Académique Documents
Professionnel Documents
Culture Documents
Embassy of India
Muscat
Website: http:// www.indemb-oman.org
E-mail : cons.muscat@mea.gov.in or indiamct@omantel.net.om
PASTE
A
PHOTO HERE
Plain white back ground and
dress in dark colour
(3.5X3.5 cm without
border)
don't sign the photo
Applicant should come personally or the documents should have been verified by the Honorary Consular Agent
authorized by the Embassy. FILL IN USING BLOCK LETTERS WITH BLUE/ BLACK INK ONLY AND ALL THE
COLUMNS SHOULD BE FILLED PROPERLY OTHER WISE THE APPLICATION MIGHT BE REJECTED.
________________________
(SURNAME NAME)
_________________________
(GIVEN NAME)
_______________________
(MIDDLE NAME)
2. IF YOU HAVE EVER CHANGED YOUR NAME, WRITE YOUR PREVIOUS NAME/Maiden name in case of a married woman:
3. PLACE OF BIRTH
4. COUNTRY OF BIRTH
5. DATE OF BIRTH
(/MM)
(YYYY)
NATIONALITY
NATIONALITY
NATIONALITY
11. PROFESSION
Company/Office
Designation
GSM. NO.
7.Educational
Qalification:
DATE OF ISSUE
15. ADDRESS OF PERSONS TO BE INTIMATED IN THE EVENT OF DEATH OR ACCIDENT ONE IN OMAN AND ONE IN INDIA:
OMAN
INDIA
16.HEIGHT
COLOUR OF EYES
COLOUR OF HAIR
ii) Descent
No
Yes
20. IF THIS APPLICATION IS FOR DUPLICATE PASSPORT, WAS THE PREVIOUS PASSPORT
LOST
DAMAGED
(If damaged, please attach damaged passport & if lost, then attach the requisite documents as per list)
21. a.) WERE YOU EVER REFUSED A PASSPORT?
Yes
NOT APPLICABLE
No
Yes
No
IF ANSWER TO ANY OF THESE QUESTIONS IS YES, PLEASE ENCLOSE A COPY OF THE OFFICIAL COMMUNICATION RECEIVED BY YOU
AND GIVE OTHER DETAILS.
22.LABOUR CARD/HEALTH CARD/DRIVING LICENCE NO.& DATE AND PLACE OF ISSUE
23.EMIGRATION STATUS: ECR/ECNR
24. ARE ANY CRIMINAL PROCEEDINGS AGAINST APPLICANT IN ANY COURT IN INDIA? IF SO, PLEASE GIVE DETAILS
25. HAS APPLICANT EVER BEEN REPATRIATED FROM ABROAD TO INDIA AT THE EXPENSE OF THE GOVT. OF INDIA? IF SO, DETAILS
PLEASE
26. NO. OF LOST/DAMAGED PASSPORT ____________ PLACE OF ISSUE _____________ DATE OF ISSUE _________________ VALID
UNTIL __________________________
27.Briefly state circumstances of loss/theft/damage of passport on a plain paper and attach copy of report lodged with local police in case
of loss/theft
28. Give details of restriction, if any, imposed on applicants damaged/lost passport
29. Did applicant avail himself/herself of transfer of residence, foreign travel scheme or any other facility like gold/silver import on
lost/damaged passport? If so, details please _______________________________________
Information given above in respect of _____________________________ of whom I am the parent / legal guardian is true.
I undertake to be entirely responsible for his / her expenses.
I solemnly declare that he / she has not lost, surrendered or been deprived of his/her citizenship of India.
I hereby declare that ________________________________ born in Oman has not applied for or acquired Omani/ any other
citizenship/travel document. Should I approach the Omani or any other authorities for such a travel document, I undertake to
inform the Embassy of India, Muscat immediately so that Indian travel document may be withdrawn.
Place: _________________________
Date: __________________________
Signature of both the Parents / Legal guardian