3 Passport Sized

Coloured Photos

Form A [DIP 1(Rev)}

For Persons above 12 years

1 X 2 inch

1. Name
Mr. / Mrs. / Miss

First
Day

Month

2. Date of Birth

3. Place of Birth

Middle

Surname

Year

(In words)

Vill/Town

Tehsil

District

Province

4. Fathers/ Husband Name:

5. Nationality:

6. Religion:

8. Profession:

7. Qualification

9. Whether Pakistani

By Birth

By Descent

Country

By migration on
(date) .

Tick the box applicable

By Registration /
Naturalisation No. .

10. National Identity Card No

11. Place of Issue

12. Date of Issue

13. Permanent Address in Pakistan.....

...
14. Present Address..
15.

16.
No

FOR AJ&K applicant

(Applicants Father / Husband)

Place

Period
.

Full Name Block letters

1) .

Place/Date of Birth
..

Sex
.

2) .

3) .

CHILDREN (Endorsed on mothers passport)

FOR OFFICIAL USE ONLY

i) In person/A/L .
ii) P.V./Exempted ...

iii) N.I.C seen and punched/already punched..

(Photocopy Attached) ...
iv) Int/Appear to be Pak National
Authority ..
Name.

Signature & Thumb Impression Both in Black ink

For Ladies Right Thumb Impression

PTO

Telephone Mobile Email.

DECLARATION

17.
1.
2.
3.

I declare on solemn affirmation as under:To the best of my knowledge and belief the information given in this application is correct.
I have not previously held or applied for a passport of any description or been refused passport facilities.
All previous passports granted to me have been surrendered other than the passport or travel document noted below
which is now attached and that I have made no other application for a passport since the attached passport or travel
document was issued to me.

a.
b.

Number of the attached passport/travel document

Date of Issue.. C) Place of Issue...

Note:
1.

If the applicant had a passport which has been lost, he should furnish particulars as per Sub para (4) below.
The passport as per details given below has been lost. In the event of its coming again into possession I undertake to
return it to the Regional Passport Office.
a)
Passport Number..
b) Date of Issue..
c)
Place of Issue
d)
Circumstances in which passport was lost or destroyed and measures taken to recover it..
I have never been repatriated at Government expenses.
I am/am not a Government servant an employee of a semi-Government body a municipality, any other local body or a
State-owned Industry.
I have/have not served in the Armed Forces.
I am/am not reservist in the Armed forces.

2.
3.
4.
5.

DECLARATION IN CASE OF MUSLIMS

i)
ii)
iii)

I .....S/o, W/o, D/o.Aged..

Years, adult Muslim, Resident of hereby solemnly declare that:
I am Muslim and believe in the absolute and unqualified finality of the Prophethood of Muhammad (peace be upon him)
the last of the Prophets.
I do not recognize any person who claims to be a prophets in any sense of the word or of any description whatsoever
after Muhammad (Peace be upon him) or recognize such a claimant as prophet or a religious reformer as a Muslim.
I consider Mirza Ghulam Ahmad Quadiani to be an imposter Nabi & also consider his followers whether belonging to the
Lahori or Quadiani group to be Non-Muslim.

Date

Signature & thumb impression (with name

in block letter of applicant in indelible ink)

ATTESTATION
Application in cases of persons who have not attained the age of 18 years and are not issued with
identity card under the National Registration Act 1973.
I, as Father/Guardian/Attestor hereby attest that the information given above is correct to the best of
my knowledge and belief and that the photograph on page 1 of this application bears the true likeness of the applicant.
Signature of Father/Guardian/Attester
Address
Identity Card No..
Dated..Place of Issue..
FOR OFFICIAL USE ONLY
1. No. of Passport issued..
2. Date of issue
3. Date upto which Passport is valid.
Authority

Name..