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    Application Form

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    viharshyadav652
    Divyansh Mukesh Yadav has applied for a fresh normal Indian passport. He was born in Ahmedabad, Gujarat in 2004 and is currently a 10th grade student. His father is Mukesh Ramabhilash Yadav and mother is Kusumben Mukesh Yadav. He has included his birth certificate and Aadhaar card with the application and affirmed that all information provided is true.

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    Application Form

    Uploaded by

    viharshyadav652
    17 views1 page
    Divyansh Mukesh Yadav has applied for a fresh normal Indian passport. He was born in Ahmedabad, Gujarat in 2004 and is currently a 10th grade student. His father is Mukesh Ramabhilash Yadav and mother is Kusumben Mukesh Yadav. He has included his birth certificate and Aadhaar card with the application and affirmed that all information provided is true.

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    Divyansh Mukesh Yadav has applied for a fresh normal Indian passport. He was born in Ahmedabad, Gujarat in 2004 and is currently a 10th grade student. His father is Mukesh Ramabhilash Yadav and mother is Kusumben Mukesh Yadav. He has included his birth certificate and Aadhaar card with the application and affirmed that all information provided is true.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    17 views1 page

    Application Form

    Uploaded by

    viharshyadav652
    Divyansh Mukesh Yadav has applied for a fresh normal Indian passport. He was born in Ahmedabad, Gujarat in 2004 and is currently a 10th grade student. His father is Mukesh Ramabhilash Yadav and mother is Kusumben Mukesh Yadav. He has included his birth certificate and Aadhaar card with the application and affirmed that all information provided is true.

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    © All Rights Reserved
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    of 1

    2/24/24, 3:41 PM Application Form

    PASSPORT APPLICATION FORM

    Government of INDIA, Ministry of External Affairs

    Service Required
    Application Reference Number 24-0003532702
    Applying For FRESH
    Type of Application NORMAL
    Type of Passport Booklet NORMAL
    Applicant Details
    Applicant's Name DIVYANSHU MUKESH YADAV
    Date of Birth (DD/MM/YYYY) 04/08/2004
    Validity Required NA
    Place of Birth (Village/Town/City) AHMEDABAD
    District AHMEDABAD
    State/UT GUJARAT
    Region/Country INDIA
    Gender MALE
    Marital Status SINGLE
    Citizenship of India by BIRTH
    Employment Type STUDENT
    Is either of your parent (in case of minor)/spouse, a
    N
    government servant?
    Educational Qualification 10TH PASS AND ABOVE
    Are you eligible for Non-ECR category? Y
    Aadhaar Number 952451861533
    Family Details
    Father's Name MUKESH RAMABHILASH YADAV
    Mother's Name KUSUMBEN MUKESH YADAV
    Present Residential Address Details
    B/28,522 VAIDEHI SOC NR NAVRANG TENAMENTS ISANPU, AHMEDABAD,
    Address
    AHMEDABAD, GUJARAT
    PIN 382443
    Police Station ISANPUR
    Mobile/Tel No. 8511730530
    E-mail [email protected]
    Emergency Contact Details
    Name and Address MUKESH YADAV
    Mobile/Tel No. 8511730530
    Other Details
    Enclosures
    1.Birth certificate issued by the Registrar of Births and Deaths or the Municipal Corporation or any other prescribed authority whosoever
    has been empowered under the Registration of Birth and Deaths Act, 1969 to register the birth of a child born in India
    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 AHMEDABAD
    Date 24/02/2024

    https://portal1.passportindia.gov.in/AppOnlineProject/secure/ApplicantSelfDeclarationAction 1/1

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