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Application Form For Miscellaneous Services On Indian Passports

This document is an application form for miscellaneous services on an Indian passport, specifically renewal and additional visa pages/booklet. It contains details about the applicant such as name, address, passport information, and services requested. Shaikh Afraz is applying to renew his passport and add additional visa pages. He provides his personal information, current passport details, and declares that the information provided is true. He signs and dates the application, providing specimen signatures as required.

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afraz_xec
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215 views3 pages

Application Form For Miscellaneous Services On Indian Passports

This document is an application form for miscellaneous services on an Indian passport, specifically renewal and additional visa pages/booklet. It contains details about the applicant such as name, address, passport information, and services requested. Shaikh Afraz is applying to renew his passport and add additional visa pages. He provides his personal information, current passport details, and declares that the information provided is true. He signs and dates the application, providing specimen signatures as required.

Uploaded by

afraz_xec
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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No.

: EAPX-II-96

Print Form

E.A. (P)-2 EXTERNAL

Sl.

FREE OF CHARGE

APPLICATION FORM FOR MISCELLANEOUS SERVICES ON INDIAN PASSPORTS

(For use in Indian Mission/Post)


(a) Renewal (b) Additional Visa Sheet (c) Additional Booklet

( Please delete Inapplicable )


Please staple one
Photograph of size of
2 x 2 inch
(51 mm x 51 mm) &
enclose three for
additional booklet

Payment of Fee (to be filled by applicant)


Amount Paid __________________________ by ________________________________ (Mode of Payment)
For Delivery by mail $/___________ extra to be paid as postal charges for each passport
____________________

2
SHAIKH AFRAZ
1. Full Name : ________________________________________________________________________
GA0420060000373
2. Applicants Car Driving Licence No. : ____________________
25/04/2026
Bicholim-Goa
Date & Place of Issue :_______________________________________

3. Residential Address :
(i) In India

(ii)

H.NO. 162, Near Rolling Mill,

------------------------------------------------------------Vathadev Sarvan,

------------------------------------------------------------Bicholim - Goa, 403529

In country of domicile
Old Ministry of Foreign Affair Building, 1th Floor,

------------------------------------------------------------------Old Salata Area, P.O.Box 207410

------------------------------------------------------------------Doha Qatar.

-------------------------------------------------------------

-------------------------------------------------------------------

+918411845866
Tel. : ________________________________

+974 5049 3765


Tel. : ___________________________________

Mechanical Engineer, Old salata, Doha -Qatar


4. Profession and business address _______________________________________________________
+974 4429 2222
Tel. : _____________________________________________________________________________

5. Is applicant registered with the Indian Mission / Post ? If not, is he a member of any Indian
Organization ?
6.

7.

Give details.

(i)

Shaikh Ismail
Name of Father : ____________________________________________

(ii)

Shaikh Ramiza
Name of Mother : ____________________________________________

(iii)

Name of Spouse & Nationality: _________________________________

F8419714
Current Passport No.: ________________________
Panaji - Goa
Place of its Issue: ___________________________

8.

25/07/2016
Valid until: ____________________________
26/07/2006
Date of Issue: _________________________

Particulars of children to be included / deleted :


Name

Place & Date of Birth

Sex (M/F)

____________________________

______________________________________

___________

____________________________

______________________________________

___________

____________________________

______________________________________

___________

Note : In case a fresh inclusion of name(s), enclose (i) birth certificate(s) bearing names of both parents (ii)
marriage certificate of parents and (iii) passports of both parents. Children below fifteen years of age can
either apply for inclusion in their parents, generally mothers passport, or apply for separate passports.
Children above fifteen years must apply for separate passports.

3
9. DECLARATION :
I solemnly affirm that :
(i) I owe allegiance to the sovereignty and integrity of India ;
(ii) Information given above is correct and nothing has been concealed and I am aware that it is an
offence under the Passport Act 1967 to knowingly furnish false information or suppress material
information ; and
(iii) I undertake to be entirely responsible for expenses of my son / daughter / ward.
__________________________________________
Signature or T.I of applicant or his legal Guardian
(Left hand thumb impression of Male & right hand
thumb impression of female)
Doha - Qatar
Place: ____________________

04/06/2015
Date: ____________________

10. Two specimen signatures or thumb impressions required for service(s) within the space given
below.

________________________________________________________________________________________

FOR OFFICE USE

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