11/27/2016 AppointmentReciept

MinistryofExternalAffairsGovernmentofIndia
OnlineAppointmentReceipt

ApplicantDetails:

PaymentDetails#
ApplicationReferenceNo. TotalFee(Rs.) 1500.00
160013777300
(ARN)
PaidFee(Rs.) 1500.00
ServiceType REISSUE
DateandTime 27/11/201609:42PM
TypeofApplication NORMAL
TransactionId CP65732699
GivenName SANGITA
Surname KHER AppointmentDetails:
Gender FEMALE PassportSevaKendra MALAD,
Father'sName SADASHIVDATTATRAYAKHEDKAR Address PASSPORTSEVAKENDRA,RAHEJATIPCO
Mother'sName USHASADASHIVKHEDKAR PLAZA,UNITNO.2B,RANISATIMARG,
MALAD(EAST),MUMBAI400097
Spouse'sName SUHASVASANTKHER
AppointmentId 100009147975516
DateofBirth 14/07/1954
AppointmentDate
PlaceofBirth PANDHARPUR,SOLAPUR 28/11/2016&04:15PM
andTime
RURAL,MAHARASHTRA
ReportingDateand 28/11/2016&04:00PM
MaritalStatus MARRIED Time
EmploymentType RETIREDGOVERNMENTSERVANT

ApplicationSubmittedDate 27/11/2016
PresentResidentialAddress B/394THFLOOR,MANDARSOCIETY,RM Batch 29
BHATTADMARG,MUMBAI,MUMBAI,
400092,MAHARASHTRA,INDIA
ApplicantsReferencesDetails: SequenceNo. 16
SADHANADILIPKURKARNI,B/384TH
FirstReference FLOORMANDARSOCIETY,RM

BHATTADMARG
HEENABARUCHA,B/404THFLOOR PreviousPassportDetails
SecondReference MANDARSOCIETY,RMBHATTADMARG,
OldPassportNo. G1256468
9819669230
PassportIssueDate 18/12/2006
PassportExpiryDate 17/12/2016
PlaceofIssue MUMBAI

PleaseReadCarefully:
PleasereachPassportSevaKendra(PSK)at04:00PMasmentionedaboveandcarrytheprintedcopyofthisappointmentreceipt.
Check Document Advisor on website 'www.passportindia.gov.in' to know the documents required at PSK.Carry original documents and their self
attestedphotocopies.FinaldecisionwithregardtodocumentsrequiredisatthediscretionofRPOstaffatPSK.
Incaseofminorapplicants(below4yearsofage),carrytherecentpassportsizephotograph(4.5X3.5cm)withwhitebackground.
OnlyapplicantisallowedinsidethePSK.However,incaseofexceptionssuchasSeniorCitizen/PhysicallyChallenged/Illiterate/Minorapplicants,one
personfromthefamilymaybeallowedtoaccompanyinsidePSK.
AtPSK,apapertokenwillbeissuedtoyouaftercheckingofdocuments.YourapplicationwillbeprocessedatCounterAfollowedbycountersBandC.At
all stages, please be alert and watch the token display screens to know the counter at which your application will be processed. Please collect
acknowledgementslipfromtheExitcounterbeforeleavingPSK.Also,youarerequestedtofillthefeedbackformattheexitcounter.
Thanksforshowingyourinterestin'PassportSevaSMSServices'enrolment.PleasepayRs40/(FORTYONLY)incashastheEnrolmentChargesduring
yourvisittoPassportSevaKendra.
Balancefee(ifapplicable)aftereditingthesubmittedformwillbepayableincashatthePassportSevaKendra.
Helpustoserveyoubetter.
#DetailsasperthePaymentDate.Paymentoncemadeforavailingpassportserviceswillnotberefunded.

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11/27/2016 AppointmentReciept
ThefollowingtablelistsApplicantCategoriesalongwiththeDocumentstobeSubmitted.TheDocumentNo.mentionedinDocumentsto
beSubmittedcolumnisthereferencegiventothedocumentmentionedinListofDocumentstable.

ApplicantCategories DocumentstobeSubmitted
AdditionalBooklet(ExhaustionofVisapages) 1(ifaddressisdifferentfromoldPassport),4
Expiryofoldpassport
1.Withinthetimeperiodofoneyearbeforeexpiryandthreeyearafterexpiryofold
1(ifaddressisdifferentfromoldPassport),4
Passport
2.Afterthreeyearsofexpiryofoldpassport 1(ifaddressisdifferentfromoldPassport),4
3.RenewalofShortValidityPassport(SVP) 1(ifaddressisdifferentfromoldPassport),4,14
4.Government/PublicSector/Statutorybodyemployees(Stillserving) 1(ifaddressisdifferentfromoldPassport),4,11or33
5.Retiredgovernmentofficial 1(ifaddressisdifferentfromoldPassport),4,6
6.Studentsgoingforhigherstudiesabroadupto2yearsfromexpiryofPassport 1(ifaddressisdifferentfromoldPassport),4,15
DamagedPassport(Passportnumberisreadable,nameislegibleandPhotoisintact) 1(ifaddressisdifferentfromoldPassport),2,4,16
1,2,16,17,18(ifavailable)
Lost/Damagedbeyondrecognition/StolenPassport Note:Otherdocumentswhichhavetobesubmittedareasperthecase,asinthecase
offreshPassport.
ChangeinParticulars
(i)4,19(ifhehasPassport)
1.Awomanapplyingforchangeofname/surnameinexistingPassportduetomarriage
(ii)8or12or13
(i)4,30
2.Divorcees/SeparatedapplyingforchangeofnameORfordeletionofspouse'sname
(ii)ifdivorced,20or21
inexistingPassport
(iii)ifseparated,12
(i)4,19(ofpresenthusband,ifhehasPassport)
3.Remarriedapplicantsapplyingforchangeofname/spouse'sname (ii)8(Remarriagecertificate)or12or29
(iii)13or21(asthecasemaybeinrespectoffirstspouse)
4.Changeofnameinothercircumstances(minorchangeinnamebothmaleandfemale
i.e.spellingdiscrepancybetweenPassportanddocumentswhichphoneticallydoesnot 4,30
resultintotalchangeinname)
5.Majorchangeinname(casesdifferentfromminorchangecase) 4,7,30
6.ChangeinnameincaseofGovernment/PublicSector/Statutorybodyemployees 4,9,10,30
7.ChangeinSex 4,22,23
8.ChangeofAppearance 4,24
9.Change/CorrectionofDoB 2,4,25(ifchangeinDoBismorethan2yearsorincaseofconflictingdocuments),31
10.Change/Correctionofplaceofbirth 4,25(ifchangeinplaceofbirthinvolvesStatechangeorCountrychange),26,32
11.ChangeinCurrentAddress 1(changedaddress),4
12.ChangeinSignature 4
(i)4
13.AdditionofSpouseName
(ii)8or12or29
14.ChangeofFather/Mothername 4,5(offather/motherwithchangednameifavailable)or27or28
15.ECRDeletion 1(ifaddressisdifferentfromoldPassport),3,4

Document
ListofDocuments
No.
ProofofPresentAddress.ForProofofAddressattachoneofthefollowingdocuments:

a.Waterbill/Telephone(landlineorpostpaidmobilebill)/Electricitybill
b.PhotopassbookofrunningBankAccount(ScheduledPublicSectorBanks,ScheduledPrivateSectorIndianBanksandRegionalRuralBanksonly)
c.IncomeTaxAssessmentOrder
d.ElectionCommissionPhotoIDcard
e.Gasconnectionbill
f.CertificatefromEmployerofreputedandwidelyknowncompaniesonletterhead(Onlypubliclimitedcompaniescangiveaddressproofoncompany
letterheadalongwithseal.Computerisedprintoutsshallnotbeentertained)
g.Spouse'spassportcopy(Firstandlastpageincludingfamilydetails),(providedtheapplicant'spresentaddressmatchestheaddressmentionedinthe
spouse'spassport)
h.Parent'spassportcopy,incaseofminors(Firstandlastpage)
i.AadhaarLetter/Card
j.RegisteredRentAgreement
1.
Note:

1.Applicantsarerequiredtosubmittheproofofaddressofthepresentaddressonly,irrespectiveofthedatefromwhichhe/shehasbeenresidingatthe
givenaddress.However,he/sheisrequiredtomentionalltheplaceofstayduringpreviousoneyearinthePassportapplicationform.

2.FurnishingofAadhaarcardwillexpediteprocessingofpassportapplications.

3.Aadhaarletter/cardortheeAadhaar(anelectronicallygeneratedletterfromthewebsiteofUIDAI),asthecasemaybe,willbeacceptedasProofof
Address(POA)andProofofPhotoIdentity(POI)foravailingpassportrelatedservices.AcceptanceofAadhaarasPoAandPoIwouldbesubjectto
successfulvalidationwithAadhaardatabase.

4.AnyoftheremainingdocumentscontainingaddressoutofsixteendocumentslistedunderTatkaalapplication,couldalsobeacceptedasproofof
residenceifsuchdocumentshavethesamepresentresidentialaddressasgivenbytheapplicantinthePassportApplicationForm.

ProofofDateofBirth.ForProofofDateofBirthattachoneofthefollowingdocuments:

a.BirthcertificateissuedbyaMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeathCertificatebytheRegistrarofBirths&Deaths
b.Schoolleavingcertificate/SecondarySchoolleavingcertificate/CertificateofRecognizedBoardsfromtheschoollastattendedbytheapplicantor
anyotherrecognizededucationalinstitution
c.AffidavitswornbeforeaMagistrate/Notarystatingdate/placeofbirthasperthespecimeninAnnexure"A"byilliterateorsemiilliterateapplicants(Less
2. than5thclass).

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11/27/2016 AppointmentReciept
Forapplicantsbornonorafter26.01.89,onlyBirthCertificateissuedbytheMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeathCertificateby
theRegistrarofBirths&Deathsisacceptable.TheBirthCertificateshouldordinarilycontainthenameofchild,nameoffatherandmother,dateofbirth,placeof
birth,sex,registrationnumberanddateofregistration.IftheBirthCertificatedoesn'tcontainthenameofchild,adeclarationonplainpapersignedbyparents,
isrequiredtobesubmittedspecifyingthenameofthechild.
3. DocumentaryproofforanyoneoftheNonECR(previouslyECNR)categories,ReferColumn2.15underSectionBofpassportinstructionbooklet
OldPassportinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)andthepageof
4.
observation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvaliditypassport
Passportofparentsinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)andthepageof
5.
observation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvaliditypassport
6. PensionPaymentOrder
Paperclippingoftwoleadingdailynewspapersinoriginal(onedailynewspapershouldbeoftheareaofApplicant'sPermanentAddressandtheotheratCurrent
7.
Addressornearbyarea)
8. AnattestedcopyofmarriagecertificateissuedbyRegistrarofMarriage
9. GazetteNotificationchangingnameinapplicant'sdepartment
10. FreshIDCertificateinchangedname
11. NoObjectionCertificate(NOC)(asperAnnexure'M')
AffidavitswornbeforeFirstClassJudicialMagistrateorExecutiveMagistrateonNonJudicialstamppaperforreissueofpassport(whichwasobtainedpriorto
12. marriage)bymarriedapplicantswhoareunabletoprovidetheprescribedmarriagecertificateorjointaffidavitwithspouseduetomaritaldiscord,separationor
withoutformaldivorcedecreebytheCourtorduetototaldesertionbythespouseasperspecimenatAnnexure'K'
Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavitshouldindicate
13.
thereasonforit.Ifapplyingforpassportforthefirsttime,thisaffidavitisrequiredonlyifthereisachangeinthefirstname.
14. ProofofdocumentswhicheliminatethecauseofissuanceofShortValidityPassport(SVP)
15. ProofofgoingabroadforstudieslikeCopyofcollegeadmissionletterorCopyofapplicationsubmittedforvisaorCopyofbankloanpaperetc
16. AffidavitstatinghowandwherethePassportgotlost/damaged(Annexure'L')
17. Policereportinoriginal
18. Selfattestedphotocopyoffirsttwoandlasttwopages,includingECR/NonECRpageofoldPassport
19. Selfattestedphotocopyofthespouse'sPassport
20. CourtcertifiedcopyofDivorcedecree
21. SelfattestedcopyofDivorcecertificate
22. Swornaffidavitregardingchangeofsex
23. Certificationfromhospitalwherehe/sheunderwentsexchangeoperationsuccessfully
Recentphotograph(requiredonlyincaseofDPC/SPC/CSCapplications).Thephotoshouldbemostrecentshowingthelatestappearance.Anotarised
24.
statementisrequiredincaseofrequestfromSikhswhowanttochangefromturbanphototocleanshavenonesortheotherway.
Firstclassjudicialmagistrate/Subdivisionalmagistratecivilcourtorder(ifchangeindateofbirthismorethan2years/incaseofconflictingdocuments/if
25.
changeinplaceofbirthinvolveschangeofStateorCountry)(Incasechangeofplaceofbirthinvolveschangeofcountry,alsoattachDocumentNo.7)
26. AffidavitstatingthereasonforchangeinPlaceofBirth
27. Proofsuchasservicerecord/pensionorder/propertydocumentsshowingthatparentshadchangedtheirname
28. Ifparentsaredeceased,suchproofthattheyhadchangedtheirnameduringlifetime
Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavitshouldindicate
29.
thereasonforit.Ifapplyingforpassportforthefirsttime,thisaffidavitisrequiredonlyifthereisachangeinthefirstname.
30. Deedpoll/swornaffidavitasperAnnexure"E"
31. AffidavitstatingthereasonforchangeinDateofBirth
32. ProofofPlaceofBirth
33. PriorIntimationLetter(PI)(asperAnnexure'N')

Note:Thelistofdocumentsprovidedinthetableaboveisindicative.ThedecisionofAPO/RPOshallbeconsideredfinal.

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