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Application Form

The document is a passport application form for Navneet Kumar, requesting a fresh normal passport. It includes personal details such as date of birth, address, and family information, along with declarations regarding the authenticity of the provided information. The application is signed and dated in Muzaffarpur on 02/03/2025.

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6 views2 pages

Application Form

The document is a passport application form for Navneet Kumar, requesting a fresh normal passport. It includes personal details such as date of birth, address, and family information, along with declarations regarding the authenticity of the provided information. The application is signed and dated in Muzaffarpur on 02/03/2025.

Uploaded by

nk0222759
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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PASSPORT APPLICATION FORM

Government of INDIA, Ministry of External Affairs

Service Required
Application Reference Number 25-0003422182
Applying For FRESH
Type of Application NORMAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name NAVNEET KUMAR
Date of Birth (DD/MM/YYYY) 18/06/1996
Validity Required NA
Place of Birth (Village/Town/City) MUZAFFARPUR
District MUZAFFARPUR
State/UT BIHAR
Region/Country INDIA
Gender MALE
Marital Status SINGLE
Citizenship of India by BIRTH
PAN HQLPK1077B
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
Visible Distinguishing Mark CUT MARK ON FOREHEAD
Aadhaar Number 585562032982
Family Details
Father's Name SHAMBHU SHARAN KUWAR
Present Residential Address Details
MN017 0081, J P COLONY, CHANDWARA, MUZAFFARPUR, MUZAFFARPUR,
Address
BIHAR
PIN 842001
Police Station TOWN
Mobile/Tel No. 8269755187
E-mail [email protected]
Permanent Residential Address
MN017 0081, J P COLONY, CHANDWARA, MUZAFFARPUR, MUZAFFARPUR,
Address
BIHAR
PIN 842001
Police Station TOWN
Mobile/Tel No. 8269755187
Emergency Contact Details
SHAMBHU SHARAN KUWAR, JP COLONY , CHANDWARA, MUZAFFARPUR,
Name and Address
BIHAR-842001
Mobile/Tel No. 9852608157
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 MUZAFFARPUR
Date 02/03/2025
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