PASSPORT APPLICATION FORM
Government of INDIA, Ministry of External Affairs
Service Required
Application Reference Number 25-1003212673
Applying For FRESH
Type of Application NORMAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name PRABHAVATHI KOMARAM
Date of Birth (DD/MM/YYYY) 08/07/2003
Validity Required NA
Place of Birth (Village/Town/City) GOKAVARAM
District ALLURI SITHARAMA RAJU
State/UT ANDHRA PRADESH
Region/Country INDIA
Gender FEMALE
Marital Status SINGLE
Citizenship of India by BIRTH
Employment Type STUDENT
Is either of your parent (in case of minor)/spouse,
N
a government servant?
Educational Qualification GRADUATE AND ABOVE
Are you eligible for Non-ECR category? Y
Family Details
Father's Name VEERA BABU KOMARAM
Mother's Name SUBADHRA KOMARAM
Present Residential Address Details
31, CHINNARAMANAYYA PETA,KAMALAMPALEM, INDUKURU PETA, ALLURI
Address
SITHARAMA RAJU, ANDHRA PRADESH
PIN 533286
Police Station DEVIPATNAM
Mobile/Tel No. 8096391879
E-mail PRCHOWDARY2003@GMAIL.COM
Emergency Contact Details
Name and Address RAJA
Mobile/Tel No. 8498019198
Other Details
Enclosures
1.Permanent Account Number Card issued by the Income-tax Department having the date of birth of the applicant
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 HYDERABAD
Date 18/03/2025
Print Close
