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PASSPORT APPLICATION FORM
Ministry of External Affairs, Government of India
Service Required
Application Reference Number - 25-1054672367
Applying For - FRESH
Type of Application - NORMAL
Type of Passport Booklet - NORMAL
Applicant's Details
Applicant's Name - JASH NANDHAN GAAJANGI
Date of Birth (DD/MM/YYYY) - 18/12/2024
Validity Required - NA
Place Of Birth (Village/Town/City) - KOWKOOR
District - CYBERABAD-MEDCHAL
State/UT - TELANGANA
Region/Country - INDIA
Gender - MALE
Marital Status - SINGLE
Citizenship of India by - BIRTH
Employment Type - OTHERS
Is either of your parent (in case of - N
minor)/spouse, a government
servant?
Educational Qualification - 7TH PASS OR LESS
Are you eligible for Non-ECR - N
category
Aadhaar Number - 968582388916
Family Details
Father Name - HARISH GAJANGI
Mother Name - SAIPRIYA PORANDLA
Present Residential Address Details
Address - 4-2-174/P/8/402, FLAT NO 402, VNR NEST, PRIYADARSHINI ENCLAVE,
KOWKOOR, RACHAKONDA-MEDCHAL, TELANGANA
Pin - 500010
Police Station - JAWAHARNAGAR
Mobile/Tel No - 7842320027
E-mail - HARISHGAAJANGI27@[Link]
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Emergency Contact Details
Name and Address - GJANGI HARISH, 4-2-174/P/8/402, FLAT NO 402, VNR NEST.
PRIYADARSHINI ENCLAVE,KOWKOOR,ALWAL,MEDCHAL,500010
Mobile/Tel No - 7842320027
Previous Passport
Details of latest held/existing/lost/damaged Ordinary Passport
Details of Previous/Current Diplomatic/Official Passport - N
Have you ever applied for passport, but not issued? - N
Other Details
Enclosures Details
1. Birth certificate issued by the Registrar of Births and Deaths or the Municipal Corporation or any other authority,
empowered under the Registration of Births and Deaths Act, 1969 (18 of 1969)
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 - KOWKOOR
Date - 20/06/2025
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