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Application Form SATISH

This document is a passport application form for Satish Maurya Saheblal, applying for a fresh passport under the Tatkaal service. The applicant's details, including personal information, family details, and residential address, are provided along with necessary enclosures such as a birth certificate and Aadhaar card. The applicant affirms the authenticity of the information and acknowledges the legal implications of providing false information.

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35 views1 page

Application Form SATISH

This document is a passport application form for Satish Maurya Saheblal, applying for a fresh passport under the Tatkaal service. The applicant's details, including personal information, family details, and residential address, are provided along with necessary enclosures such as a birth certificate and Aadhaar card. The applicant affirms the authenticity of the information and acknowledges the legal implications of providing false information.

Uploaded by

Royal Aircon
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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3/31/25, 2:49 PM Application Form

PASSPORT APPLICATION FORM

Government of INDIA, Ministry of External Affairs

Service Required
Application Reference Number 25-0004855384
Applying For FRESH
Type of Application TATKAAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name SATISH MAURYA SAHEBLAL
Date of Birth (DD/MM/YYYY) 15/10/1991
Validity Required NA
Place of Birth (Village/Town/City) SIHOLI KERAKAT
District JAUNPUR
State/UT UTTAR PRADESH
Region/Country INDIA
Gender MALE
Marital Status MARRIED
Citizenship of India by BIRTH
Employment Type PRIVATE
Is either of your parent (in case of
N
minor)/spouse, a government servant?
Educational Qualification 10TH PASS AND ABOVE
Are you eligible for Non-ECR category? Y
Aadhaar Number 381584097744
Family Details
Father's Name SAHEBLAL MAURYA
Mother's Name LALTI DEVI MAURYA
Spouse's Name AAKANSHA SATISH MAURYA
Present Residential Address Details
SR NO 82/1/2/3,RN 04,JAY VIJAY CHAWL,VASAI VIRAR, SHRIRAM COVASAI
Address
PALGHAR,VASAI, PALGHAR, MAHARASHTRA
PIN 401209
Police Station PALGHAR
Mobile/Tel No. 7666346327
E-mail SATISHMAURYA312@GMAIL.COM
Emergency Contact Details
LALTI DEVI MAURYA,SR NO 82/1/2/3 RN 04,JAY VIJAY CHAWL,VASAI VIRAR
Name and Address
CITY,SHRIRAM COVASAI PALGHAR,401209
Mobile/Tel No. 7666346327
E-mail SATISHMAURYA312@GMAIL.COM
Other Details
Enclosures
1.Birth certificate issued by the Registrar of Births and Deaths or the Municipal Corporation or any other authority, empowered under
the Registration of Births and Deaths Act, 1969 (18 of 1969)
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 MUMBAI
Date 31/03/2025

https://portal1.passportindia.gov.in/AppOnlineProject/secure/ApplicantSelfDeclarationAction 1/1

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