Form No. 1 EXTERNAL

FREE OF CHARGE

(PHOTOCOPY OF THIS FORM IS ALSO ACCEPTABLE)

GOVERNMENT OF INDIA

APPLICATION FOR INDIAN PASSPORT AT AN INDIAN MISSION/POST

(For Fresh/re-issue after expiry of validity/duplicate in lieu of lost/damaged/appearance change)

Please paste one recent
Reason for: / colour photo of the size of
Fresh/validity expired/pages exhausted/ / 2 inch X 2 inch & enclose
Lost/damaged/appearance change / two extra photos

Applicant to sigh/put thumb impression

on the photograph with half the signature/T.I. on the photo and half on application

Specimen Signature or left/right

Thumb impression (Applicants or

Minor who can not sign)

(Please delete inapplicable)

Payment of Fee (to be filled by applicant)

Amount paid HK$ ______by______Mode of payment

1. / Surname
Given Name:
Aliases, if any: / Sex / :MALE/FEMALE
Has applicant ever changed his/her name ? If so, give previous / name in full:
2. / Date of Birth: / Height (Cms)
Place & Country of Birth
Colour of Eyes / Hair
Visible distinguishing marks, if any
3. / Present Passport/Nationality, if any No.______
Date and Place of Issue______
4. / Permanent address:
In India
______
______Telephone No.______
In Hong Kong
______
______
Telephone:______
5. / Name of Father: / Country of his birth:
Name of Mother: / Country of her birth:
Nationality of father at the time of applicant’s birth ______
Nationality of mother at the time of applicant’s birth ______
______
6. / Married ( )/Unmarried ( )
7. / Name & Nationality of Spouse
8. / Particulars of person to be intimated in the event of death or accident:
Name ______
Address ______
9. / Local car driving Licence No. / Date & Place of Issue
10. / Educational qualification
(in order to determine emigration
status)
11. / When did applicant first leave India / When was he/she in India last:
How long has applicant continuously resided abroad?
12.
Present Emigration status (with documentary evidence):
13. / (ECR/ECNR)
Occupation and business address
14.
Telephone:
Please mention, if citizen of India by
15. / Birth/Descent/Naturalization/Registration.
Did the applicant ever possess any other nationality or travel
16. / document of any other country, if so, please give details:
17. / Was the applicant ever refused an Indian passport? (Yes/No)
Was applicant's passport ever impounded/revoked ? If so,
18. / details please. (Yes/No)
19. / Name and address of two relatives/friends in Hong Kong / India:
i. / ii.
Is applicant in Govt. Service/Public Undertaking Service/Statutory Bodies Services of India? If so, please give
20. / details and enclose 'No objection certificate' from you employer in original.
(i) Are any criminal proceedings pending against the applicant in any court in India? If so, please give details :
21.
(ii) Has applicant ever been repatriated from abroad to India at the expenses of the Govt. of India? If so please give details :
22. / No. of lost/damaged passport: / Date of issue:
Place of issue: / Valid Until
(i) Briefly state circumstances of loss/theft/damage of passport on a plain paper and attach copy of report lodged with local
23. / police in case of loss/theft.
(ii) Give details of restriction, if any, put in applicant's damaged/lost passport.
(ii) Did the applicant avail transfer of residence, foreign travel scheme facility on lost/damaged passport ? If so, details please
Is the applicant registered with Indian Mission/Post? If not, is he a member of any Indian Organization?
24.

25. DECLARATION: I owe allegiance to the sovereignty, unity and integrity of India and have not voluntarily acquitted the citizenship or travel document of another country. I have not lost, surrendered or been deprived of citizenship of India.

The information given by me is true and I am solely responsible for its accuracy. I am aware that it is an offence under the Passports Act, 1967 to furnish any false information or to suppress any material information with a view to obtaining Passport or any other travel document.

Signature/Thumb Impression of applicant (Left hand T.I if male and right hand T.I. if female)

Date ______Place ______

  1. In case of Minors, following passport particulars of both parents must be given:

Mother / Father
a) / Passport No. / ______/ ______
b) / Date of Issue: / ______/ ______
c) / Place of Issue: / ______/ ______

d)If parents have applied for a passport, please give file No. & date:______

  1. Declaration of Parents or Guardian if passport is for minor: (To be signed by both parents or Guardian):

We affirm that the particulars given above are in respect of (Name) ______

son/daughter of Smt. ______Sh. ______

of whom we are the Parents/Guardian. We undertake the entire responsibility for his/her expenses. We solemnly declare that he/she has not lost, surrendered or been deprived of his/her citizenship of India and that the information given in respect of him/her in this application is true. It is also certified that the name of the child mentioned is not included in Passport of either parent.

Signature of Mother Signature of Father Signature of Guardian

Name & Signature/T.I. of both the parents/Guardian (Left hand T.I if male and right hand T.I. if female)

Place______Date______

28. Specimen signature or T.I. of applicant within the space given below:

______

FOR OFFICE USE