PASSPORT FACT SHEET

 No Mehendi and Scratches on fingers.

 Fresh Reschedule PCC

 Name of Applicant: - __________________________________________

 Date of Birth: - ___________________ Place of Birth:-________________

 District: - ___________________ State:-_______________________

 Married Status :- ________________________________________

 Aadhar Card :-_________________________________________________

 Voter ID:-______________________________________________________

 Pan Card:-_____________________________________________________

 Profession:-_____________________

 Is either of parents/spouse, a Govt. Servant :- ____________________

 Educational Qualification :- __________________________________

 Are you eligible for Non-ECR category?:-________________________

 Father’s Name: - _______________________________________________

 Mother’s Name: - ______________________________________________

 Spouse’s Name:-_________________________________________
 Address: - _____________________________________________________

______________________________________________________

Pin Code: - _______________

 Contact No: - Cell ____________________(R) ______________________

 Email: - _______________________________________________________

 Permanent Residential Address:-________________________________

______________________________________________________________

 Police Station:-__________________

 In case of Passport Renewal (Details of Old Passport) :-

File Number: - _____________________

Passport No.:- _____________________

Place of Issue: - ____________________

Date of Issue: - _____________________

Date of Expiry: - ____________________

 Travelled and Overstay in any country:-______________________

Date: - ______________ Signature: - ________________