PASSPORT APPLICATION FORM
Ministry of External Affairs, Government of India
Service Required
Application Reference Number - 26-0056418561
Applying For - REISSUE
If Re-issue, specify reason(s) - CHANGE IN EXISTING PERSONAL PARTICULARS
If change in existing personal - SPOUSE NAME , ADDRESS
particulars, specify
Type of Application - NORMAL
Type of Passport Booklet - NORMAL
Applicant's Details
Applicant's Name - NANCY
Date of Birth (DD/MM/YYYY) - 07/04/1999
Validity Required - NA
Place Of Birth (Village/Town/City) - RAMPURA PHUL
District - BATHINDA
State/UT - PUNJAB
Region/Country - INDIA
Gender - FEMALE
Marital Status - MARRIED
Citizenship of India by - BIRTH
Employment Type - GOVERNMENT
Is either of your parent (in case of - N
minor)/spouse, a government
servant?
Educational Qualification - 10TH PASS AND ABOVE
Are you eligible for Non-ECR - Y
category
Aadhaar Number - 247319420750
PAN - CRCPN5834J
Family Details
Father Name - SANJEEV GARG
Mother Name - SEEMA GARG
Spouse's Name - PAAVAN GARG
Present Residential Address Details
Address - HOUSE NO 261 GUPTA MANDIR STREET NEW MARKET, RAMPURA PHUL,
BATHINDA, PUNJAB
Pin - 151103
Police Station - CITY RAMPURA
Mobile/Tel No - 9988499259
E il GARGNANCY777@GMAIL COM
E-mail - GARGNANCY777@[Link]
Permanent Residential Address Details
Address - HOUSE NO 81-A DASHMESH AVENUE,CHHEHARTA, AMRITSAR,
AMRITSAR, PUNJAB, INDIA
Pin - 143105
Police Station - CHHEHARTA
Mobile/Tel No - 9988499259
Emergency Contact Details
Name and Address - NANCY,RAMPURA PHUL
Mobile/Tel No - 9988499259
Previous Passport
Details of latest held/existing/lost/damaged Ordinary Passport
Passport Number - AG416566
Date of Issue - 27/10/2025
Date of Expiry - 26/10/2035
Place of Issue - AMRITSAR
File Number - AS1065940053425
Details of Previous/Current Diplomatic/Official Passport - N
Have you ever applied for passport, but not issued? - N
Other Details
Enclosures Details
1. Permanent Account Number Card issued by the Income-tax Department having the date of birth of the applicant
2. Rent Agreement
3. School leaving certificate / Secondary School leaving certificate/ Certificate of Recognized Boards from the school
last attended by the applicant or any other recognized educational institution
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 - AMRITSAR
Date - 03/03/2026