11/17/2015

AppointmentReciept

MinistryofExternalAffairsGovernmentofIndia
OnlineAppointmentReceipt
ApplicantDetails:

PaymentDetails#

ApplicationReferenceNo.
151010159447
(ARN)

TotalFee(Rs.)

1500.00

PaidFee(Rs.)

1500.00

DateandTime

17/11/201502:02PM

TransactionId

CP33098702

ServiceType

REISSUE

TypeofApplication

NORMAL

GivenName

NITHYA

Surname

CHINNASAMY

AppointmentDetails:

Gender

FEMALE

Father'sName

CHINNASAMY

Spouse'sName

LAKSHMINARAYANAN

PassportSevaKendra MADURAI,
Address
CLARETPLAZA,MELAKKALMAINROAD,
KOCHADAI,MADURAI

DateofBirth

25/06/1987

PlaceofBirth

SATTUR,VIRUDHUNAGAR,TAMIL
NADU

MaritalStatus

MARRIED

EmploymentType

HOMEMAKER

ApplicationSubmitted
Date

17/11/2015

PresentResidential
Address

2/89A,CHOKKALINGAPURAMEAST,
KUNDALAKUTHOOR,
VIRUDHUNAGAR,626202,TAMIL
NADU,INDIA

ApplicantsReferencesDetails:

FirstReference

SecondReference

KUMARAGURU2/89A
CHOKKALINGAPURAMEAST
STREET,KUNDALAKUTHOOR,
SATTURTK,VIRUDHUNAGARDT.,
9715923651
MANIKANDAN2/89A
CHOKKALINGAPURAMEAST
STREET,KUNDALAKUTHOOR,
SATTURTK,VIRUDHUNAGARDT.,
9965408407

AppointmentId
100007470377015
AppointmentDate 18/11/2015&11:45AM
andTime
ReportingDateand 18/11/2015&11:30AM
Time

Batch

Sequence
No.

10

28

PreviousPassportDetails
OldPassportNo.

H3766704

PassportIssueDate

24/04/2009

PassportExpiryDate 23/04/2019
PlaceofIssue

CHENNAI

FileNumber

MASZ90051909

PleaseReadCarefully:
PleasereachPassportSevaKendra(PSK)at11:30AMasmentionedaboveandcarrytheprintedcopyofthisappointmentreceipt.
Check Document Advisor on website 'www.passportindia.gov.in' to know the documents required at PSK.Carry original documents and
theirselfattestedphotocopies.FinaldecisionwithregardtodocumentsrequiredisatthediscretionofRPOstaffatPSK.
Incaseofminorapplicants(below4yearsofage),carrytherecentpassportsizephotograph(4.5X3.5cm)withwhitebackground.
OnlyapplicantisallowedinsidethePSK.However,in case of exceptions such as Senior Citizen / Physically Challenged / Illiterate / Minor
applicants,onepersonfromthefamilymaybeallowedtoaccompanyinsidePSK.
At PSK, a paper token will be issued to you after checking of documents.Your application will be processed at Counter A followed by
countersBandC.Atallstages,pleasebealertandwatchthetokendisplayscreenstoknowthecounteratwhichyourapplicationwillbe
processed.PleasecollectacknowledgementslipfromtheExitcounterbeforeleavingPSK.Also,youarerequestedtofillthefeedbackform
attheexitcounter.
Thanks for showing your interest in 'Passport Seva SMS Services' enrolment. Please pay Rs 35/ (THIRTY FIVE ONLY) in cash as the
EnrolmentChargesduringyourvisittoPassportSevaKendra.
ATMfacilityavailableatPSKforallBankCards.
Helpustoserveyoubetter.
#DetailsasperthePaymentDate.Paymentoncemadeforavailingpassportserviceswillnotberefunded.

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ThefollowingtablelistsApplicantCategoriesalongwiththeDocumentstobeSubmitted.TheDocumentNo.mentionedin
DocumentstobeSubmittedcolumnisthereferencegiventothedocumentmentionedinListofDocumentstable.

ApplicantCategories

DocumentstobeSubmitted

AdditionalBooklet(ExhaustionofVisapages)

1(ifaddressisdifferentfromoldPassport),4

Expiryofoldpassport
1.Withinthetimeperiodofoneyearbeforeexpiryandthreeyearafterexpiryof
1(ifaddressisdifferentfromoldPassport),4
oldPassport
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.Studentsgoingforhigherstudiesabroadupto2yearsfromexpiryof
Passport

1(ifaddressisdifferentfromoldPassport),4,15

DamagedPassport(Passportnumberisreadable,nameislegibleandPhotois
intact)

1(ifaddressisdifferentfromoldPassport),2,4,16

Lost/Damagedbeyondrecognition/StolenPassport

1,2,16,17,18(ifavailable)
Note:Otherdocumentswhichhavetobesubmittedareasperthecase,asin
thecaseoffreshPassport.

ChangeinParticulars
1.Awomanapplyingforchangeofname/surnameinexistingPassportdueto
marriage

(i)4,19(ifhehasPassport)
(ii)8or12or13

2.Divorcees/SeparatedapplyingforchangeofnameORfordeletionof
spouse'snameinexistingPassport

(i)4,30
(ii)ifdivorced,20or21
(iii)ifseparated,12

3.Remarriedapplicantsapplyingforchangeofname/spouse'sname

(i)4,19(ofpresenthusband,ifhehasPassport)
(ii)8(Remarriagecertificate)or12or29
(iii)13or21(asthecasemaybeinrespectoffirstspouse)

4.Changeofnameinothercircumstances(minorchangeinnamebothmale
andfemalei.e.spellingdiscrepancybetweenPassportanddocumentswhich
phoneticallydoesnotresultintotalchangeinname)

4,30

5.Majorchangeinname(casesdifferentfromminorchangecase)

4,7,30

6.ChangeinnameincaseofGovernment/PublicSector/Statutorybody
employees

4,9,10,30

7.ChangeinSex

4,22,23

8.ChangeofAppearance

4,24

9.Change/CorrectionofDoB

2,4,25(ifchangeinDoBismorethan2yearsorincaseofconflicting
documents),31

10.Change/Correctionofplaceofbirth

4,25(ifchangeinplaceofbirthinvolvesStatechangeorCountrychange),26,
32

11.ChangeinCurrentAddress

1(changedaddress),4

12.ChangeinSignature

13.AdditionofSpouseName

(i)4
(ii)8or12or29

14.ChangeofFather/Mothername

4,5(offather/motherwithchangednameifavailable)or27or28

15.ECRDeletion

1(ifaddressisdifferentfromoldPassport),3,4

Document
No.

ListofDocuments
ProofofPresentAddress.ForProofofAddressattachoneofthefollowingdocuments:

1.

a. Waterbill/Telephone(landlineorpostpaidmobilebill)/Electricitybill
b. PhotopassbookofrunningBankAccount(ScheduledPublicSectorBanks,ScheduledPrivateSectorIndianBanksandRegionalRural
Banksonly)
c. IncomeTaxAssessmentOrder
d. ElectionCommissionPhotoIDcard
e. Gasconnectionbill
f. CertificatefromEmployerofreputedandwidelyknowncompaniesonletterhead(Onlypubliclimitedcompaniescangiveaddressproof
oncompanyletterheadalongwithseal.Computerisedprintoutsshallnotbeentertained)
g. Spouse'spassportcopy(Firstandlastpageincludingfamilydetails),(providedtheapplicant'spresentaddressmatchestheaddress
mentionedinthespouse'spassport)
h. Applicant'scurrentandvalidrationcard
Note:Ifanyapplicantsubmitsonlyrationcardasproofofaddress,itshouldbeaccompaniedbyonemoreproofofaddressoutofthe
givencategories.
i. Parent'spassportcopy,incaseofminors(Firstandlastpage)
j. AadhaarLetter/Card(IfaadhaarcardissuancedateislessthanayearfrompassportapplicationprocessingdateatPSK,itshouldbe
accompaniedbyonemoreproofofaddressoutofthegivencategories)
k. RegisteredRentAgreement(foraperiodofmorethanoneyear)
Note:Applicantsarerequiredtosubmittheproofofaddressofthepresentaddressonly,irrespectiveofthedatefromwhichhe/shehasbeen
residingatthegivenaddress.However,he/sheisrequiredtomentionalltheplaceofstayduringpreviousoneyearinthePassportapplication
form.
ProofofDateofBirth.ForProofofDateofBirthattachoneofthefollowingdocuments:

2.

a. BirthcertificateissuedbyaMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeathCertificatebytheRegistrarofBirths
&Deaths
b. Schoolleavingcertificate/SecondarySchoolleavingcertificate/CertificateofRecognizedBoardsfromtheschoollastattendedbythe
applicantoranyotherrecognizededucationalinstitution
c. AffidavitswornbeforeaMagistrate/Notarystatingdate/placeofbirthasperthespecimeninAnnexure"A"byilliterateorsemiilliterate
applicants(Lessthan5thclass).

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AppointmentReciept
Forapplicantsbornonorafter26.01.89,onlyBirthCertificateissuedbytheMunicipalAuthorityoranyofficeauthorizedtoissueBirthandDeath
CertificatebytheRegistrarofBirths&Deathsisacceptable.TheBirthCertificateshouldordinarilycontainthenameofchild,nameoffatherand
mother,dateofbirth,placeofbirth,sex,registrationnumberanddateofregistration.IftheBirthCertificatedoesn'tcontainthenameofchild,a
declarationonplainpapersignedbyparents,isrequiredtobesubmittedspecifyingthenameofthechild.
3.

DocumentaryproofforanyoneoftheNonECR(previouslyECNR)categories,ReferColumn2.15underSectionBofpassportinstruction
booklet

4.

OldPassportinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)andthe
pageofobservation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvaliditypassport

Passportofparentsinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopages,includingECR/NonECRpage(previouslyECNR)
5. andthepageofobservation(ifany),madebyPassportIssuingAuthorityandvalidityextensionpage,ifany,inrespectofshortvalidity
passport
6. PensionPaymentOrder
7.

Paperclippingoftwoleadingdailynewspapersinoriginal(onedailynewspapershouldbeoftheareaofApplicant'sPermanentAddressandthe
otheratCurrentAddressornearbyarea)

8. AnattestedcopyofmarriagecertificateissuedbyRegistrarofMarriage
9. GazetteNotificationchangingnameinapplicant'sdepartment
10. FreshIDCertificateinchangedname
11. NoObjectionCertificate(NOC)(asperAnnexure'M')
12.

AffidavitswornbeforeFirstClassJudicialMagistrateorExecutiveMagistrateonNonJudicialstamppaperforreissueofpassport(whichwas
obtainedpriortomarriage)bymarriedapplicantswhoareunabletoprovidetheprescribedmarriagecertificateorjointaffidavitwithspousedue
tomaritaldiscord,separationorwithoutformaldivorcedecreebytheCourtorduetototaldesertionbythespouseasperspecimenatAnnexure
'K'

13.

Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavit
shouldindicatethereasonforit.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
24.

Recentphotograph(requiredonlyincaseofDPC/SPC/CSCapplications).Thephotoshouldbemostrecentshowingthelatestappearance.A
notarisedstatementisrequiredincaseofrequestfromSikhswhowanttochangefromturbanphototocleanshavenonesortheotherway.

Firstclassjudicialmagistrate/Subdivisionalmagistratecivilcourtorder(ifchangeindateofbirthismorethan2years/incaseofconflicting
25. documents/ifchangeinplaceofbirthinvolveschangeofStateorCountry)(Incasechangeofplaceofbirthinvolveschangeofcountry,also
attachDocumentNo.7)
26. AffidavitstatingthereasonforchangeinPlaceofBirth
27. Proofsuchasservicerecord/pensionorder/propertydocumentsshowingthatparentshadchangedtheirname
28. Ifparentsaredeceased,suchproofthattheyhadchangedtheirnameduringlifetime
29.

Ajointaffidavitfromhusbandandwifealongwithajointphotograph,(SpecimenatAnnexure"D")Whenjointaffidavitisnotpossibletheaffidavit
shouldindicatethereasonforit.Ifapplyingforpassportforthefirsttime,thisaffidavitisrequiredonlyifthereisachangeinthefirstname.

30. Deedpoll/swornaffidavitasperAnnexure"E"
31. AffidavitstatingthereasonforchangeinDateofBirth
32. ProofofPlaceofBirth
33. PriorIntimationLetter(PI)(asperAnnexure'N')

Note:Thelistofdocumentsprovidedinthetableaboveisindicative.ThedecisionofAPO/RPOshallbeconsideredfinal.

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