15/2/2014

Application Form

Passport Application Government of India, Ministry of External Affairs Online Application Receipt

ATM facility available in PSK for all Bank Cards

Applicant Details : Application Reference No 14-1001410601 Batch 6 Service Type FRESH Type of Application Normal Sequence No. 10 Application Submitted Date14/02/2014 Date of Birth 16/05/1992 Reporting Time 10:30 AM Gender MALE Employment Type STUDENT Marital Status SINGLE Place of Birth CHENNAI,CHENNAI,TAMIL NADU Given Name DILIP KUMAR Surname VIGNESH Father's Name BABU DORAIKANNU Mother's Name DEVIKA BABU Present Address ROOM NO 235,ZIRCON-C HOSTEL, NIT TRICHY, TRICHIRAPALLI, TRICHY RURAL - 620015, TAMIL NADU, INDIA Applicants References : First Reference Details K R ARUN MOZHI DEVAN Second Reference Details PRATAPAN K Payment Details:# Total Fee (Rs.) Paid Fee (Rs.) Date and Time Transaction Id Appointment Details : PSK Location Date & Time of Appointment Appointment Id Reporting Time 2000.00 2000.00 15/02/2014 07:06 AM CP04686397 Trichy, PLOT NO. A5, SALAI ROAD & SHASTRI ROAD JUNCTION, THILLAI NAGAR, TRICHY 14/03/2014 & 10:45 AM 100005207599214 10:30 AM

Thanks for showing your interest in 'Passport Seva SMS Services' enrolment. Please pay Rs 30/- (THIRTY ONLY) in cash as the Enrolment Charges during your visit to Passport Seva Kendra.
Note: Applicant should reach the Passport Seva Kendra by the reporting tim e m entioned above for pre-checking of docum ents to avoid any hassles in issuance of token. Applicant should bring all the originals and one set of photo copy, photo copies should be self attested by the applicant. In case of m inor either of the parents has to sign on all photo copies. One accom panying person from the fam ily w ill be allow ed along w ith Senior Citizens, Physically Challenged, Illiterate and Minor applicants only. Applicant w ill not be issued token at Passport Seva Kendra, if they report after scheduled appointm ent tim e.
https://portal2.passportindia.gov.in/AppOnlineProject/secure/openPdfForApplReciept 1/2

15/2/2014

Application Form

Minor applicants below 4 years of age need to carry a recent coloured passport size (4.5 x 3.5 cm ) photograph w ith a w hite background w hile visiting Passport Seva Kendra. Other applicants need not carry any photograph as photograph w ill be captured at the Passport Seva Kendra. Carrying of corrosive substances or explosives, arm s or any sharp objects w hich m ay cause physical harm or violence are prohibited inside the PSK. Electronic item such as cam era is prohibited inside the PSK. Balance fee (if applicable) after editing the subm itted form w ill be payable in cash at the Passport Seva Kendra.

# Details as per the Payment Date. Payment once made for availing passport services will not be refunded.

https://portal2.passportindia.gov.in/AppOnlineProject/secure/openPdfForApplReciept

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