Scribd
Upload
34 views2 pages

Passport Application for Urvashi Rajani

Urvashi Rajani has submitted a passport application form providing personal details like name, date of birth, place of birth, gender, marital status, etc. She is applying for a fresh normal passport as an Indian citizen born in Chhindwara, Madhya Pradesh. She has included required documents like her Aadhaar card and has declared her allegiance to India and responsibility for the accuracy of the information provided in the application form.

Uploaded by

shivangi
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
34 views2 pages

Passport Application for Urvashi Rajani

Urvashi Rajani has submitted a passport application form providing personal details like name, date of birth, place of birth, gender, marital status, etc. She is applying for a fresh normal passport as an Indian citizen born in Chhindwara, Madhya Pradesh. She has included required documents like her Aadhaar card and has declared her allegiance to India and responsibility for the accuracy of the information provided in the application form.

Uploaded by

shivangi
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

3/22/18 Application Form

PASSPORT APPLICATION FORM

Government of INDIA, Ministry of External Affairs

Service Required
Application Reference Number 18-0004587318
Applying For FRESH
Type of Application NORMAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name URVASHI RAJANI
Date of Birth (DD/MM/YYYY) 18/03/1994
Validity Required NA
Place of Birth (Village/Town/City) CHHINDWARA
District CHHINDWARA
State/UT MADHYA PRADESH
Country INDIA
Gender FEMALE
Marital Status SINGLE
Citizenship of India by BIRTH
Employment Type STUDENT
Is either of your parent (in case of
N
minor)/spouse, a government servant?
Educational Qualification GRADUATE AND ABOVE
Are you eligible for Non-ECR category? Y
Visible Distinguishing Mark SIX FINGERS ON BOTH HAND
Aadhaar Number 855579017896
Family Details
Father's Name VINAY RAJANI
Mother's Name DAKSHA RAJANI
Present Residential Address Details
Residing Since(MM/YYYY) 03/1994
WARD NO 14 NAI ABADI NEAR GANJ MAZJID CHHINDWARA, CHHINDWARA,
Address
KUNDIPURA, CHHINDWARA, MADHYA PRADESH
PIN 480001
Mobile/Tel No. 8109666052
Permanent Residential Address
WARD NO 14 NAI ABADI NEAR GANJ MAZJID CHHINDWARA, CHHINDWARA,
Address
KUNDIPURA, CHHINDWARA, MADHYA PRADESH
PIN 480001
Mobile/Tel No. 8109666052
Emergency Contact Details
Name and Address RATNESH RAJANI
Mobile/Tel No. 8109666052
Mobile/Tel No. 8109666052
Other Details
Enclosures

[Link] Card/E-Aadhaar
[Link] Card
Self Declaration

[Link] 1/2
3/22/18 Application Form
I owe allegiance to the sovereignty, unity and 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 and I affirm that the information
given by me in this form and the enclosures is true and I am solely responsible for its accuracy, and 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.
Place CHHINDWARA
Date 22/03/2018
Print Close

[Link] 2/2

You might also like