PASSPORT APPLICATION FORM
Government of INDIA, Ministry of External Affairs
Service Required
Application Reference Number 25-1000683133
Applying For FRESH
Type of Application NORMAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name KOMALA GUNNALA
Date of Birth (DD/MM/YYYY) 01/01/1968
Validity Required NA
Place of Birth (Village/Town/City) WARANGAL
District WARANGAL
State/UT TELANGANA
Region/Country INDIA
Gender FEMALE
Marital Status MARRIED
Citizenship of India by BIRTH
PAN CTUPG9482K
Employment Type OTHERS
Is either of your parent (in case of minor)/spouse,
N
a government servant?
Educational Qualification 7TH PASS OR LESS
Are you eligible for Non-ECR category? Y
Visible Distinguishing Mark A MOLE ON THE LEFT CHEEK
Aadhaar Number 293676265094
Family Details
Father's Name UPPARAPELLY KOMURAIAH
Mother's Name UPPARAPELLY LAXMI
Spouse's Name GUNNALA BHIKSHAPATHI
Present Residential Address Details
H NO:11-1-135, LABOUR COLONY, WARANGAL, WARANGAL, WARANGAL,
Address
TELANGANA
PIN 506013
Police Station MILLS COLONY
Mobile/Tel No. 7093265421
E-mail GUNNULARAMAKRISHNA198@GMAIL.COM
Emergency Contact Details
Name and Address GUNNALA BHIKSHAPATHI, H NO:11-1-135, LABOUR COLONY, WARANGAL
Mobile/Tel No. 9701045141
E-mail GUNNULARAMAKRISHNA198@GMAIL.COM
Other Details
Enclosures
1.PAN Card issued by the Income Tax Department
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 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 WARANGAL
Date 16/01/2025
