Scribd
Upload
67 views2 pages

Application Form NISHAR

Nishar Ansari has applied for a fresh normal Indian passport. He provides details such as his date of birth, place of birth, address, contact information, and encloses his PAN card and Aadhaar card as proof. He declares that he owes allegiance to India, has not acquired citizenship of another country, and affirms that all information provided is true.

Uploaded by

Public Garbage
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
67 views2 pages

Application Form NISHAR

Nishar Ansari has applied for a fresh normal Indian passport. He provides details such as his date of birth, place of birth, address, contact information, and encloses his PAN card and Aadhaar card as proof. He declares that he owes allegiance to India, has not acquired citizenship of another country, and affirms that all information provided is true.

Uploaded by

Public Garbage
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
You are on page 1/ 2

PASSPORT APPLICATION FORM

Government of INDIA, Ministry of External Affairs

Service Required
Application Reference Number 24-0001354864
Applying For FRESH
Type of Application NORMAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name NISHAR ANSARI
Date of Birth (DD/MM/YYYY) 20/08/2000
Validity Required NA
Place of Birth (Village/Town/City) BOKARO
District BOKARO
State/UT JHARKHAND
Region/Country INDIA
Gender MALE
Marital Status MARRIED
Citizenship of India by BIRTH
PAN DRAPA6974H
Employment Type SELF EMPLOYED
Is either of your parent (in case of minor)/spouse, a government
N
servant?
Educational Qualification 10TH PASS AND ABOVE
Are you eligible for Non-ECR category? Y
Visible Distinguishing Mark NOT AVAILABLE
Aadhaar Number 205092162439
Family Details
Father's Name INTAF ANSARI
Mother's Name GORIMAN BIBI
Spouse's Name HALIMA BIBI
Present Residential Address Details
Address SOTRIBERA, BOKARO, BOKARO, JHARKHAND
PIN 828134
Police Station CHANDANKIYARI
Mobile/Tel No. 8210490722
E-mail [email protected]
Emergency Contact Details
Name and Address FAIZ AHMAD KHAN
Mobile/Tel No. 9102828100
E-mail [email protected]
Other Details
Enclosures
1.PAN Card issued by the Income Tax Department
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 BOKARO
Date 21/01/2024

You might also like