AV.

22025/02/2014-PMR
Government of India,
Directorate General of Civil Aviation
Opposite Safdarjung Airport, New Delhi-110 001

Dated: 12-3-2015
CIRCULAR No. Med 1/2015

Subject: Amendment of Personal Details in the records held at Medical Cell, DGCA.

At times, individuals are approaching medical cell, DGCA for change of Name/Date of
Birth/Place of Birth/Address due to discrepancy in various records held by them viz. school certificates,
passport etc. The following documents (attested copies) should be submitted to DGCA along with
updated and correct personal details with duly filled in prescribed application form (Annexure 2):

S. Amendment Documents required in support ( Any one of the following )

No
1 Name (a) Affidavit signed and attested in presence of a Judicial Magistrate
or Executive Magistrate/Notary Public or Consular Officer in an
Indian Mission abroad. Additionally, the applicant should insert
advertisements in two reputed newspapers (one local newspaper of
the area in which he/she is residing and the other in newspaper of
the area of permanent address) and submit original newspaper at
the time of applying
(b) Promulgation of a change of name in the Gazette of India/State
Govt. /Union Territory.
(c) Class X Board Certificate
(d) Passport
(e) Marriage registration Certificate (In case of post-marriage changes
in name )
2 Date of Birth (a) Birth Certificate issued by a Municipal Authority or district office
of the Registrar of Births & Deaths. The Birth Certificate should
contain the name of child, name of father and mother, date of
birth, place of birth, sex, registration number and date of
registration. If the Birth Certificate doesnt contain the name of
child, a declaration on plain paper signed by parents, is required to
be submitted specifying the name of the child.
(b) Class X Board Certificate
(c) Passport

Contd.2/
 -2-

3 Place of Birth (a) Birth Certificate

4 Address Change (a) Water/Electricity/Telephone Bill
(b) Passport
(c) UID/Aadhaar Card

This supersedes earlier Public Notice dated 21 May 2012.

Sd/-
(Seema Gambhir)
Wing Commander
Jt Director Medical Services
For Director General of Civil Aviation
 Annexure 2

GOVERNMENT OF INDIA
OFFICE OF DIRECTOR GENERAL OF CIVIL AVIATION
OPPOSITE SAFDARJUNG AIRPORT, NEW DELHI-110 003

APPLICATION FORM FOR AMENDENT OF PERSONAL DETAILS

IN THE RECORDS HELD AT MEDICAL CELL, DGCA

1. PMR file No. .

2. Name & Initials Self attested photo
3. Licence No. (if issued).
4. Correspondence Address
.
.

5. Contact No. & Email Id:
6. Justification for change in
particulars





7. Details where amendment required
(Strike whichever is not applicable)

OLD* NEW* REMARKS

Name
Date of Birth
Place of Birth
Address Change

* To be filled in capital letters

P.T.O
Attachment:

Tick () the attached document:-

(For Amendment in Name)

- Affidavit signed and attested in presence of a Judicial Magistrate or Executive

Magistrate/Notary Public or Consular Officer in an Indian Mission abroad. Additionally,
the applicant should insert advertisements in two reputed newspapers (one local
newspaper of the area in which he/she is residing and the other in newspaper of the area
of permanent address) and submit original newspaper at the time of applying
- Promulgation of a change of name in the Gazette of India/State Govt./Union Territory.
- Class X Board Certificate
- Passport
- Marriage registration Certificate (In case of post marriage changes in name )

(For Amendment in Date of Birth)

- Birth Certificate issued by a Municipal Authority or district office of the Registrar of

Births & Deaths. The Birth Certificate should contain the name of child, name of father
and mother, date of birth, place of birth, sex, registration number and date of registration.
If the Birth Certificate doesnt contain the name of child, a declaration on plain paper
signed by parents, is required to be submitted specifying the name of the child.
- Class X Board Certificate
- Passport
(For Amendment in Place of Birth)
- Birth Certificate
(For Amendment in Address)

- Water/Electricity/Telephone Bill
- Passport
- UID/Aadhaar Card

( Signature of applicant )
Place:

Date :

Remarks by Medical Cell

 ..22025/02/2014-


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