16/03/2016 AppointmentReciept

MinistryofExternalAffairsGovernmentofIndia
OnlineAppointmentReceipt

ApplicantDetails: PaymentDetails#
ApplicationReferenceNo. TotalFee(Rs.) 1500.00
161002507377
(ARN)
PaidFee(Rs.) 1500.00
ServiceType FRESH
DateandTime 16/03/201608:36PM
TypeofApplication NORMAL
TransactionId IG0BQXKVH0
GivenName SUDHADAS
Surname KHAN AppointmentDetails:
Gender FEMALE PassportSeva KOLKATA,
Father'sName MALAYKUMARDAS KendraAddress AAKASHTOWER,EASTERNBYEPASSRUBY,
Mother'sName LALITADAS KASBA781,ANANDPUR,KOLKATA700107
Spouse'sName ARIJITKHAN Appointment 100007866384216
Id
DateofBirth 01/11/1988
Appointment 21/03/2016&10:30AM
PlaceofBirth KUMARGRAM,JALPAIGURI,WEST DateandTime
BENGAL
Reporting
MaritalStatus MARRIED 21/03/2016&10:15AM
DateandTime
EmploymentType OTHERS
ApplicationSubmittedDate 14/03/2016

PresentResidential 17HNALINSARKARSTREET, Batch 9
Address KOLKATA,KOLKATA,700004,WEST
BENGAL,INDIA
ApplicantsReferencesDetails: SequenceNo. 9
DEBASISDEB,DEPARTMENTOF
MININGENGINEERING,IIT

FirstReference
KHARAGPUR,KHARAGPUR721302,
9434701966
MILONCHAKRABORTY,P122A,CIT
SecondReference ROAD,SCHEMEM6,KOLKATA700054,
9432260617

PleaseReadCarefully:
PleasereachPassportSevaKendra(PSK)at10:15AMasmentionedaboveandcarrytheprintedcopyofthisappointmentreceipt.
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.YourapplicationwillbeprocessedatCounterAfollowedby countersB
andC.Atallstages,pleasebealertandwatchthetokendisplayscreenstoknowthecounteratwhichyourapplicationwillbeprocessed.Please
collectacknowledgementslipfromtheExitcounterbeforeleavingPSK.Also,youarerequestedtofillthefeedbackformattheexitcounter.
Thanks for showing your interest in 'Passport Seva SMS Services' enrolment. Please pay Rs 40/ (FORTY ONLY) in cash as the Enrolment
ChargesduringyourvisittoPassportSevaKendra.
Balancefee(ifapplicable)aftereditingthesubmittedformwillbepayableincashatthePassportSevaKendra.
ATMfacilityavailableatPSKforallBankCards.
Helpustoserveyoubetter.
#DetailsasperthePaymentDate.Paymentoncemadeforavailingpassportserviceswillnotberefunded.

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16/03/2016 AppointmentReciept
ThefollowingtablelistsApplicantCategoriesalongwiththeDocumentstobeSubmitted.TheDocumentNo.mentionedin
DocumentstobeSubmittedcolumnisthereferencegiventothedocumentmentionedinListofDocumentstable.

ApplicantCategories
OrdinaryCase(CitizenofIndiabybirth)
CitizenofIndiabyDescent(BorntoIndianparent(s)outsideIndia)
CitizenofIndiabyRegistration/Naturalization(GrantedcitizenshipbyMHA)
ApplicantsrepatriatedfromabroadatGovernmentcost
ApplicantsdeportedtoIndia/EmergencyCertificatecases
Government/PublicSector/Statutorybodyemployees
DependentfamilymembersofGovernment/PublicSector/Statutorybody
employees(ForJ&Kchildreninagegroup1015yearsarecovered.Forrestof
Indiachildreninagegroup1821arecovered)
Retiredgovernmentofficials
ApplicantshavingDiplomatic/OfficialPassportandapplyingforordinaryPassport (ii)21or20or27ifapplicantisGovernment/PublicSector/Statutorybody
whileinservice
DependentfamilymembersofDiplomatic/OfficialPassportholderswhoarenot
governmentservants(ForJ&KChildreninagegroup1015yearsarecovered)
Owner,partnersanddirectorsofCompanieswhicharemembersofCII,FICCI&
ASSOCHAM.
Minorchangeinname
Majorchangeinname
Change/Additioninsurnameduetomarriage
ChangeinnameincaseofGovernment/PublicSector/Statutorybodyemployees 1,2,15,16,23
NagalandResidents
NagaoriginsresidingoutsideNagaland
JammuandKashmirResidents
JammuandKashmirResidentsstayingoutsideJ&Kformorethanfiveyears
Studentsstayingawayfromtheirparent'scurrentresidence
SeniorCitizens(ForJ&K:Men65+years,Women60+yearsForrestofIndia
65+years)
DocumentstobeSubmitted
1,2,3(iftheapplicantiseligibleforNonECR)
(i)1,2,3(iftheapplicantiseligibleforNonECR)
(ii)4or5or6
1,2,3(iftheapplicantiseligibleforNonECR),7
1,2,3(iftheapplicantiseligibleforNonECR),5(ifavailable),8,9
1,2,3(iftheapplicantiseligibleforNonECR),5(ifavailable),8(ifany),9
(i)1,2
(ii)21(ifNoPoliceVerificationisrequired)or20(ifPostPoliceVerificationis
required)or27(ifPrePoliceVerificationisrequired).
1,2,3(iftheapplicantiseligibleforNonECR),21(ofdependent)and24ifNo
PoliceVerificationisrequired
1,2,10(ifPostPoliceVerificationisrequired)
(i)1,2,11(12ifsurrendercertificateisnotavailable)
employee
Note:Incasetheapplicantsubmits"12","2"isnotrequired
1,2,3(iftheapplicantiseligibleforNonECR),26
(i)1,2
(ii)24and25ifPostPVisrequired
1(innewname),2(inoldname),3(iftheapplicantiseligibleforNonECR
Documentsinoldnameareallowed),23
1(innewname),2(inoldname),3(iftheapplicantiseligibleforNonECR
Documentsinoldnameareallowed),13,23
(i)1,2,3(iftheapplicantiseligibleforNonECR)
(ii)14or22
1,2,3(iftheapplicantiseligibleforNonECR)
Note:AdditionalPVrequiredfromGuwahatithroughMHA.
1,2,3(iftheapplicantiseligibleforNonECR)
Note:AdditionalPVrequiredfromGuwahatithroughMHA.
1,2,3(iftheapplicantiseligibleforNonECR)
1,2,3(iftheapplicantiseligibleforNonECR)
1,2,3(iftheapplicantiseligibleforNonECR),17,18
1,2,3(iftheapplicantiseligibleforNonECR),19(ifPostPoliceVerificationis
required)

Document
ListofDocuments
No.
ProofofPresentAddress.ForProofofAddressattachoneofthefollowingdocuments:

a.Waterbill/Telephone(landlineorpostpaidmobilebill)/Electricitybill
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
Note:Ifanyapplicantsubmitsonlyrationcardasproofofaddress,itshouldbeaccompaniedbyonemoreproofofaddressoutofthegiven
1. categories.
i.Parent'spassportcopy,incaseofminors(Firstandlastpage)
j.AadhaarLetter/Card
k.RegisteredRentAgreement(foraperiodofmorethanoneyear)

Note:

1.Applicantsarerequiredtosubmittheproofofaddressofthepresentaddressonly,irrespectiveofthedatefromwhichhe/shehasbeen
residingatthegivenaddress.However,he/sheisrequiredtomentionalltheplaceofstayduringpreviousoneyearinthePassport
applicationform.

2.Aadhaarletter/cardortheeAadhaar(anelectronicallygeneratedletterfromthewebsiteofUIDAI),asthecasemaybe,willbeacceptedas
ProofofAddress(POA)andProofofPhotoIdentity(POI)foravailingpassportrelatedservices.AcceptanceofAadhaarasPoAandPoI
wouldbesubjecttosuccessfulvalidationwithAadhaardatabase.

ProofofDateofBirth.ForProofofDateofBirthattachoneofthefollowingdocuments:

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16/03/2016 AppointmentReciept
a.BirthcertificateissuedbyaMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeathCertificatebytheRegistrarofBirths&
Deaths
b.Schoolleavingcertificate/SecondarySchoolleavingcertificate/CertificateofRecognizedBoardsfromtheschoollastattendedbythe
2. applicantoranyotherrecognizededucationalinstitution
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. BirthRegistrationCertificateissuedbyEmbassy/HighCommission/ConsulateofIndia
OldPassportinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)andthepage
5.
ofobservation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvaliditypassport
Passportofparentsinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)and
6.
thepageofobservation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvaliditypassport
7. CitizenshipCertificateissuedbyMinistryofHomeAffairs
8. Proofofrefundofrepatriation/deportationcost(ifany)toMinistryofExternalAffairs
9. OriginalEmergencyCertificate/SeizureMemoissuedbyAirportImmigrationAuthoritiesonapplicant'sarrivalinIndia
10. PensionPaymentOrder
11. ProofofsurrenderorcancellationofDiplomatic/officialPassport
12. CancelledPassport(ifsurrendercertificateisnotavailable),withaletterexplainingwhysurrendercertificateisnotavailable
Paperclippingoftwoleadingdailynewspapersinoriginal(onedailynewspapershouldbeoftheareaofApplicant'sPermanentAddressandtheother
13.
atCurrentAddressornearbyarea)
14. AnattestedcopyofmarriagecertificateissuedbyRegistrarofMarriage
15. GazetteNotificationchangingnameinapplicant'sdepartment
16. FreshIDCertificateinchangedname
17. StudentIdentityCardissuedbyGovernmentRecognizedEducationalInstitutions,inrespectoffulltimecourses
18. BonafideLetterfromauthorizedsignatoryofcollege(OnofficialletterheadofUGCrecognizedCollege)
19. Copyofchild's(Age>18)Passport,whoisstayingabroad(withpagehavingparent'sname)
20. NoObjectionCertificate(NOC)(asperAnnexure'M')
21. "IdentityCertificate"inoriginalasperAnnexure"B"
Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavit
22.
shouldindicatethereasonforit.Ifapplyingforpassportforthefirsttime,thisaffidavitisrequiredonlyifthereisachangeinthefirstname.
23. Deedpoll/swornaffidavitasperAnnexure"E"
24. StandardAffidavitasperAnnexure"I"
25. VerificationCertificateasperAnnexure"J"
26. PhotocopyofDiplomatic/OfficialPassport
27. PriorIntimationLetter(PI)(asperAnnexure'N')

Note:Thelistofdocumentsprovidedinthetableaboveisindicative.ThedecisionofAPO/RPOshallbeconsideredfinal.

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