14/09/2016 AppointmentReciept

MinistryofExternalAffairsGovernmentofIndia
OnlineAppointmentReceipt

ApplicantDetails:

PaymentDetails#
ApplicationReferenceNo. TotalFee(Rs.) 1500.00
160008948462
(ARN)
PaidFee(Rs.) 1500.00
ServiceType REISSUE
DateandTime 19/07/201610:04PM
TypeofApplication NORMAL
TransactionId CP53867770
GivenName PANKAJKUMAR
Surname AppointmentDetails:
Gender MALE PassportSevaKendra LUCKNOW,
Father'sName ASHOKKUMAR Address RATANSQUARE,20A,VIDHANSABHA
Mother'sName PREMADEVI MARG,LUCKNOW226001

Spouse'sName POOJACHANDRA AppointmentId 100008811581116

DateofBirth 04/10/1983 AppointmentDate 27/09/2016&10:30AM
andTime
PlaceofBirth LUCKNOW,LUCKNOW,UTTARPRADESH
ReportingDateand 27/09/2016&10:15AM
MaritalStatus MARRIED Time
EmploymentType SELFEMPLOYED

ApplicationSubmittedDate 19/07/2016
PresentResidentialAddress 56/127/1A,B,C(65)CHHITWAPUR Batch 5
BHUIYANVIKASDEEP,LUCKNOW,
LUCKNOW,226001,UTTARPRADESH,
INDIA SequenceNo. 29
ApplicantsReferencesDetails:
HARSHKESARWANI56/127/13MANAS

FirstReference VIHARCOLONYCHITWAPURBHUIYAN
LUCKNOW,9984822220
PreviousPassportDetails
SHARADTIWARI55/120CHITWAPUR
OldPassportNo. F9862620
SecondReference BHUIYANVIKASDEEPLUCKNOW,
9415761429 PassportIssueDate 16/11/2006
PassportExpiryDate 15/11/2016
PlaceofIssue LUCKNOW

PleaseReadCarefully:
PleasereachPassportSevaKendra(PSK)at10:15AMasmentionedaboveandcarrytheprintedcopyofthisappointmentreceipt.
Check Document Advisor on website 'www.passportindia.gov.in' to know the documents required at PSK.Carry original documents and their self
attestedphotocopies.FinaldecisionwithregardtodocumentsrequiredisatthediscretionofRPOstaffatPSK.
Incaseofminorapplicants(below4yearsofage),carrytherecentpassportsizephotograph(4.5X3.5cm)withwhitebackground.
OnlyapplicantisallowedinsidethePSK.However,incaseofexceptionssuchasSeniorCitizen/PhysicallyChallenged/Illiterate/Minorapplicants,one
personfromthefamilymaybeallowedtoaccompanyinsidePSK.
AtPSK,apapertokenwillbeissuedtoyouaftercheckingofdocuments.YourapplicationwillbeprocessedatCounterAfollowedbycountersBandC.At
all stages, please be alert and watch the token display screens to know the counter at which your application will be processed. Please collect
acknowledgementslipfromtheExitcounterbeforeleavingPSK.Also,youarerequestedtofillthefeedbackformattheexitcounter.
Youhavenotoptedfor'PassportSevaSMSServices'.Toenrol,pleasegoto'EnrolforSMSServices(Optional)'linkavailableat'ApplicantHome'Pageof
thewebsite.
Balancefee(ifapplicable)aftereditingthesubmittedformwillbepayableincashatthePassportSevaKendra.
Helpustoserveyoubetter.
#DetailsasperthePaymentDate.Paymentoncemadeforavailingpassportserviceswillnotberefunded.

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14/09/2016 AppointmentReciept
ThefollowingtablelistsApplicantCategoriesalongwiththeDocumentstobeSubmitted.TheDocumentNo.mentionedinDocumentsto
beSubmittedcolumnisthereferencegiventothedocumentmentionedinListofDocumentstable.

ApplicantCategories DocumentstobeSubmitted
AdditionalBooklet(ExhaustionofVisapages) 1(ifaddressisdifferentfromoldPassport),4
Expiryofoldpassport
1.Withinthetimeperiodofoneyearbeforeexpiryandthreeyearafterexpiryofold
1(ifaddressisdifferentfromoldPassport),4
Passport
2.Afterthreeyearsofexpiryofoldpassport 1(ifaddressisdifferentfromoldPassport),4
3.RenewalofShortValidityPassport(SVP) 1(ifaddressisdifferentfromoldPassport),4,14
4.Government/PublicSector/Statutorybodyemployees(Stillserving) 1(ifaddressisdifferentfromoldPassport),4,11or33
5.Retiredgovernmentofficial 1(ifaddressisdifferentfromoldPassport),4,6
6.Studentsgoingforhigherstudiesabroadupto2yearsfromexpiryofPassport 1(ifaddressisdifferentfromoldPassport),4,15
DamagedPassport(Passportnumberisreadable,nameislegibleandPhotoisintact) 1(ifaddressisdifferentfromoldPassport),2,4,16
1,2,16,17,18(ifavailable)
Lost/Damagedbeyondrecognition/StolenPassport Note:Otherdocumentswhichhavetobesubmittedareasperthecase,asinthecase
offreshPassport.
ChangeinParticulars
(i)4,19(ifhehasPassport)
1.Awomanapplyingforchangeofname/surnameinexistingPassportduetomarriage
(ii)8or12or13
(i)4,30
2.Divorcees/SeparatedapplyingforchangeofnameORfordeletionofspouse'sname
(ii)ifdivorced,20or21
inexistingPassport
(iii)ifseparated,12
(i)4,19(ofpresenthusband,ifhehasPassport)
3.Remarriedapplicantsapplyingforchangeofname/spouse'sname (ii)8(Remarriagecertificate)or12or29
(iii)13or21(asthecasemaybeinrespectoffirstspouse)
4.Changeofnameinothercircumstances(minorchangeinnamebothmaleandfemale
i.e.spellingdiscrepancybetweenPassportanddocumentswhichphoneticallydoesnot 4,30
resultintotalchangeinname)
5.Majorchangeinname(casesdifferentfromminorchangecase) 4,7,30
6.ChangeinnameincaseofGovernment/PublicSector/Statutorybodyemployees 4,9,10,30
7.ChangeinSex 4,22,23
8.ChangeofAppearance 4,24
9.Change/CorrectionofDoB 2,4,25(ifchangeinDoBismorethan2yearsorincaseofconflictingdocuments),31
10.Change/Correctionofplaceofbirth 4,25(ifchangeinplaceofbirthinvolvesStatechangeorCountrychange),26,32
11.ChangeinCurrentAddress 1(changedaddress),4
12.ChangeinSignature 4
(i)4
13.AdditionofSpouseName
(ii)8or12or29
14.ChangeofFather/Mothername 4,5(offather/motherwithchangednameifavailable)or27or28
15.ECRDeletion 1(ifaddressisdifferentfromoldPassport),3,4

Document
ListofDocuments
No.
ProofofPresentAddress.ForProofofAddressattachoneofthefollowingdocuments:

a.Waterbill/Telephone(landlineorpostpaidmobilebill)/Electricitybill
b.PhotopassbookofrunningBankAccount(ScheduledPublicSectorBanks,ScheduledPrivateSectorIndianBanksandRegionalRuralBanksonly)
c.IncomeTaxAssessmentOrder
d.ElectionCommissionPhotoIDcard
e.Gasconnectionbill
f.CertificatefromEmployerofreputedandwidelyknowncompaniesonletterhead(Onlypubliclimitedcompaniescangiveaddressproofoncompany
letterheadalongwithseal.Computerisedprintoutsshallnotbeentertained)
g.Spouse'spassportcopy(Firstandlastpageincludingfamilydetails),(providedtheapplicant'spresentaddressmatchestheaddressmentionedinthe
spouse'spassport)
h.Parent'spassportcopy,incaseofminors(Firstandlastpage)
i.AadhaarLetter/Card
j.RegisteredRentAgreement
1.
Note:

1.Applicantsarerequiredtosubmittheproofofaddressofthepresentaddressonly,irrespectiveofthedatefromwhichhe/shehasbeenresidingatthe
givenaddress.However,he/sheisrequiredtomentionalltheplaceofstayduringpreviousoneyearinthePassportapplicationform.

2.FurnishingofAadhaarcardwillexpediteprocessingofpassportapplications.

3.Aadhaarletter/cardortheeAadhaar(anelectronicallygeneratedletterfromthewebsiteofUIDAI),asthecasemaybe,willbeacceptedasProofof
Address(POA)andProofofPhotoIdentity(POI)foravailingpassportrelatedservices.AcceptanceofAadhaarasPoAandPoIwouldbesubjectto
successfulvalidationwithAadhaardatabase.

4.AnyoftheremainingdocumentscontainingaddressoutofsixteendocumentslistedunderTatkaalapplication,couldalsobeacceptedasproofof
residenceifsuchdocumentshavethesamepresentresidentialaddressasgivenbytheapplicantinthePassportApplicationForm.

ProofofDateofBirth.ForProofofDateofBirthattachoneofthefollowingdocuments:

a.BirthcertificateissuedbyaMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeathCertificatebytheRegistrarofBirths&Deaths
b.Schoolleavingcertificate/SecondarySchoolleavingcertificate/CertificateofRecognizedBoardsfromtheschoollastattendedbytheapplicantor
anyotherrecognizededucationalinstitution
2. c.AffidavitswornbeforeaMagistrate/Notarystatingdate/placeofbirthasperthespecimeninAnnexure"A"byilliterateorsemiilliterateapplicants(Less
than5thclass).

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14/09/2016 AppointmentReciept
Forapplicantsbornonorafter26.01.89,onlyBirthCertificateissuedbytheMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeathCertificateby
theRegistrarofBirths&Deathsisacceptable.TheBirthCertificateshouldordinarilycontainthenameofchild,nameoffatherandmother,dateofbirth,placeof
birth,sex,registrationnumberanddateofregistration.IftheBirthCertificatedoesn'tcontainthenameofchild,adeclarationonplainpapersignedbyparents,
isrequiredtobesubmittedspecifyingthenameofthechild.
3. DocumentaryproofforanyoneoftheNonECR(previouslyECNR)categories,ReferColumn2.15underSectionBofpassportinstructionbooklet
OldPassportinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)andthepageof
4.
observation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvaliditypassport
Passportofparentsinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)andthepageof
5.
observation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvaliditypassport
6. PensionPaymentOrder
Paperclippingoftwoleadingdailynewspapersinoriginal(onedailynewspapershouldbeoftheareaofApplicant'sPermanentAddressandtheotheratCurrent
7.
Addressornearbyarea)
8. AnattestedcopyofmarriagecertificateissuedbyRegistrarofMarriage
9. GazetteNotificationchangingnameinapplicant'sdepartment
10. FreshIDCertificateinchangedname
11. NoObjectionCertificate(NOC)(asperAnnexure'M')
AffidavitswornbeforeFirstClassJudicialMagistrateorExecutiveMagistrateonNonJudicialstamppaperforreissueofpassport(whichwasobtainedpriorto
12. marriage)bymarriedapplicantswhoareunabletoprovidetheprescribedmarriagecertificateorjointaffidavitwithspouseduetomaritaldiscord,separationor
withoutformaldivorcedecreebytheCourtorduetototaldesertionbythespouseasperspecimenatAnnexure'K'
Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavitshouldindicate
13.
thereasonforit.Ifapplyingforpassportforthefirsttime,thisaffidavitisrequiredonlyifthereisachangeinthefirstname.
14. ProofofdocumentswhicheliminatethecauseofissuanceofShortValidityPassport(SVP)
15. ProofofgoingabroadforstudieslikeCopyofcollegeadmissionletterorCopyofapplicationsubmittedforvisaorCopyofbankloanpaperetc
16. AffidavitstatinghowandwherethePassportgotlost/damaged(Annexure'L')
17. Policereportinoriginal
18. Selfattestedphotocopyoffirsttwoandlasttwopages,includingECR/NonECRpageofoldPassport
19. Selfattestedphotocopyofthespouse'sPassport
20. CourtcertifiedcopyofDivorcedecree
21. SelfattestedcopyofDivorcecertificate
22. Swornaffidavitregardingchangeofsex
23. Certificationfromhospitalwherehe/sheunderwentsexchangeoperationsuccessfully
Recentphotograph(requiredonlyincaseofDPC/SPC/CSCapplications).Thephotoshouldbemostrecentshowingthelatestappearance.Anotarised
24.
statementisrequiredincaseofrequestfromSikhswhowanttochangefromturbanphototocleanshavenonesortheotherway.
Firstclassjudicialmagistrate/Subdivisionalmagistratecivilcourtorder(ifchangeindateofbirthismorethan2years/incaseofconflictingdocuments/if
25.
changeinplaceofbirthinvolveschangeofStateorCountry)(Incasechangeofplaceofbirthinvolveschangeofcountry,alsoattachDocumentNo.7)
26. AffidavitstatingthereasonforchangeinPlaceofBirth
27. Proofsuchasservicerecord/pensionorder/propertydocumentsshowingthatparentshadchangedtheirname
28. Ifparentsaredeceased,suchproofthattheyhadchangedtheirnameduringlifetime
Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavitshouldindicate
29.
thereasonforit.Ifapplyingforpassportforthefirsttime,thisaffidavitisrequiredonlyifthereisachangeinthefirstname.
30. Deedpoll/swornaffidavitasperAnnexure"E"
31. AffidavitstatingthereasonforchangeinDateofBirth
32. ProofofPlaceofBirth
33. PriorIntimationLetter(PI)(asperAnnexure'N')

Note:Thelistofdocumentsprovidedinthetableaboveisindicative.ThedecisionofAPO/RPOshallbeconsideredfinal.

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