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Application Form Suneel Psport

Suneel Kumar Yadav has applied for a fresh normal passport. He was born on July 20th, 1979 in Jagbandanpur, Jaunpur, Uttar Pradesh, India. He has been residing at the same village address since July 1979. Suneel has indicated his father Ram Raj Yadav and mother Minta Devi as family details. He has self-declared that the information provided in the application is true.

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38 views2 pages

Application Form Suneel Psport

Suneel Kumar Yadav has applied for a fresh normal passport. He was born on July 20th, 1979 in Jagbandanpur, Jaunpur, Uttar Pradesh, India. He has been residing at the same village address since July 1979. Suneel has indicated his father Ram Raj Yadav and mother Minta Devi as family details. He has self-declared that the information provided in the application is true.

Uploaded by

ARVIND
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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12/23/2015

Application Form

PASSPORT APPLICATION FORM


Government of INDIA, Ministry of External Affairs
Service Required
Application Reference Number
Applying For
Type of Application
Type of Passport Booklet

15-0015762354
FRESH
NORMAL
NORMAL

Applicant Details
Applicant's Name
Date of Birth (DD/MM/YYYY)
Validity Required
Place of Birth (Village/Town/City)
District
State/UT
Country
Gender
Marital Status
Citizenship of India by
Employment Type
Is either of your parent (in case of
minor)/spouse, a government servant?
Educational Qualification
Are you eligible for Non-ECR category?
Visible Distinguishing Mark

SUNEEL KUMAR YADAV


20/07/1979
NA
JAGBANDANPUR
JAUNPUR
UTTAR PRADESH
INDIA
MALE
MARRIED
BIRTH
SELF EMPLOYED
N
10TH PASS AND ABOVE
Y
MOLE ON THE NECK BELOW THE CHIN

Family Details
Father's Name
Mother's Name
Spouse's Name

RAM RAJ YADAV


MINTA DEVI
SAROJ YADAV

Present Residential Address Details


Residing Since(MM/YYYY)
Address
PIN
Mobile/Tel No.
E-mail
First Reference Name And Address
Mobile/Tel No.
Second Reference Name And Address
Mobile/Tel No.

07/1979
VILLAGE JAGBANDANPUR TEHSIL SHAHGANJ, POLICE STATION
KHUTHAN, KHUTHAN, JAUNPUR, UTTAR PRADESH
223104
9004374147
[email protected]
DASRATH YADAV
8726605874
NEERAJ YADAV
8604780360

Permanent Residential Address


Address
PIN
Mobile/Tel No.

VILLAGE JAGBANDANPUR TEHSIL SHAHGANJ, POLICE STATION


KHUTHAN, KHUTHAN, JAUNPUR, UTTAR PRADESH
223104
9004374147

Emergency Contact Details


Name and Address
Mobile/Tel No.
Mobile/Tel No.

RAM RAJ YADAV


9956525074
9956525074

Other Details
Self Declaration
I owe allegiance to the sovereignty, unity and 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 and I affirm that the
information given by me in this form and the enclosures is true and I am solely responsible for its accuracy, and I am liable
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12/23/2015

Application Form

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.
Place
JAUNPUR
Date
23/12/2015

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