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Indian Passport Application Form

The document is a passport application form for Mathavan Saravanan, a male student born on August 9, 2003, from Chidambaram, Tamil Nadu, India. The application is for a fresh, normal passport, and includes personal details, family information, and a self-declaration affirming the authenticity of the provided information. The applicant has submitted relevant enclosures such as a PAN card and Aadhaar card as proof of identity and residence.

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7 views2 pages

Indian Passport Application Form

The document is a passport application form for Mathavan Saravanan, a male student born on August 9, 2003, from Chidambaram, Tamil Nadu, India. The application is for a fresh, normal passport, and includes personal details, family information, and a self-declaration affirming the authenticity of the provided information. The applicant has submitted relevant enclosures such as a PAN card and Aadhaar card as proof of identity and residence.

Uploaded by

m3334468
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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1/17/25, 1:47 PM Application Form

PASSPORT APPLICATION FORM

Government of INDIA, Ministry of External Affairs

Service Required
Application Reference Number 25-1000720373
Applying For FRESH
Type of Application NORMAL
Type of Passport Booklet NORMAL
Applicant Details
Applicant's Name MATHAVAN SARAVANAN
Date of Birth (DD/MM/YYYY) 09/08/2003
Validity Required NA
Place of Birth (Village/Town/City) CHIDAMBARAM
District MAYILADUTHURAI
State/UT TAMIL NADU
Region/Country INDIA
Gender MALE
Marital Status SINGLE
Citizenship of India by BIRTH
PAN PJGPS2406L
Voter Id YDW2052421
Employment Type STUDENT
Is either of your parent (in case of minor)/spouse, a
N
government servant?
Educational Qualification 10TH PASS AND ABOVE
Are you eligible for Non-ECR category? Y
Visible Distinguishing Mark MOLE ON THE NECK
Aadhaar Number 560660900480
Family Details
Father's Name SARAVANAN SAMBANDAM
Mother's Name MALARMANGAI SARAVANAN
Present Residential Address Details
33 GNANASAMBANDAR STREET, SIRKALI, MAYILADUTHURAI, TAMIL
Address
NADU
PIN 609110
Police Station SIRKALI
Mobile/Tel No. 9345823358 / 9080792021
E-mail MATHAVANMADDY983@[Link]
Permanent Residential Address
33 GNANASAMBANDAR STREET, SIRKALI, MAYILADUTHURAI, TAMIL
Address
NADU
PIN 609110
Police Station SIRKALI
Mobile/Tel No. 9345823358 / 9080792021
Emergency Contact Details
Name and Address MATHAVAN , 33 GNANASAMBANDAR STREET , SIRKALI - 609110
Mobile/Tel No. 9345823358 / 9080792021
E-mail MATHAVANMADDY983@[Link]
Other Details
Enclosures
[Link] Card issued by the Income Tax Department
[Link] 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.

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1/17/25, 1:47 PM Application Form
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 SIRKALI
Date 17/01/2025

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