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Passport Application

The document is a passport application form for Chengole Sagar, a male student born on February 6, 2002, from Malkapur, Telangana, applying for a fresh normal passport. The application includes personal details, family information, residential address, emergency contact, and declarations regarding the authenticity of the information provided. Enclosures include a school certificate and Aadhaar card as proof of identity and address.

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maheshsandapuram
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22 views2 pages

Passport Application

The document is a passport application form for Chengole Sagar, a male student born on February 6, 2002, from Malkapur, Telangana, applying for a fresh normal passport. The application includes personal details, family information, residential address, emergency contact, and declarations regarding the authenticity of the information provided. Enclosures include a school certificate and Aadhaar card as proof of identity and address.

Uploaded by

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

Ministry of External Affairs, Government of India

Service Required
Application Reference Number - 25-1053615962
Applying For - FRESH
Type of Application - NORMAL
Type of Passport Booklet - NORMAL

Applicant's Details
Applicant's Name - CHENGOLE SAGAR
Date of Birth (DD/MM/YYYY) - 06/02/2002
Validity Required - NA
Place Of Birth (Village/Town/City) - MALKAPUR
District - VIKARABAD
State/UT - TELANGANA
Region/Country - INDIA
Gender - MALE
Marital Status - SINGLE
Citizenship of India by - BIRTH
Employment Type - STUDENT
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 - Y
category
Visible Distinguishing Mark - A MOLE ON LEFT CHEE
Aadhaar Number - 750497612636
Voter ID - XLV2718435

Family Details
Father Name - JAGAPPA
Mother Name - PADMAMMA

Present Residential Address Details


Address - 5-58/1, MALKAPUR (V) , TANDUR (M), VIKARABAD, TELANGANA
Pin - 501141
Police Station - KARANKOTE
Mobile/Tel No - 8688677338
E-mail - CHENGOLESAGAR@GMAIL.COM

Emergency Contact Details


Name and Address - PADMAMMA
Mobile/Tel No - 9885087092

Previous Passport
Details of latest held/existing/lost/damaged Ordinary Passport

Details of Previous/Current Diplomatic/Official Passport - N

Have you ever applied for passport, but not issued? - N

Other Details
Enclosures Details
1. Transfer or school leaving or matriculation certificate issued by the recognised school last attended or recognised
educational board 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 - MALKAPUR

Date - 08/06/2025

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