04/01/2025, 11:46 Application Form
PASSPORT APPLICATION FORM
Government of INDIA, Ministry of External Affairs
Service Required
Application Reference Number 25-1000145787
Applying For FRESH
Type of Application NORMAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name KAVYA DHARSHINI RAMANATHAN
Date of Birth (DD/MM/YYYY) 18/12/2000
Validity Required NA
Place of Birth (Village/Town/City) SIVAGANGAI
District SIVAGANGA
State/UT TAMIL NADU
Region/Country INDIA
Gender FEMALE
Marital Status MARRIED
Citizenship of India by BIRTH
Employment Type OTHERS
Is either of your parent (in case of minor)/spouse, a
N
government servant?
Educational Qualification GRADUATE AND ABOVE
Are you eligible for Non-ECR category? Y
Aadhaar Number 212344434796
Family Details
Father's Name RAMANATHAN
Mother's Name DHANALAKSHMI
Spouse's Name GANESH LINGAM
Present Residential Address Details
78-1,INDRA NAGAR,ILAYANGUDI ROAD WEST, SIVAGANGAI, SIVAGANGA,
Address
TAMIL NADU
PIN 630561
Police Station SIVAGANGAI TOWN
Mobile/Tel No. 9488705746
E-mail KAVYAGANESH22122@GMAIL.COM
Permanent Residential Address
78-1,INDRA NAGAR,ILAYANGUDI ROAD WEST, SIVAGANGAI, SIVAGANGA,
Address
TAMIL NADU
PIN 630561
Police Station SIVAGANGAI TOWN
Mobile/Tel No. 9488705746
Emergency Contact Details
Name and Address GANESH LINGAM
Mobile/Tel No. 9488705746
Other Details
Enclosures
1.Transfer/School leaving/Matriculation Certificate issued by the school last attended/recognized educational board
2.Aadhaar Card (Address Proof)
Self Declaration
I owe allegiance to the sovereignty, unity & integrity of India, and have not voluntarily acquired citizenship or travel document of any other
country. I have not lost, surrendered or been deprived of the citizenship of India. I have not contravened any of the conditions relating to
the possession and use of an Indian passport.
I affirm that the information and particulars given by me in this form are true and correct. I further state that I am not suppressing any
material information in this regard. I further affirm that the enclosures and documentary proof submitted in support of my application for an
Indian passport are authentic and solely pertain to me and I am fully responsible for the accuracy of the same. I am liable to be penalized
or prosecuted if found otherwise. I am aware that under the Passports Act, 1967 it is a criminal offence to furnish any false information or
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04/01/2025, 11:46 Application Form
to suppress any material information with a view to obtaining passport or travel document.
I have read and understood the contents of the above and by submitting this form certify that all the information submitted by me in the
form is bonafide.
Place SIVAGANGAI
Date 04/01/2025
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