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Application Form

The document is a passport application form for Kowsalya E, a married female applicant from Dindigul, India, born on June 1, 1997. She is applying for a fresh normal passport and has provided personal details, including her residential address, family information, and emergency contact. The application includes a self-declaration affirming the accuracy of the information provided and compliance with the Passports Act, 1967.

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23 views2 pages

Application Form

The document is a passport application form for Kowsalya E, a married female applicant from Dindigul, India, born on June 1, 1997. She is applying for a fresh normal passport and has provided personal details, including her residential address, family information, and emergency contact. The application includes a self-declaration affirming the accuracy of the information provided and compliance with the Passports Act, 1967.

Uploaded by

ddsplusdindigulcsc
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PASSPORT APPLICATION FORM

Government of INDIA, Ministry of External Affairs

Service Required
Application Reference Number 24-1009369099
Applying For FRESH
Type of Application NORMAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name KOWSALYA E
Date of Birth (DD/MM/YYYY) 01/06/1997
Validity Required NA
Place of Birth (Village/Town/City) DINDIGUL
District DINDIGUL
Region/Country INDIA
Gender FEMALE
Marital Status MARRIED
Citizenship of India by BIRTH
PAN DSXPK2249P
Voter Id NMJ2348969
Employment Type NOT EMPLOYED
Is either of your parent (in case of minor)/spouse, a
Y
government servant?
Educational Qualification GRADUATE AND ABOVE
Are you eligible for Non-ECR category? Y
Visible Distinguishing Mark RIGHT LEG OF THE SCAR
Aadhaar Number 295702249336
Family Details
Father's Name ESWARAN V
Mother's Name PERIYA VALLI E
Spouse's Name AYYAPPAN C
Present Residential Address Details
3/153,GANDHI NAGAR COLONY,CHETTINAICKEN PATTI, DINDIGUL,
Address
DINDIGUL, TAMIL NADU
PIN 624004
Police Station THADICOMBU
Mobile/Tel No. 6380400920
E-mail EKOWSI97@GMAIL.COM
Permanent Residential Address
3/153,GANDHI NAGAR COLONY,CHETTINAICKEN PATTI, DINDIGUL,
Address
DINDIGUL, TAMIL NADU
PIN 624004
Police Station THADICOMBU
Mobile/Tel No. 6380400920
Emergency Contact Details
Name and Address AYYAPPAN
Mobile/Tel No. 6379832104
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
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 DINDIGUL
Date 24/07/2024

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