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AppointmentReciept

MinistryofExternalAffairsGovernmentofIndia
OnlineAppointmentReceipt
ApplicantDetails:
PaymentDetails#
ApplicationReferenceNo.(ARN)

160010501690

TotalFee(Rs.)

1500.00

ServiceType

FRESH

PaidFee(Rs.)

1500.00

TypeofApplication

NORMAL

DateandTime

28/08/201601:20PM

GivenName

MADHAV

TransactionId

CP56360049

Surname

THAREJA

Gender

MALE

AppointmentDetails:

Father'sName

JAIPALTHAREJA

Mother'sName

LOVELYTHAREJA

PassportSeva
KendraAddress

DateofBirth

07/07/1993

BAREILLY,
RADHAKRISHNATOWER,CC146/A,PLOTNO.317/1KHA,JAGATPURLALA
BEGUM,PILIBHITBYPASSROAD,BAREILLY243001,UTTARPRADESH

PlaceofBirth

UJHANI,BADAUN,UTTARPRADESH

100008769711716

MaritalStatus

SINGLE

EmploymentType

STUDENT

ApplicationSubmittedDate

26/08/2016

AppointmentId
Appointment
DateandTime
ReportingDate
andTime

PresentResidentialAddress

HOUSENO.250,SHRINARAYANGANJ,UJHANI,BADAUN,
243639,UTTARPRADESH,INDIA

ApplicantsReferencesDetails:
FirstReference

KANWALTHAREJA,SHRINARAYANGANJ
UJHANI,BADAUN,UP,9917172777

SecondReference

SEEMATHAREJA,SHRINARAYANGANJ
UJHANI,BADAUN,UP,9045032077

02/09/2016&09:45AM
02/09/2016&09:30AM

Batch

SequenceNo.

25

PleaseReadCarefully:
PleasereachPassportSevaKendra(PSK)at09:30AMasmentionedaboveandcarrytheprintedcopyofthisappointmentreceipt.
CheckDocumentAdvisoronwebsite'www.passportindia.gov.in'toknowthedocumentsrequiredatPSK.Carryoriginaldocumentsandtheirselfattestedphotocopies.Finaldecisionwithregardtodocumentsrequiredis
atthediscretionofRPOstaffatPSK.
Incaseofminorapplicants(below4yearsofage),carrytherecentpassportsizephotograph(4.5X3.5cm)withwhitebackground.
OnlyapplicantisallowedinsidethePSK.However,incaseofexceptionssuchasSeniorCitizen/PhysicallyChallenged/Illiterate/Minorapplicants,onepersonfromthefamilymaybeallowedtoaccompanyinsidePSK.
AtPSK,apapertokenwillbeissuedtoyouaftercheckingofdocuments.YourapplicationwillbeprocessedatCounterAfollowedbycountersBandC.Atallstages,pleasebealertandwatchthetokendisplayscreensto
knowthecounteratwhichyourapplicationwillbeprocessed.PleasecollectacknowledgementslipfromtheExitcounterbeforeleavingPSK.Also,youarerequestedtofillthefeedbackformattheexitcounter.
Thanksforshowingyourinterestin'PassportSevaSMSServices'enrolment.PleasepayRs40/(FORTYONLY)incashastheEnrolmentChargesduringyourvisittoPassportSevaKendra.
Balancefee(ifapplicable)aftereditingthesubmittedformwillbepayableincashatthePassportSevaKendra.
ATMfacilityavailableatPSKforallBankCards.
Helpustoserveyoubetter.
#DetailsasperthePaymentDate.Paymentoncemadeforavailingpassportserviceswillnotberefunded.

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ThefollowingtablelistsApplicantCategoriesalongwiththeDocumentstobeSubmitted.TheDocumentNo.mentionedinDocumentstobeSubmittedcolumnisthereferencegiventothe
documentmentionedinListofDocumentstable.

ApplicantCategories

DocumentstobeSubmitted

OrdinaryCase(CitizenofIndiabybirth)

1,2,3(iftheapplicantiseligibleforNonECR)

CitizenofIndiabyDescent(BorntoIndianparent(s)outsideIndia)

(i)1,2,3(iftheapplicantiseligibleforNonECR)
(ii)4or5or6

CitizenofIndiabyRegistration/Naturalization(GrantedcitizenshipbyMHA)

1,2,3(iftheapplicantiseligibleforNonECR),7

ApplicantsrepatriatedfromabroadatGovernmentcost

1,2,3(iftheapplicantiseligibleforNonECR),5(ifavailable),8,9

ApplicantsdeportedtoIndia/EmergencyCertificatecases

1,2,3(iftheapplicantiseligibleforNonECR),5(ifavailable),8(ifany),9

Government/PublicSector/Statutorybodyemployees

(i)1,2
(ii)21(ifNoPoliceVerificationisrequired)or20(ifPostPoliceVerificationisrequired)or27(ifPrePoliceVerificationis
required).

DependentfamilymembersofGovernment/PublicSector/Statutorybodyemployees(ForJ&Kchildreninagegroup1015
yearsarecovered.ForrestofIndiachildreninagegroup1821arecovered)

1,2,3(iftheapplicantiseligibleforNonECR),21(ofdependent)and24ifNoPoliceVerificationisrequired

Retiredgovernmentofficials

1,2,10(ifPostPoliceVerificationisrequired)

ApplicantshavingDiplomatic/OfficialPassportandapplyingforordinaryPassportwhileinservice

(i)1,2,11(12ifsurrendercertificateisnotavailable)
(ii)21or20or27ifapplicantisGovernment/PublicSector/Statutorybodyemployee
Note:Incasetheapplicantsubmits"12","2"isnotrequired

DependentfamilymembersofDiplomatic/OfficialPassportholderswhoarenotgovernmentservants(ForJ&KChildrenin
agegroup1015yearsarecovered)

1,2,3(iftheapplicantiseligibleforNonECR),26

Owner,partnersanddirectorsofCompanieswhicharemembersofCII,FICCI&ASSOCHAM.

(i)1,2
(ii)24and25ifPostPVisrequired

Minorchangeinname

1(innewname),2(inoldname),3(iftheapplicantiseligibleforNonECRDocumentsinoldnameareallowed),23

Majorchangeinname

1(innewname),2(inoldname),3(iftheapplicantiseligibleforNonECRDocumentsinoldnameareallowed),13,23

Change/Additioninsurnameduetomarriage

(i)1,2,3(iftheapplicantiseligibleforNonECR)
(ii)14or22

ChangeinnameincaseofGovernment/PublicSector/Statutorybodyemployees

1,2,15,16,23

NagalandResidents

1,2,3(iftheapplicantiseligibleforNonECR)
Note:AdditionalPVrequiredfromGuwahatithroughMHA.

NagaoriginsresidingoutsideNagaland

1,2,3(iftheapplicantiseligibleforNonECR)
Note:AdditionalPVrequiredfromGuwahatithroughMHA.

JammuandKashmirResidents

1,2,3(iftheapplicantiseligibleforNonECR)

JammuandKashmirResidentsstayingoutsideJ&Kformorethanfiveyears

1,2,3(iftheapplicantiseligibleforNonECR)

Studentsstayingawayfromtheirparent'scurrentresidence

1,2,3(iftheapplicantiseligibleforNonECR),17,18

SeniorCitizens(ForJ&K:Men65+years,Women60+yearsForrestofIndia65+years)

1,2,3(iftheapplicantiseligibleforNonECR),19(ifPostPoliceVerificationisrequired)

Document
No.

ListofDocuments
ProofofPresentAddress.ForProofofAddressattachoneofthefollowingdocuments:
a.Waterbill/Telephone(landlineorpostpaidmobilebill)/Electricitybill
b.PhotopassbookofrunningBankAccount(ScheduledPublicSectorBanks,ScheduledPrivateSectorIndianBanksandRegionalRuralBanksonly)
c.IncomeTaxAssessmentOrder
d.ElectionCommissionPhotoIDcard
e.Gasconnectionbill
f.CertificatefromEmployerofreputedandwidelyknowncompaniesonletterhead(Onlypubliclimitedcompaniescangiveaddressproofoncompanyletterheadalongwithseal.Computerisedprintoutsshallnotbe
entertained)
g.Spouse'spassportcopy(Firstandlastpageincludingfamilydetails),(providedtheapplicant'spresentaddressmatchestheaddressmentionedinthespouse'spassport)
h.Parent'spassportcopy,incaseofminors(Firstandlastpage)
i.AadhaarLetter/Card
j.RegisteredRentAgreement

1.

Note:

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1.Applicantsarerequiredtosubmittheproofofaddressofthepresentaddressonly,irrespectiveofthedatefromwhichhe/shehasbeenresidingatthegivenaddress.However,he/sheisrequiredtomentionalltheplaceof
stayduringpreviousoneyearinthePassportapplicationform.
2.FurnishingofAadhaarcardwillexpediteprocessingofpassportapplications.
3.Aadhaarletter/cardortheeAadhaar(anelectronicallygeneratedletterfromthewebsiteofUIDAI),asthecasemaybe,willbeacceptedasProofofAddress(POA)andProofofPhotoIdentity(POI)foravailingpassport
relatedservices.AcceptanceofAadhaarasPoAandPoIwouldbesubjecttosuccessfulvalidationwithAadhaardatabase.
4.AnyoftheremainingdocumentscontainingaddressoutofsixteendocumentslistedunderTatkaalapplication,couldalsobeacceptedasproofofresidenceifsuchdocumentshavethesamepresentresidentialaddressas
givenbytheapplicantinthePassportApplicationForm.
ProofofDateofBirth.ForProofofDateofBirthattachoneofthefollowingdocuments:

2.

a.BirthcertificateissuedbyaMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeathCertificatebytheRegistrarofBirths&Deaths
b.Schoolleavingcertificate/SecondarySchoolleavingcertificate/CertificateofRecognizedBoardsfromtheschoollastattendedbytheapplicantoranyotherrecognizededucationalinstitution
c.AffidavitswornbeforeaMagistrate/Notarystatingdate/placeofbirthasperthespecimeninAnnexure"A"byilliterateorsemiilliterateapplicants(Lessthan5thclass).
Forapplicantsbornonorafter26.01.89,onlyBirthCertificateissuedbytheMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeathCertificatebytheRegistrarofBirths&Deathsisacceptable.TheBirthCertificate
shouldordinarilycontainthenameofchild,nameoffatherandmother,dateofbirth,placeofbirth,sex,registrationnumberanddateofregistration.IftheBirthCertificatedoesn'tcontainthenameofchild,adeclarationonplain
papersignedbyparents,isrequiredtobesubmittedspecifyingthenameofthechild.

3. DocumentaryproofforanyoneoftheNonECR(previouslyECNR)categories,ReferColumn2.15underSectionBofpassportinstructionbooklet
4. BirthRegistrationCertificateissuedbyEmbassy/HighCommission/ConsulateofIndia
5.

OldPassportinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)andthepageofobservation(ifany),madebyPassportIssuingAuthorityandvalidity
extensionpage,ifany,inrespectofshortvaliditypassport

6.

Passportofparentsinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)andthepageofobservation(ifany),madebyPassportIssuingAuthorityandvalidity
extensionpage,ifany,inrespectofshortvaliditypassport

7. CitizenshipCertificateissuedbyMinistryofHomeAffairs
8. Proofofrefundofrepatriation/deportationcost(ifany)toMinistryofExternalAffairs
9. OriginalEmergencyCertificate/SeizureMemoissuedbyAirportImmigrationAuthoritiesonapplicant'sarrivalinIndia
10. PensionPaymentOrder
11. ProofofsurrenderorcancellationofDiplomatic/officialPassport
12. CancelledPassport(ifsurrendercertificateisnotavailable),withaletterexplainingwhysurrendercertificateisnotavailable
13. Paperclippingoftwoleadingdailynewspapersinoriginal(onedailynewspapershouldbeoftheareaofApplicant'sPermanentAddressandtheotheratCurrentAddressornearbyarea)
14. AnattestedcopyofmarriagecertificateissuedbyRegistrarofMarriage
15. GazetteNotificationchangingnameinapplicant'sdepartment
16. FreshIDCertificateinchangedname
17. StudentIdentityCardissuedbyGovernmentRecognizedEducationalInstitutions,inrespectoffulltimecourses
18. BonafideLetterfromauthorizedsignatoryofcollege(OnofficialletterheadofUGCrecognizedCollege)
19. Copyofchild's(Age>18)Passport,whoisstayingabroad(withpagehavingparent'sname)
20. NoObjectionCertificate(NOC)(asperAnnexure'M')
21. "IdentityCertificate"inoriginalasperAnnexure"B"
22.

Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavitshouldindicatethereasonforit.Ifapplyingforpassportforthefirsttime,this
affidavitisrequiredonlyifthereisachangeinthefirstname.

23. Deedpoll/swornaffidavitasperAnnexure"E"
24. StandardAffidavitasperAnnexure"I"
25. VerificationCertificateasperAnnexure"J"
26. PhotocopyofDiplomatic/OfficialPassport
27. PriorIntimationLetter(PI)(asperAnnexure'N')

Note:Thelistofdocumentsprovidedinthetableaboveisindicative.ThedecisionofAPO/RPOshallbeconsideredfinal.

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