MIME-Version: 1.0 Date: Sun, 17 Nov 2024 19:53:29 +0530 Message-ID: Subject: Set photograph ad signature From: Khushboo Pandey To: Khushboo Pandey Content-Type: multipart/alternative; boundary="00000000000076e29906271c8b53" --00000000000076e29906271c8b53 Content-Type: text/plain; charset="UTF-8" [image: Passport Logo] File Number (For Office Use Only) [image: No Image] GOVERNMENT OF INDIA, MINISTRY OF EXTERNAL AFFAIRS PASSPORT APPLICATION FORM Please read the Passport Instruction Booklet carefully before filling the form. Fill this form in CAPITAL LETTERS using blue/black ink ball point pen only. Furnishing of incorrect information/ suppression of information would lead to rejection of the application and would attract penal provisions as prescribed under the Passports Act, 1967. Please produce your original documents at the time of submission of the form. Service Required Application Reference Number *24-0018978348* Applying For FRESH Type of Application NORMAL Type of Passport Booklet NORMAL Applicant Details Applicant's Name KHUSHBOO PANDEY Date of Birth (DD/MM/YYYY) 19/03/2000 Validity Required NA Place of Birth (Village/Town/City) NEW DELHI District SOUTH DELHI State/UT DELHI Region/Country INDIA Gender FEMALE Marital Status SINGLE Citizenship of India by BIRTH PAN GCPPP5402N Employment Type NOT EMPLOYED Is either of your parent (in case of minor)/spouse, a government servant? N Educational Qualification GRADUATE AND ABOVE Are you eligible for Non-ECR category? Y Visible Distinguishing Mark NO Aadhaar Number 937797718735 Signature/Left Hand Thumb Impression of Illiterate Applicant and Minors who cannot sign. Family Details Father's Name MANOJ KUMAR PANDEY Mother's Name USHA DEVI Present Residential Address Details Address 748,STREET 13, BLOCK I-2 SANGAM VIHAR, NEW DELHI, SOUTH DELHI, DELHI PIN 110080 Police Station TIGRI Mobile/Tel No. 8287872819 E-mail KHUSHBOOPANDEY2819@GMAIL.COM Permanent Residential Address Address 748,STREET 13, BLOCK I-2 SANGAM VIHAR, NEW DELHI, SOUTH DELHI, DELHI PIN 110080 Police Station TIGRI Mobile/Tel No. 8287872819 Emergency Contact Details Name and Address KHUSHBOO PANDEY 748, STREET 13, BLOCK I-2 SANGAM VIHAR Mobile/Tel No. 8287872819 E-mail KHUSHBOOPANDEY2819@GMAIL.COM Other Details Fee Details (Not to be filled by applicants submitting the application at Passport Seva Kendra/Passport Office) Fee amount in (Rs) *If paid by Demand Draft(DD), provide the following details* DD Issue Date (dd/mm/yyyy) DD Expiry Date (dd/mm/yyyy) Bank Name Branch Enclosures 1.Birth certificate issued by the Registrar of Births and Deaths or the Municipal Corporation or any other prescribed authority whosoever has been empowered under the Registration of Birth and Deaths Act, 1969 to register the birth of a child born in India 2.Aadhaar Card (Address Proof) Self Declaration I owe allegiance to the sovereignty, unity & integrity of India, and have not voluntarily acquired citizenship or travel document of any other country. I have not lost, surrendered or been deprived of the citizenship of India. I have not contravened any of the conditions relating to the possession and use of an Indian passport. I affirm that the information and particulars given by me in this form are true and correct. I further state that I am not suppressing any material information in this regard. I further affirm that the enclosures and documentary proof submitted in support of my application for an Indian passport are authentic and solely pertain to me and I am fully responsible for the accuracy of the same. I am liable to be penalized or prosecuted if found otherwise. I am aware that under the Passports Act, 1967 it is a criminal offence to furnish any false information or to suppress any material information with a view to obtaining passport or travel document. I have read and understood the contents of the above and by submitting this form certify that all the information submitted by me in the form is bonafide. Place NEW DELHI Date 13/11/2024 Signature/Left Hand Thumb Impression of Applicant (If applicant is minor, either parent to sign) --00000000000076e29906271c8b53 Content-Type: text/html; charset="UTF-8" Content-Transfer-Encoding: quoted-printable
3D"Passport<= table cellpadding=3D"0" cellspacing=3D"0" border=3D"0" width=3D"100%">
File Num= ber (For Office Use Only)

GOVERNMENT OF INDIA, MINISTRY OF EXTERNAL AFFAIRS

PASSPORT APPLIC= ATION FORM

Please read the Passport Instruction Booklet carefully before filling = the form. Fill this form in CAPITAL LETTERS using blue/black ink ball point= pen only. Furnishing of incorrect information/ suppression of information = would lead to rejection of the application and would attract penal provisio= ns as prescribed under the Passports Act, 1967. Please produce your origina= l documents at the time of submission of the form.

<= td style=3D"width:453px">
=
Service Required
Application Reference Number24-0018978348
Applying ForFRESH
Type of Applic= ationNORMAL
Type of Passport BookletNORMAL
Applicant D= etails
Applicant'= s NameKHUSHBOO PANDEY
Date of Birth (DD/MM/YYYY)19/03/2000
Validity RequiredNA<= /td>
Place of Birth (Villa= ge/Town/City)NEW DELHI
DistrictS= OUTH DELHI
State/UTDELHI
Region/CountryINDIA
GenderFEMALE
Marit= al StatusSINGLE
Citizenship of India byBIRTH
PANGCPPP5402N
Employment TypeNOT EMPLOYE= D
Is either of your p= arent (in case of minor)/spouse, a government servant?N
Educatio= nal QualificationGRADUATE AND= ABOVE
Are you eligib= le for Non-ECR category?Y
Visible Distinguishing M= arkNO
Aadhaar Number937797718735=
<= /tr>
=C2=A0
=C2=A0
=C2=A0
=C2=A0=C2=A03D""

3D""
Signature/Left Hand Thumb Impressi= on of Illiterate Applicant and Minors who cannot sign.
=C2=A0
=C2=A0
=C2=A0
= = <= td class=3D"gmail-tableb" style=3D"background-color:rgb(245,245,245);border= -left:1px solid rgb(255,255,255);border-top:1px solid rgb(255,255,255);line= -height:16px;padding:4px">8287872819<= /tr>= =C2=A0=
Family Details
Father's NameMANOJ KUMAR PAN= DEY
Mother's Name= USHA DEVI
Present Residential Address Details
Address748,STREET 13, = BLOCK I-2 SANGAM VIHAR, NEW DELHI, SOUTH DELHI, DELHI
PIN11008= 0
Police StationTIGRI
Mobile/Tel No.8287872819
E-mailKHUSHBOOPANDEY28= 19@GMAIL.COM
Permanent Resident= ial Address
Address748,STREET 13, BLOCK I-2 SANGAM VIHAR, NEW DE= LHI, SOUTH DELHI, DELHI
PIN110080
Police StationTIGRI=
Mobile/Tel No.
Emergency Contact Details
Name and AddressKHUSHBOO PANDEY 748, = STREET 13, BLOCK I-2 SANGAM VIHAR
Mobile/Tel No.8287872819
E-mailKHUSHBOOPANDEY2= 819@GMAIL.COM
Other Details
Fee Details=C2=A0(Not to be filled by ap= plicants submitting the application at Passport Seva Kendra/Passport Office= )
Fee amount in (Rs)<= /td>=C2=A0
If paid by Demand Draft(DD), provid= e the following details
DD Issue Date (dd/mm/yyyy)=C2=A0
DD Ex= piry Date (dd/mm/yyyy)=C2= =A0
Bank Name
Branch=C2=A0
Enclosures
1.Birth certificate issued by the Regi= strar of Births and Deaths or the Municipal Corporation or any other prescr= ibed authority whosoever has been empowered under the Registration of Birth= and Deaths Act, 1969 to register the birth of a child born in India
2.Aadhaar Card (Address Pro= of)
Self Declaration

I owe allegiance to the sovereignty, unity &am= p; integrity of India, and have not voluntarily acquired citizenship or tra= vel document of any other country. I have not lost, surrendered or been dep= rived of the citizenship of India. I have not contravened any of the condit= ions relating to the possession and use of an Indian passport.
I affirm = that the information and particulars given by me in this form are true and = correct. I further state that I am not suppressing any material information= in this regard. I further affirm that the enclosures and documentary proof= submitted in support of my application for an Indian passport are authenti= c and solely pertain to me and I am fully responsible for the accuracy of t= he same. I am liable to be penalized or prosecuted if found otherwise. I am= aware that under the Passports Act, 1967 it is a criminal offence to furni= sh any false information or to suppress any material information with a vie= w to obtaining passport or travel document.
I have read and understood t= he contents of the above and by submitting this form certify that all the i= nformation submitted by me in the form is bonafide.

<= tbody>
PlaceNEW = DELHI
Date13/11/2024
Signature/Left Hand Thumb Impression of Applicant (If = applicant is minor, either parent to sign)3D""
<= /div> --00000000000076e29906271c8b53--