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ONLINE DATA SUBMISSION FOR LOCK DOWN

PASS - COVID-19
Inter State / Inter District Movement pass (
Vehicle/Individual ) 2020

Applicant Personal Details

Individual Type*
---Select here---
Pass Holder Name*

Contact Mobile No.*

Emergency Mobile No.*

Aadhar No*

Why do you need pass? *

---Select here---
Purpose

Required Pass for*

GROUP
KYC Type*
---Select here---
Vehicle Type*
---Select here---
Vehicle Registartion No.*

Route Details

From Commissioenrate/District*
KHAMMAM
Police station limit of residence *
---Select here---
Destination State*
---Select here---
Destination District*
---Select here---
Destination Tehsil *

Address (House No, Street/Village/Colony,Town)) *

Destination Pincode *

Route Details *

Note: Route Details for Area must be comma separated. Ex:- Malakpet,Koti ..

ext.

Pass validity Period

From(YYYY-MM-DD)*

YYYY-MM-DD
To (YYYY-MM-DD)*

YYYY-MM-DD
Pass validity time window*
---Select here---

Correspondence Address

Address (House No, Building)*

Address Line 2 (Street/Village/Colony)

Address Line 3

City/Town*

District*

State*
TELANGANA
PIN*

Transport Details

Vehicle Seater Capacity *

---Select here---
Total Number of Persons( excluding Pass Holder
Name)*
---Select here---

Sl.No Name Aadhar No.

Photo (Only JPEG/JPG Format File size should be less

than 80KB)

Choose File no file selected

KYC Document (Only PDF Format File size should be

less than 500kb)*

Choose File no file selected

Purpose Document (Only PDF Format File size should

be less than 500kb)*

Choose File no file selected

Jurisdiction Details

Jurisdiction Name*
KHAMMAM

Captcha*

Note:- Issue of e passes shall be subject to

conditions viz., Resident of individual / office
location / area of movement

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