a person referred to in item (J) Or item (2) above when travelling WIth Or ioining such officer or person at Govej-n-, ment expense s--, Wife or official hostess, as the case may be, husband, son and daughter,
PART II- TRAVEL DOCUMENTS Class of Travel Documents r 2 I. Emergency Certificate Cit.i,r.:ns of India outside India who have been rdused passports or whose passports have been impounded or revokeJ, Perwn~ exempted under secrron z r from the p-ovisions of dame Ca) of sub-section (2) (;1" ~cctiotl 6, H. Certificate of Identity SCltEDULE III (See rule 5) " FORM EA(P) :I. .... Application fOT the issue oj an Ordinary Passport (To be made in duplicate) To The Regional Passport Officer Duplicate appllcation BubnrlUed on-----------through •• •• •• •• •• • ~ _ •• , I I ~ •• • •• ~ •• •• •• •• •• •• •• • • • • •• •• •• •• •• • • •• •• •• •••••••••• t • ~ The, District Magistrate, } Tb~ Deputy Commissioner, , . The Collector. ' , , , . ' The Sub-Dtviaional otRcer, The Commissioner of Police, SJr. I hereby apply for an O~dinary Passport, The pa.ssport fee ot Ra. 115.00bas been remitted by Money Order/paid and the receipt No.... ,., .... dated ... ,',. r••••• , •• , • " ioued at ... ,',", .. ,.... 19 attacbed herewith. TIlE GAZETTE OF INDIA EXTRAORDINARY 217 I solemnly declare that I am a citizen of India and I have not lost, surrendered or been deprived of my citizenship of In ia and that the information given by me in reply to the Questionnaire is true. Yours faithfully, Place . Date . (Signature of applicant) QUESTIONNAIRE Particu.lars and D~ec"'iption
1. Full name, with alias, if any (in capital letters).
2. Have you ever changed your name? It so, what was your previous name(s)?
3. Are you married or single?
4. If married woman/widow-
(a) State maiden name
(b) State husband's or late husband's nationality, name and place of birth and address.
(c) If married to a person who is not a citizen of . India, state place and date of marriage.
5. (a) Place (village. town district etc.) of birth.
(b) Date of birth (attach documents in support, if available.)
6. (a) Permanent address
(b) Present address
7. (a) Professlon
(b) Present occupation giv:mg full details including monthly income.
8. Educational Qualifications.
9. Personal particulars:- 0) of applicant . (H) of children, if to be included ill ihe passport.
(a) Height (in M. Cm.)
(b) Colour of eyes
(c) Colour of hair
(d) 'Visible distinguishing marks, if any. Full Name Date of Sex l' r.;~1 bIrth· 1'.
2. a. .ol • •Please attach three certified copies of photographs (size approximarelv . 3.5 Cm X 3 Cm.) .Bnd a birth certificate of each child
10. (a) Fath6r'lI name
(b) Place and date at birth. If the date at birth is not known, approximate age ;u8 THE GAZETTE OF INDIA EXTRAORDINARY lPART I1-
11. (a) What was your father's nationality-
(i) at the time of your birth? (It) on the 26th January, 1!}50?
(b) It he had acquired alien nationallcy when did he do Ba? Particulars of any travel document held by him.
12. Mother's name and place and date of birth?
13. How long have \IOU been conunuously residing In IndIa? .
14. Have you at any time resided abroad, including Pakistan? State eo....al!.rieu and periods, It resident in Pakistan. date 0f migraticz, thererrom.
15. What was your occupation while residing abroad?
16. Were you ever repatriated at Government expense from any cccr"b'y at':t·c·ad? I.i so, give j!miculara and state whether yeu bave reimbursed me expenditure Incurred In connection with such repatriation giving da'to and place G;~raimburnement,
17. National Statue:
(a) What is fOW" naHt:l:1aEty?
(b) Are you a citizen of India by birth?
(c) Are yoc a e~ilit:Il.:-l Ir.diu t·y re' :1strationl t ali L' ? ~f t: - ..~;.na ur ~~HWll .•:.. 10, a ;aCll ctJn:..:J..C8'Ui'.
18. Did you evsr :10r.'i'HS' ;T:,-' (,",hrt:" nr.~ir,nr.litj·1 if so, what?
19. Have you (or any :your of children, if to be included in the P&'!l.iport) t,~i':ilconvicted by a court in India tor any offfn.('o;' an.I f'~ntenced ';') mpriBOnment for not less then t'?70 j'e6\rn, It so s1ye date and particulars. Have you (or vour children. if to De included in the passpm:t) lk:c.: Ivi c~eIl l~.~~':'","'::Gi;:.. t. passport or travel document cefcre? If so, &:1.veparticulars (number, pls ':! and date of Issue). l .•.ave the particulars been. df>It'!te~ ~r.U:.e 'l:)a~:Jr(':-:'t (Jr t.r::wel document and tf' ,".\ h:~ 'Tl\O!U?' C!'l~ ~v~'.~~n,:ein support. I
20.
21. Have yO~l ever s.p.•..Iied for ? p3S~O':t'! If so, give the follovrL~~ :'ltt!( l.,Jl.?::"S: IL _I.
(a) Au"i.h9i ty ~I') whorr: anfl·!irf.!UC·l; WplO .:t!.bde.
(b) Wh~tt~ubiaS&po! t W"':J i&l;u..:uh .:.fu:sed.
(c) 11 t...1cmed. ~h?~ p;s~p(lrt v·~·Hr;u:.-...'s.
(d) Whether the passport was ever Impounded or r('vok.~do
22.
25.
24. N:ur.e~~••~ ."':.mtrW.l' ~I;~whirr. 1198.'!1)ort is requiredt Wbl'.t 'h tb, }YF,rq;,?, ,,{ y.:'.'~ "ih~:": r'~.~,;.,'I'" Ho~ dr; :H)U f!r'::':J':''.'~,.J 3UJ::W!''t ::'v.xL'w:f Ind1&T outside \ SEc.3(i») THE GAZETTE OF INDU .k!.XTRAORDINARY 219 ===:;-;:--:-.---~====~
26. Names and addresses of two responsible persons in your locality who would be prepared to vouch for you. Verification Certificate J hereby certify that I have known Shrt/Shrimati/Kumari son/wife/daughter 01 for more than two years. The appIJcant is financially sound. J have satisfied ni.J'uen t~.at the partk::.ltU·!j ~ul'.nhh~d in the passport applies· tion are correct to the besc of my kz.owledge. I regard the applicant a suitable person to be considered for the issue of a passport. /, ••I Office , " Telephone: Signature .•..•...•. NM'1e in block letters: Designation Office Seal: Residence ..•.•.•......... Place ". 9_. ~ Date . Caution: This is an important document ano snourd be signed after due consideration (,to -be signed by an Officer :lnt below the rank of Deputy Secretary OT Stipendiary Ma,~istrate First Cl8.8B). --------------~-----------------. ------------------------------- Remarka!- Signature , . Date . Seal S1enature ...•..••.•...• Dlltp. ...•.....•..••.......... Seal (Orders of Reqional Pasmort Of/f.CeT) Seal Signature . Date ............. 220 THE GA7..ETT[ OF INDIA EXTRAORDINARY [p,uy 11- ScHEDULE III (See rule 5) FORM EA(P) 2 Application for the issue of an Ordinary Pas8I OTt (.~t b::ha~t 0: ..L ~t:·J:) •.t ")eIow 18 veaTS of age 'To De mad iu uuplicate) To The Regional Passport Orficer, . Duplicate application submitted on.---- through Tre Tt\(! The The District Magistrate, Deputy Commissioner, Collector, Commissioner at Pollce SIr, I. the undersigned .. .. ... .. ... .. ... .. .. .. .. .. .. .. ., ... .. .. .. .. residing at ... .. . .. .. .. . .. .. .. .. " .. " .. .. ... .• . .. .. ... .. .. hereby apply tor the Issue ('of a assport to .......................................• of whom I am the parent/legal guardian. I undertake to be entirely responsible for a~~his/her expenses. The passport tee of Rs. 15 has besn remitted by Money Order/paid and the cash receipt No dated issued at is attached herewith. I solemnly declare that Sbri/Kumari , is a citizen of India and he/she has no, lost. :;,' r i1(1.l'e;i OL' been deprived of his/her Citizenship of India and that the information givf;!n h respect of him/ her in reply to the questionnaire is true. Yours faithfully, (Signature of applicant) Place Date . '. QUES'l'IONNAIRE (N.B.-Items 1·13 below relate to the person on whose behalf the application is made)
1. Full name, with ali~ if any (in capital letters).
1. (a) ~f there has been a .:':1~!1~e'JY.~E_~ H~, State previous name.
2. '(a) Place (village, town. dlstrict etc.) , of birth.
(b) Date of birth.
3. Address in Indh. THE CAZETIE OF INDIA l!X.TRAOIUlINAkY 22l
4. Personal particulars:
(a) Height m cm,
(b) Colour of eyes .
(c) .Colour of hair . (j,) Visible dlstinguishlna' marks, It any ................................•...
4. (a) Educatlor.al quallftcatlon (attach attested copy of certificate, it any). ~. Father's name, place and date of birth, and nationality at the time of birth of person on whose behalf appltcatlon Is being made.
6. Mother's name, place and. date ot birth, and natlona- Uty.
7. Husband's name, pl~.ce ~:mG.date ::.: birth and nationality.
8. Length Of continuous residence 11.1 India, with dates and places ;::-t resldE!'nc~.
9. Has he/she at any time resided abroad including Pakistan? [,te.tt countrlsu and. ',cerlOds. If resided In Pakistan, date of migration therefrom.
10. National lstutua.
(a) What is his/her nationality?
(b) Is he/she a cltrz sn (/: Inuia 'uy birth?
(c) r s ha/ she a citizen of India by registration' naturalfzatton ~ I:l so, attacb -erttncate.
11. Did he/she ever hold a passport or travel document before? 1f so, l.ive particulars (number, place ana dab of Issue). N.B.-U still in his/her ,OS5e1.l icn, the passport or trs, VI::] j(' U111!"llt 3hol~~'. b- attached to tbls application. If not. state what hEJ.~ happened to It.
12. What is the purpose of the visit sbroad? Give full details,
13. What 1~"tne country ot final destination? What i countrtes will he/she be touching or passing thl:ough?
14. Has he.'sr.'0 :'een C('.!lvl.c::ed [''Y a court ill India for any ol!ence and sentenceu 'to imprisonment for not less than two years; If ~), give date and parttculazn.
15. Names and addresses of two l'''ISponslble persons In the locality who W'JJd be prepared to vouch .tor the appH.:-ant: (i'j (2, Spetimen !...!gtHr:ur:! ~f the !;~!:lun on wha3~ behalf the apollcaUon Is beln~ made. TH GAZ£TTE OF INDiA I..:XT ORDINARY [PART II- (For OfJidal use o'd1.') REMARKS:- Seal Signautre ... " • --.1 D'l+'e .. .. (For U8e of Pl'.1U-=:O'1' vf Emigrants) 5~./!.tlautre ... " ,.. .. ., ~" )) +,e .' •• •• ., •• • •• (OrrJ.ers of Regh..i-._-.1P :~spoTt Offlcer) :Seal Signautre . DQte ... , .•..•.••• ~.. Scmmuu HI (Sp.e ule 5) FORM E..A (P) 3 Application for the Issue of a Diplol·;.atic PM$pOrt/Of]icla.t Pasport. ,1. (a) Surname (in block letters).
(b) Personal and/or other names, if any (in block letters).
(c) Aliases, if any (in block let/~~rJ).
2. Profession.
3. Present appointment.
4. Permanent home address. f5. Present addre su. ~. (a) Place (vjtIab~) town dL.trl..:" atc.) of birth.
(b) Date' of .'birth.
7. Father'sjhusband't; name a Personal Partlcular S:-
(1) of applicant ~a) Height .
(b) Colour of eyes ., .. .. .. (.~) Colour Of hair .. . .. .. .. . A Cc j V.bdble distlngulshlni marks. if any 810, 3(1)) THE GAZETTE OF INDIA UTRAOllDlNARY : =-
(11) of child! children, if to be included in the passport. Fun name Date of birth Sex
1.
2.
4.
3. • • 1 •• •• ~ , •• I • • •• •• • • • • • , , , • • • •• •• •••• t ••••••••• .o. I I ••••••••••• !). Particulars of passport, if any, beld at present. N.B.-The passport should be submitted together with this application.
10. Countries to be visited on official duty, with the exact nature of the duty and duration of stay; Name of country Exact nature of official duty Period of stay giving approximate dates ] 1. Mode of travel and route; Place Date •••••• , ••••••••• n •.•••• '" •••• , •••••••••• I ••••• I I • I I • I , , • ,. I •••••• , • I I ••• SIgnature of appllcant "" ......•...... (To b~ lled it appltcable) I certify that ., I I ••• I' ••••••. 11 " •• , • I ••.••••••••••••.•••••.• , •••••.•••••••• ~ •••••••• . (tull name and designation) Is proceeding out ot India on omcial duty as indicated under item 10 above. Place Date ••••••• 11 •• I I'., _ •• • • " ••••••••••••••• " ••• I •••• " ••• 4 ••• Signature of Head ot Office Designation .. , . SpecImen signature 9f applicant. THE GAZETTE OF INDIA EXTRAORDINARY [PUT ll-
SCHEDULE III (See rule 5) FORM EA (P) 4 Application tor the Issue of an Emergency Certificate It the undersigned at present residing at , , , hereby apply for the issue ot an Emergency Certificate for travel to mdla. I solemnly declare that I was born at . .. . .. .. on ,.f••• I am a citizen of India. I solemnly declare that an the r-artrculars given by me in respect of this application are true. r hold passport/travel document No . dated , ,... issued at . by ,. .,. which Is surrendered herewith; or I do not have any passport or travel document. Presonai Particulars
1. Full name, with aliases, If. any (ir. capltal letters).
2. Have you ever changed YOUl:" name? If so, what was your previous name?
3. It married woman/widow
(a) State maiden name
(b) State husband's or late husband's nationality. name and place at bj:.rti.l.
(c) If married to an alien .• state »lace and date of marriage.
4. (a) Place (Village town, distrjct etc.) of bIrth:
(b) Date ot birth:
5. Present national status.
6. Name of father
7. Profession.
8. Address in 1~~dia. g. Address ah~3rJ·
10. Heigh'i,.
11. Colour' of Hulr.
12. Colour of (;.Yoci3.
13. VisiblE distinguishing marks, if. any.
14. If held a 'pb.o~j)()li or travel document and not surrendered ~nlong' wi'h thln ~p~.~c?t.l0 1 the reasons theretor.'. . .... " " " . Specimen signatUre o~ .appUcpnt .. .. . . " "" " . S~.~;'1ture ot applicant Date . Particulars ·of child! children below the age ot fifteen accompanylni~- Name Oa(:1,; of bi th sex Sl';C. !(1)] THE GAZETIE OF' INDIA EXTRAORDINARY SCUEDULE III (See rule 5) FORM EA (P) 5 Application for the Issue of a Certifl,catp. of Identity I, the undersigned....... . . . . . . .. " . . .. at present residing at .............................................. hereby apply for a Certificate of Identity for travel to . I solemnly declare that I was born at . on the , . I am of , , , nationality /stateless, and have not obtained a. passport becaus.e .....................•......................... I solemnly declare that all the !)articulars given by me in respect of this appU- cation are true. I further declare that I have no other passport or travel document in my possesslon, I attach the following documents:- Residential Permit. Three unmounted Passport size n~loto<~rllphs---<>ne copy duly countersigned by the Local Police Authority. PersonaL PMticular8
1. (a) Surname: (in block letturs)
(b) Personal and lor other names, it any (in block letters) .
(c) Aliases, if any (in block letters)
2. Place and date ot birth.
3. NationaUty of miifn.
4. Present National status,
6. Name of fnther,
6. Name of mother.
7. Prefesslon.
8. Present occupation. 9· Period of J:e3~d~Il'::'-= in India..
10. Last permanent address abrcad.
11. Present auuress-
12. Height.
13. Colour or hair-. "
14. Colour 01 ,eYG8.
15. Visible dlsungulshlng ma.rAll, if an)". " •• fI •••••••• I •••••• " • " •••• ' at' ~ Specbnen sienature of. appllcant. Particulars of child/d1l1dren bel0W tne Name Date of birth ' Signature of applicant Dated , . ge of fifteen ac<:ompanying:- Sex THE GAZ!'.TTJ!. OF INDIA EXTRAORDINARY lPAAr1I-~====================~========~=====- SCHEDUL~ HI (See rule 5) FORM EA(P) 6 Application for the Renewal 0/ a Passport or TTaveZ document .NOTL-ApplicaUon for renewingthe period ot validity at a passport must be made direct to the passport. 8..J.i.ho.dty in India or to an Indian Mission Post outside India. I I the 1mr1~rsjgnedat present residing at.. ................• hereby apply :for renewing the period of validity for a further period of .........•. Y~lU'(8) ot passport or travel document No•................... issued to me at . on the . I have paid the prescribed f~e In C98h at the counteryrernltted the fee by Money Order and Receipt No. dated .. '.................. issued at .. , , ........• 18 attached tor r,~fe;:t:\nce. ·1 declare t:imt 1 have not iost or surrendered my citizenship of India since the above passport or travel document was issued to me. t solemnly tlHclsre that an the pa:rtir.ul~r.'l £1ven by me in respectof this application are tnv:, 1 further declare that r have no other passport or travel document in my possession. Particulars of AppZicantt
1. Full name .:In block ]ett'!r.:) ."--
2. Place wd durt:';:,1 1::trth ----_ ..,. -~., ..-------------~-~--
4. Profession and present occupatton,~--~-------~------ (Give 6~tail&)
5. Whetbflt' man ied or singl~
6. It married woman/wldow i->
(a) Mait.,~_, ~lmlAt..'----"-·--·-··-·~--~·-------------
(b) Husband'a/Iate husband's natlonanty, name and placeof 'Ok _h-- ' .• - ._--. --- - • - --- -- -- -
7. PUrposefor which Reneval IS e4uired,-----------------·-~_. ,--...._ ...._-_ ..---_ ...._._- '--------- Date----~-- (Signature of applicant.) -To be t1He:l or! WSJena~~dc"-i";le. SClf£DtJU'; III (See rule 5) FORM EA(P) 7 .4pplicatio1l. jar add1t1anaL endOT3ements
1. Full naL.lC -.._------ .-- ..-~--- 2a Sorl/wJJd/d&kgll.ter of -----"~ ~ ~-.~-
3. Address _~ •• u· __ • ~-
4. Pro£~lJg10r ~.' Present cr-::uI'pt!on' -----. (Giving full details) --_..-- .--.---------~- , THE GA7.ETIE OF I mI. Q(.TllAOllDINARY
6. Educational qualiftcatlons- 'j Number, date and pl ce of Issu of 6Jsport{travel document held and date upto which it is valid --- -----------
8. Countries for which valid - ~-- 9, Country/countries for which additional endorsemerr; ~',~' I ?qutred ~ - -' - - ID, Reasons for addrtional endo sement asked for ~--~---~-- 11, Amount of fee, it any, paid and particulars thereof ---.--.---- --- Dated ---- - -- _.-,-- Signature of applicant. Sr. ;;r,ll.); fl, {5'cm'r "1) PeRM J!A(?} 8 4!.pUca.tion tor m C(!IW,1l-eO/JSservices L Full name -.--.-----------
2. Father's/husb9nd's name.
3. Address
4. Number, date and place of if/QI':- ')~ • 9~ort or travel document h Id and date Up~1,)W ul:h it continuee \) fOI'CI"
5. Nature ot service required
6. Amount or -:B~',if aur, 'tJaid and 'iHrtiCt lars thereof --------- Date ---- ...-----. Slgnature ot applicant Scaa.oULE III (See rule l)) A pplication for the iss~e oJ' a new p<LS8po.n. 01 travel document when aU the pages of the pasbI>or~ .;;t ~rtl.1,8t do. tu;',!! ,t :.cl..:' b"./ the appLicant are used up.
1. Full name .A - --------------- •
2. Father'f:f.husb.and's name ----.-- .---
3. Address -
4. Number, d~.ta and place of 1651.1 . 11 31': oort or travel uocume t hf'i"t ana ri 1p u ti v."'If~h.it continues i:r~ o: e ----~--------
5. Amount of fee. if any, paid in ~ ..1t. ·jet. ls rs thereof Date -- ~-.. -- - ---- Place ~-~--~ ..-..:.~--- Signature of appltcant l'HE GAZETTE OF 11 'DIA EXTRAORllINAR y [PAin U-
SCHEDULE III FORM EA(P) io App~icC1tioll jor tue I$~ue 0) a duplicate passport or tr(tt'el document in lieu of the passport or trcswt ('or-lImp?'!t which has. been lost, stolen or damaged. To be mad., n u(.1-licate) 1 Full name
2. FQther's/h!t~band's name
3. Profession
4. Place and date of birth
5. Domicile
6. Height " M.. Cm.
7. Colour of eyes
8. Colour of hair
9. Visible di5tingu1shinll mark. if p,rl~'
10. Number. date una. :plac~ of i~!,:;1';; of Passport Or travet document held, date upto which It wouic continue in force and the countries fur which it was endorsed
11. State briefly the clreumstsnces under which the passport or trave; document has been lost, stolen or damaged.
12. In case fA 10,;1 or tht1it attach p copy of the report in that regard sent to the police
13. ParticuLars 'Jf f!hi!d/ chHd1'en in.duded Narne Date of birth Male/Female
14. Address Dat<:> Signature of the applicant. Pla~f.! N.B.-The: Cil)I}U:~QnOl\ ;;~Ii)'L~hl~"! a::<'•.w.I· Ilie( by three copies of passport size phoroa:rapl!s. Specimen slguaturc. FORM Cif GUARANTEE. " -..:.,Xo 'le eX(l'c1..1.ted on ncn ;1\dIdal stamp paper) wife/ son/ daughter ot is desirous ul proceeding abroad accompantsd -by h!s/her* ---- -- '~--'--.-----~ Whereas 1/ we the undersigned ----- do hereby agree nod undertake )oLI'J.Ly and severally co AJt"rvlde sultable maintenance tor and pay. the travelling ,~X'Dens~$ of till. :l'~id-- .- - -- - durlng the period &le/she/they shall he abroad snc, 1.1 Lie event or my/our failing to provide or cause to be j,")~("" k,l. si.eh t: -IH: tIll?, 't! .1.: t.rrwelllng expenses as aforesaid I/we joint;y and SE:!V.:=l~jJy hereby asre- to I18:' to t;)1I!' President of. India and his IIUCCI!BIIOrs in OffiC9 a'.'"d 1:I'":,;.l..!r·)~ I ~t.Freil)."fte.L caiied "the' Government of India") all such costs and expen:&<':':fjU~ l'i1<lY bt: Incurred Dj" 1.11!.! C,_ -emment of India on the maintenance and repatriutlo» o.~ t,t..;. said----·---,--·-- --- wife/children in the event of . hh;/her /thelr I' patr! ation to India. 'ire..3(i)1 229 In the event of thr- said ' dying abroad, I/we hereby undertake and agree to reimburse to 1.he Government of India all such costs and expenses as may be incurred for her/nisitheir burtat/r-rernatlou. And it 18 hereby further ::tgre.::d by me/u« Jointly and severanv .v-
(1) That th» Go -ernment said - propr-r ~r1(1 ot Tndi a ~hpll be at Uberty to grant to the such indulgence as it may think without (ljs('~arging er impairing my/our liability hereunder, (U) that the authorrty to determine the costs. charges and expenses ill such .case referred to above s all rest exclusively with the Government ot India and that it shull be bindu .•g on me/us and my/our heirs, executors, adrninistrators, and \e,7;3.] representatlves as a continuing guarantee to :~rtY SI en costs, ('harge, and :;x,?ensE'S us may be determinerl by thf! GO-lcrnmf'nt of India, without question Signed by th, g'!nr.Jntor.-- (l)~----------- Address-------------------and Andress-------------.on the --------,day 01'---19 III the presence 01:~ Place of execution of guarantee tl)I------~~----- Addre6s--~-------
(ii)I-------------- AddtesB-----~---~- "Here insert the names of w.te nn{.' er 'wife .md children, it a joint passport Is tu he issued. IV.B.-This form mu" t be '-I { '('ompa'1iec1 by:- (J) a .certifi'cate from the appropriate> l'i.evenue Authority giving the value of the immovable prcperty in the oossessioz, of the signatory /sijplatories, ur (ii) a certificate from d ounk giving the period during w hlch the signatory zsignutor ics hq~:(11;3,/(' been their client/clients, the amount at his/her/their credit at ttlie' ~ilIie ut' h.i.:l/her/their signing the guarantee and the period during which this amount has been at his/her/their credit, or I,Hi) if the' i[;1HHory /3ignatories has /have a regular fixed income/ incomes, a certillcRte from the head of his/her / their department, firm. etc , giving his/her';'fn Ir monthly income, .
(2) ,\Vor-:,l.0lPh·3~E'S ~v;1 r.•'Jplic$ b: (' in the fo ra should not be reproduced 1J) . the guarantee. "
(3) The '/dUf, of th« n(':l-J'.dii ial :.1~~mp paper will be as specified in th<:' 8/s.mp Act In for'." in ~ ~.:,'1t-~ ""hE":! tl:i}~ Bond jq executed, T 1£ GAZETTI OF INDV F..XTRAORDlNARY [PAJl.t JJ- t.See rule 7) Schedule of fees payable 'i,n Tfspeci: of appticatwns for Pf'l.SSP01'ts and trQ1Jela.n ~ m,:/!'ltt,j
1.No. Particulars of nprUcat,()U Scale of fees ------~...-- ...-...•~.----~, ..........._-,,-------------
(1) ----------------------------------.-----~------------------------ I Ordinary Passport Rs, 151ft 2 Renewal of Ordinarv Psssnorr RB. 6/- for three years or Rs, 2./- per year or part of a year. 3 Duplicate Passport in lieu of the rdinerv Passport which has been lost, stolen or damaged Rs, 1<; I• .~ Emergency (.tl't:.i1cure . Rs, 3,'- 5 Renewal of Ernerg-ncv Cem.'k,te Re. I r~ t) Duplicate Emergency Certmcatc vn ,I.: l of tL: Emergency Certificate that has been lost, stolen 0 -::"o~!,er1, , Rs. 31- R9. 10/- !i Renewal of Certificate of Identn If Re. 2./. per year or part of a year. " Duplic ••.:c ~~~\.'.:.i,,1t,~c M !w,:",:,~.~.1;:',! 0;:1••• c-i~hf Ceruficate of Idennty that has been L~\:. stole(, '1:"' ?~m£l~~d, , ,. Rs. 10- 10 Additicnul ::11d~)l'~~:ner.·~,0:', ,,::,','''. 1i'1"n ,?, sport, Bmcrgcncj Certificate, Certificate of Identir~. . R5. zl- S'::l EDI1Llt V1 . " Emblem These are to request and recuire L". '~':-.::;.r!mle of the President of the Republi(' ot. India nnd all those wh,j!<)1',; il.Ily I.,Vu.;Clll to allow the bearer to pal'S freely with- . out let or hindrance .. tP1Q 1(' f'lf" _ ',•• ()~ "1pr "'JFry assistance and nroter-tion of THE GAZETTE ()lo I:"JDJ.\ 1'-~ rRf\UkUl~,\RY - - - ~. which he or she rnsy stand in ne-( - - ....- ----.&....--_ ..I' nf ----- -- --- --.- 1f}f----, By uTdu' uL tile President of the Repuhlic of Jndm --- -~-----~-- Tmfl Passport contains ;~2pages DIPLOMATIC PAss.rORf}'iOFP~Cl.'li. PA:lSPORT 'ORDINARY PASSPORT PTliIA No. of Pa6sport Name of Beart'f Aceompanied by his wife (M~lden name)-------~~-..-- AND ( t_ilLDREN '~AT10NAL S'fA'fUS Professron Place and date of birth Domicile Height M Cm. M. (;.Dl. Colour of C)'L'S Colour of hair Visible distingu~shing ..~nI;k8 CHILDREN NBmC .... .. . .... I.,. * • • • ~ I • • • • • • ~ -oj • • • • I •• [1> \RI 11- I'U JfOG]t'.l tl 01· ilEA}U:}, PHOTO Signuture of bearer WIFE .------------_._- .~-.-.- PHOTO .-~~--_\ (P ~e 4) Countries for which this passport is \'1'.1. J Unless renewed. the validity of fh s P ••1)!;,,; ...•;t expires on issued at . Date . -~'- - - - --- (Pa.sre 5) Home address Permanent address in India: (Inc)uding village or tOWJl, district and Slate) • ,., ••••• ~ ,. .' • • , •.••.• 11" •.•.••••••••••••.• Name of Father/Husband and his full address (Including vtllage or town. district ~l"-C fl:l.~) ,. '. ~ . . '" . OBSEP.'V A TIONS ..~----- --- - -----' (Pa~e 6) RENEWALS--- ..._----.....--.-- ------ ---.- - -.-- .- - --_ ..- (P~I;~E'S' ·0 29) 'ill.:J.f"iS THE. GAZETTE Of INDIA 2.XTRAORDlNARY ....,- FOREIGN EXCHANG[ F-OR •., AVELLING EXPENSEs Nil entries to be made 1l!1this page except • an authorised dealer in toreign exchange Date Country of t ravet -:'lll' which exchange has been sold )\-)1 1U;\ - issued or refunded (Sterling or J upee quivalcnt to '. a'~· £ Or Re.) ------------------- ----------------- 1 Stamp and signature of Authorised Dealer selling , exchange. I-~---- ---.------- -1------- I NOl'E: L The colour of the cover of the Diplomatic Passport booklet shall be maroon with the words "Dtp.omatic Passvort ' inscribed on the front cover. NOTE: 2. The colour of the cover of the 01 cial passport booklet shall be ~rey with the words "Offkil1: Passport" .nsc .•-":r r' 1,\ the front cover. NOTE; 3. The colour or the cover of 1. ••• Orowary passport booklet shall be deep blue with the words "0 dinarv Passr-ert" l•..•C;r.f~1 ed on the front cover. SCIU''!>Ut~ Vl FORM OF EMERGENCY CERTIFICATE Er li"'f. E1VIF.•RCENC'" C-:::Q1'rF'ICATE No. This is to certify that " .. . .. . ... .. .. . .. . . .. . has applied to me for the arant of an Emergency CE"rtitlc"lte j)\")t1 that I have no reason to doubt his / her statement. Signature of passport authority Seal Date . IP?t{e ? lr n~~CI'jptiv_~
(a) Profasaion .
(b) National Status .. . . , .
(c) Father's/Husband's name " ..
(d) Place and rlat~ of birth . .. ..
(e) Address in India .. , . . . . . .. . ....
(f) Visfble distinguishing marks, if ar , .............•..
(g) Helght "; .
(h) Colour ot hail' : .
( i) Colour of eyp.s .. , , , . .. ." .. THE GAZETTfi, OF l~DTA. EXTRAORDINAR.Y (PUT U- :--"'""-----:-. ..,....~-~ ..-=---------=~- =="""'==:-0---::-:,.. ~ - -- -=- ..•••==='"""_ --===-""'=""""=-"==-==:-:=r==-- .. a:::za: ~:z::::="" J. o. Tln,-' holder i.~ aC:';,)ffip,l£Ht!d U" a (; 11 I .... are given below: .t \ children whose particulah. Particulars ot child/chlldren. ----.. -~----~------S. No. ", • Ill7!t StX --- ..~--- ..----------------4J.I.t; vf birth 1 ..)............ '" o .,) ••••••••••••••• _0 ••••••• 4 . j.-..._-----! I j 1- J Photoarapb of holdet" S~atute of holder o This cel'tHlcate Is enl)' t,- •• lid "or: tou 1'e,' to... . . . . via , ' . ...•. . .. Unless renewed. the alldity of UP I'·:l'.;it: expires on .: . Renewed up to " '" , , . Issued at " . . .... ,., , ". Date ., , ~ ';.' __ • __ ~ ••••• ,.- •• ~_ •• L 4 __ N.B.~Tht! p'lf'Se'8SI(}'1 of PllS Y.".l"w· . "''';' Certificate does not e."tempt the holdtlr trom compiiance wit any Immigru.Iou r Iattons in force ill the country of destination or from tne n'ere~8ity of l' . ,1 i a visa when required. S~JLE VI (Su .ule 9) FORM OF cERTIQ' '," TE OF IDENTITY \.•..l'o. ( over) oov u .!J!vl_iJ.·d' OF INDIA ,!'.1. '~tn} C?'"::;.T'::::FJt;L\' ~ :JF IDENTIT~ ID~ 'r~:".•._ Jo.triFICATE This certificate is issued for the s. . ')ul'Pose of providing the holder with I Identlty papers in lieu. of a i'l~lio:ml .VI!!.-if '.ft. It is without prejudice to and in no way affects thP. i:ul~i:"l;'1 ctatus et ~h~' ,1'. It the holder obtains a national passport tbls' cutin. ~\:.:! ~e.~.JS tc t(-. \/;.'.:1 ur.c, must be surrendered to the nearest Passport Authcl'it,v in lndl:.: c' r.n lr : .:. !.:l~:.l::'z~or Post outalde India. ')ao !I(i) J THE CAJETl" ~ )." 1')J EXTR.\ORDINAllY ------: -- -.-=-=---=-=.-::--..:-= ----_. - .-----=-.:;;- -'-:==-========== Thi! certiflcate 1:3 valid for tr a el io Countries mentioned at page 5 and its validity expires on . Place ..... " .. (SIgnature and seal 01 Passport authority) Date -.. ----- -._----- Th1B Certlftcate ,e: lie: tl':;f vontalns 13 P8ie9 CERTlFIC. T INn lA IDENTITY No. ot Certificate ut :de'lt.!t',V . . Name of holder . ~ atlonality m: Ofi.,2.uj •• ~ • I ••••• '. • •••••• ~ •• • I ••••• to ~ • •• • •• • •• •• • No P':!TWr..<:. . . ~~ipion Protessfon l):..te of birth Piace of birth Height Colour 01 hatr C01/)11T of eYe!! '!'fo. abroad Nb. I ' . .children WhOM pef'tlcu ten are THE CAZETTE OF IND£c\ . .EXTRAORDINARY [PAt:l II-SEc.!I (1)J S. No, Name Date ot birth
1. ", 2 . . , .
3 ... 4•..... tl.... Si&nature ot hulder,------- ----- - - /PHOTOGRAPH OF HOLDER ,-------- --' - --- (Page 5) No, (Pages 6 and 7) No RENEWALS No. VISAS [No. F. VI/401/26/67-VoJ. 11.1 S. BIKRAM SHAlI, Jt, Secy -------------~---------- PRINTED IN INDIA BY THE GENERAL MA:KAGER, GOVl:ft!'Mnl:r \1M: JNDIA PRESS, NEW DELHI AND PUBLlSHt;n .~, ');'" M'-·.~.GFR OP' PUBL~ATIONS. -..,llELHI, UI67 mw ChT'1:1\J1Q5I J.R1T'CWUT ~-II m-3 \3Q~;S(i) FcR;~p:j511<'111 ~~.10~1967 m.~.f.t709.- QlflQl20 ~~~T, 1967 (1967 QiT 4) cfit 'q"RT 23 &RI' ~ ~TfC'RI<:ITQiT 'WWT ~ ~ $tn:r fl'!ChR Q(1{;tI'!1PP:41~~(1 PtIn:r ~ '6, 3f~:-
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