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9 views

Application FormMA

Form

Uploaded by

arrunraja
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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7/12/24, 6:17 PM Application Form

PASSPORT APPLICATION FORM

Government of INDIA, Ministry of External Affairs

Service Required
Application Reference Number 24-1008719909
Applying For FRESH
Type of Application NORMAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name MARIYA SINDHIYA SOLAMON
Date of Birth (DD/MM/YYYY) 27/02/1992
Validity Required NA
Place of Birth (Village/Town/City) SALEM
District SALEM
State/UT TAMIL NADU
Region/Country INDIA
Gender FEMALE
Marital Status SINGLE
Citizenship of India by BIRTH
Employment Type PRIVATE
Is either of your parent (in case of minor)/spouse, a
N
government servant?
Educational Qualification GRADUATE AND ABOVE
Are you eligible for Non-ECR category? Y
Aadhaar Number 805103623324
Family Details
Father's Name SOLAMON
Mother's Name STELLA
Present Residential Address Details
118/90 PALANIAPPA COLONY ,ANNA THANAPPATTI, SHEVAPET, SALEM, TAMIL
Address
NADU
PIN 636002
Police Station SHEVAPET
Mobile/Tel No. 7708194627
E-mail [email protected]
Permanent Residential Address
118/90 PALANIAPPA COLONY ,ANNA THANAPPATTI, SHEVAPET, SALEM, TAMIL
Address
NADU
PIN 636002
Police Station SHEVAPET
Mobile/Tel No. 7708194627
Emergency Contact Details
Name and Address STELLA
Mobile/Tel No. 7708194627
Other Details
Enclosures
1.Transfer/School leaving/Matriculation Certificate issued by the school last attended/recognized educational board
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 SALEM
Date 12/07/2024

https://portal2.passportindia.gov.in/AppOnlineProject/secure/ApplicantSelfDeclarationAction 1/1

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