6/2/2015

AppointmentReciept

MinistryofExternalAffairsGovernmentofIndia
OnlineAppointmentReceipt
ApplicantDetails:

PaymentDetails#

ApplicationReferenceNo.
150006768044
(ARN)

TotalFee(Rs.)

1500.00

PaidFee(Rs.)

1500.00

DateandTime

02/06/201512:17AM

TransactionId

CP20919196

ServiceType

REISSUE

TypeofApplication

NORMAL

GivenName

PRAMODSHARAN

Surname

SINHA

AppointmentDetails:

Father'sName

LATEBHAGWATISHARANSINHA

Mother'sName

LATELALITASINHA

Spouse'sName

MEERASHARAN

DateofBirth

07/02/1948

PassportSevaKendra THANE,
Address
PASSPORTSEVAKENDRA,DOSTI
PINNACLE,UNITNOG1,PLOTNO
E7,ROADNO22,WAGLEINDUSTRIAL
ESTATE,THANEWEST400604

PlaceofBirth
Gender

MUZAFFARPUR,MUZAFFARPUR,BIHAR AppointmentId
MALE
AppointmentDate

MaritalStatus

MARRIED

EmploymentType

RETIREDGOVERNMENTSERVANT

ApplicationSubmitted
Date

01/06/2015

PresentResidential
Address

204,NEWHAPPYHOMECHS,PLOT
NO:03,SEC48,SEAWOODS,NAVI
MUMBAI,400706,MAHARASHTRA,
INDIA

ApplicantsReferencesDetails:
FirstReference

PRAMITSARAN,9029064413

SecondReference

SHILPASARAN,9833816576

100006555533315

26/06/2015&03:15PM
andTime
ReportingDateand 26/06/2015&03:00PM
Time

Batch

SequenceNo.

21

42

PreviousPassportDetails
OldPassportNo.

F4448155

PassportIssueDate

19/08/2005

PassportExpiryDate

18/08/2015

PlaceofIssue

PATNA

PleaseReadCarefully:
PleasereachPassportSevaKendra(PSK)at03:00PMasmentionedaboveandcarrytheprintedcopyofthisappointmentreceipt.
CheckDocumentAdvisoronwebsite'www.passportindia.gov.in' to know the documents required at PSK.Carry original documents and their
selfattestedphotocopies.FinaldecisionwithregardtodocumentsrequiredisatthediscretionofRPOstaffatPSK.
Incaseofminorapplicants(below4yearsofage),carrytherecentpassportsizephotograph(4.5X3.5cm)withwhitebackground.
Only applicant is allowed inside the PSK. However, in case of exceptions such as Senior Citizen / Physically Challenged / Illiterate / Minor
applicants,onepersonfromthefamilymaybeallowedtoaccompanyinsidePSK.
AtPSK,apapertokenwillbeissuedtoyouaftercheckingofdocuments.YourapplicationwillbeprocessedatCounterAfollowedbycounters B
andC.Atallstages,pleasebealertandwatchthetokendisplayscreenstoknowthecounteratwhichyourapplicationwillbeprocessed.Please
collectacknowledgementslipfromtheExitcounterbeforeleavingPSK.Also,youarerequestedtofillthefeedbackformattheexitcounter.
Thanksforshowingyourinterestin'PassportSevaSMSServices'enrolment.PleasepayRs35/(THIRTYFIVEONLY)incashastheEnrolment
ChargesduringyourvisittoPassportSevaKendra.
Balancefee(ifapplicable)aftereditingthesubmittedformwillbepayableincashatthePassportSevaKendra.
ATMfacilityavailableatPSKforallBankCards.
Helpustoserveyoubetter.
#DetailsasperthePaymentDate.Paymentoncemadeforavailingpassportserviceswillnotberefunded.

https://portal1.passportindia.gov.in/AppOnlineProject/secure/openPdfForApplReciept

1/3

6/2/2015

AppointmentReciept

ThefollowingtablelistsApplicantCategoriesalongwiththeDocumentstobeSubmitted.TheDocumentNo.mentionedin
DocumentstobeSubmittedcolumnisthereferencegiventothedocumentmentionedinListofDocumentstable.

ApplicantCategories

DocumentstobeSubmitted

AdditionalBooklet(ExhaustionofVisapages)

1(ifaddressisdifferentfromoldPassport),4

Expiryofoldpassport
1.Withinthetimeperiodofoneyearbeforeexpiryandthreeyearafterexpiryof
oldPassport

1(ifaddressisdifferentfromoldPassport),4

2.Afterthreeyearsofexpiryofoldpassport

1(ifaddressisdifferentfromoldPassport),4

3.RenewalofShortValidityPassport(SVP)

1(ifaddressisdifferentfromoldPassport),4,14

4.Government/PublicSector/Statutorybodyemployees(Stillserving)

1(ifaddressisdifferentfromoldPassport),4,11

5.Retiredgovernmentofficial

1(ifaddressisdifferentfromoldPassport),4,6

6.Studentsgoingforhigherstudiesabroadupto2yearsfromexpiryofPassport

1(ifaddressisdifferentfromoldPassport),4,15

DamagedPassport(Passportnumberisreadable,nameislegibleandPhotois
intact)

1(ifaddressisdifferentfromoldPassport),2,4,16

Lost/Damagedbeyondrecognition/StolenPassport

1,2,16,17,18(ifavailable)
Note:Otherdocumentswhichhavetobesubmittedareasperthecase,asinthe
caseoffreshPassport.

ChangeinParticulars
1.Awomanapplyingforchangeofname/surnameinexistingPassportdueto
marriage

(i)4,19(ifhehasPassport)
(ii)8or12or13

2.Divorcees/SeparatedapplyingforchangeofnameORfordeletionofspouse's
nameinexistingPassport

(i)4,30
(ii)ifdivorced,20or21(issuedbyQazi)
(iii)ifseparated,12

3.Remarriedapplicantsapplyingforchangeofname/spouse'sname

(i)4,19(ofpresenthusband,ifhehasPassport)
(ii)8(Remarriagecertificate)or12or29
(iii)13or21(asthecasemaybeinrespectoffirstspouse)

4.Changeofnameinothercircumstances(minorchangeinnamebothmaleand
femalei.e.spellingdiscrepancybetweenPassportanddocumentswhich
phoneticallydoesnotresultintotalchangeinname)

4,30

5.Majorchangeinname(casesdifferentfromminorchangecase)

4,7,30

6.ChangeinnameincaseofGovernment/PublicSector/Statutorybody
employees

4,9,10,30

7.ChangeinSex

4,22,23

8.ChangeofAppearance

4,24

9.Change/CorrectionofDoB

2,4,25(ifchangeinDoBismorethan2yearsorincaseofconflicting
documents),31

10.Change/Correctionofplaceofbirth

4,25(ifchangeinplaceofbirthinvolvesStatechangeorCountrychange),26,32

11.ChangeinCurrentAddress

1(changedaddress),4

12.ChangeinSignature

13.AdditionofSpouseName

(i)4
(ii)8or12or29

14.ChangeofFather/Mothername

4,5(offather/motherwithchangednameifavailable)or27or28

15.ECRDeletion

1(ifaddressisdifferentfromoldPassport),3,4

Document
No.

ListofDocuments
ProofofPresentAddress.ForProofofAddressattachoneofthefollowingdocuments:

1.

a. Waterbill/Telephone(landlineorpostpaidmobilebill)/Electricitybill(atleast2billsarerequiredOnebillshouldofbeoflastyearandthe
otherbillofcurrentyear)
b. PhotopassbookofrunningBankAccount(ScheduledPublicSectorBanks,ScheduledPrivateSectorIndianBanksandRegionalRural
Banksonly)
c. IncomeTaxAssessmentOrder
d. ElectionCommissionPhotoIDcard
e. Gasconnectionbill
f. CertificatefromEmployerofreputedandwidelyknowncompaniesonletterhead(Onlypubliclimitedcompaniescangiveaddressproofon
companyletterheadalongwithseal.Computerisedprintoutsshallnotbeentertained)
g. Spouse'spassportcopy(Firstandlastpageincludingfamilydetails),(providedtheapplicant'spresentaddressmatchestheaddress
mentionedinthespouse'spassport)
h. Applicant'scurrentandvalidrationcard
NOTE1:Ifanyapplicantsubmitsonlyrationcardasproofofaddress,itshouldbeaccompaniedbyonemoreproofofaddressoutofthe
givencategories.
i. Parent'spassportcopy,incaseofminors(Firstandlastpage)
j. AadhaarLetter/Card(IfaadhaarcardissuancedateislessthanayearfrompassportapplicationprocessingdateatPSK,itshouldbe
accompaniedbyonemoreproofofaddressoutofthegivencategories)
k. RegisteredRentAgreement(foraperiodofmorethanoneyear)
ProofofDateofBirth.ForProofofDateofBirthattachoneofthefollowingdocuments:
a. BirthcertificateissuedbyaMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeathCertificatebytheRegistrarofBirths&
Deaths
b. Schoolleavingcertificate/SecondarySchoolleavingcertificate/CertificateofRecognizedBoardsfromtheschoollastattendedbythe
applicantoranyotherrecognizededucationalinstitution

https://portal1.passportindia.gov.in/AppOnlineProject/secure/openPdfForApplReciept

2/3

6/2/2015

AppointmentReciept
2.

c. AffidavitswornbeforeaMagistrate/Notarystatingdate/placeofbirthasperthespecimeninAnnexure"A"byilliterateorsemiilliterate
applicants(Lessthan5thclass).
Forapplicantsbornonorafter26.01.89,onlyBirthCertificateissuedbytheMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeath
CertificatebytheRegistrarofBirths&Deathsisacceptable.TheBirthCertificateshouldordinarilycontainthenameofchild,nameoffatherand
mother,dateofbirth,placeofbirth,sex,registrationnumberanddateofregistration.IftheBirthCertificatedoesn'tcontainthenameofchild,a
declarationonplainpapersignedbyparents,isrequiredtobesubmittedspecifyingthenameofthechild.

3. DocumentaryproofforanyoneoftheNonECR(previouslyECNR)categories,ReferColumn2.15underSectionBofpassportinstructionbooklet
4.

OldPassportinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)andthepage
ofobservation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvaliditypassport

5.

Passportofparentsinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)and
thepageofobservation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvaliditypassport

6. PensionPaymentOrder
7.

Paperclippingoftwoleadingdailynewspapersinoriginal(onedailynewspapershouldbeoftheareaofApplicant'sPermanentAddressandtheother
atCurrentAddressornearbyarea)

8. AnattestedcopyofmarriagecertificateissuedbyRegistrarofMarriage
9. GazetteNotificationchangingnameinapplicant'sdepartment
10. FreshIDCertificateinchangedname
11. NoObjectionCertificate(NOC)(asperAnnexure'M')
AffidavitswornbeforeFirstClassJudicialMagistrateorExecutiveMagistrateonNonJudicialstamppaperforreissueofpassport(whichwas
12. obtainedpriortomarriage)bymarriedapplicantswhoareunabletoprovidetheprescribedmarriagecertificateorjointaffidavitwithspousedueto
maritaldiscord,separationorwithoutformaldivorcedecreebytheCourtorduetototaldesertionbythespouseasperspecimenatAnnexure'K'
13.

Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavit
shouldindicatethereasonforit.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
24.

Recentphotograph(requiredonlyincaseofDPC/SPC/CSCapplications).Thephotoshouldbemostrecentshowingthelatestappearance.A
notarisedstatementisrequiredincaseofrequestfromSikhswhowanttochangefromturbanphototocleanshavenonesortheotherway.

Firstclassjudicialmagistrate/Subdivisionalmagistratecivilcourtorder(ifchangeindateofbirthismorethan2years/incaseofconflicting
25. documents/ifchangeinplaceofbirthinvolveschangeofStateorCountry)(Incasechangeofplaceofbirthinvolveschangeofcountry,alsoattach
DocumentNo.7)
26. AffidavitstatingthereasonforchangeinPlaceofBirth
27. Proofsuchasservicerecord/pensionorder/propertydocumentsshowingthatparentshadchangedtheirname
28. Ifparentsaredeceased,suchproofthattheyhadchangedtheirnameduringlifetime
29.

Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavit
shouldindicatethereasonforit.Ifapplyingforpassportforthefirsttime,thisaffidavitisrequiredonlyifthereisachangeinthefirstname.

30. Deedpoll/swornaffidavitasperAnnexure"E"
31. AffidavitstatingthereasonforchangeinDateofBirth
32. ProofofPlaceofBirth

Note:Thelistofdocumentsprovidedinthetableaboveisindicative.ThedecisionofAPO/RPOshallbeconsideredfinal.

https://portal1.passportindia.gov.in/AppOnlineProject/secure/openPdfForApplReciept

3/3