1/18/2014

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 14-1000454459 Batch 1 Service Type FRESH Type of Application Normal Sequence No. 6 Application Submitted Date16/01/2014 Date of Birth 15/12/1992 Reporting Time 09:15 AM Gender MALE Employment Type STUDENT Marital Status SINGLE Place of Birth SILCHAR,CACHAR,ASSAM Given Name PAWAN KUMAR Surname RATHI Father's Name RAM CHANDRA RATHI Mother's Name KIRAN RATHI Present Address ROOM 131, G HOSTEL,NIT CALICUT, KOZHIKODE, KOZHIKODE CITY - 673601, KERALA, INDIA Applicants References : First Reference Details MANISH JAISWAL,ROOM 131, G HOSTEL,NIT CALICUT,KOZHIKODE, 8714919727 Second Reference Details ANKIT SETHIA,ROOM 148, C HOSTEL,NIT CALICUT,KOZHIKODE, 7736205459 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 1500.00 1500.00 16/01/2014 08:11 PM IGQ0034782 Kozhikode, KOYENCO HOUSE, WEST HILL CHUNGAM, KANNUR ROAD, KOZHIKODE - 673005 21/01/2014 & 09:30 AM 100005133991414 09:15 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. 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. Appointm ent is available due to cancellation of previously booked appointm ent.

# 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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