Professional Documents
Culture Documents
Se rv ice Re qui re d
Applicant De tai ls
Marital
Country INDIA Gender MALE SINGLE
Status
Fam il y De tai ls
PIN 575025
Mobile/Tel No 9686422743
Email aru91190@gmail.com
Mobile/Tel No 9742020255
Mobile/Tel No 9972331987
Pe rm ane nt Addre ss
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Application Form https://portal2.passportindia.gov.in/wps/PA_PSPOnlineProject/popuponli...
PIN 581400
Othe r D e tai ls
Se lf De cl aratio n
I owe allegiance to the sovereignty, unity and integrity of India, and have not voluntarily acquired citizenship or travel document of any
other country. I have not lost, surrendered or been deprived of the citizenship of India and I affirm that the information given by me in
this form and the enclosures is true and I am solely responsible for its accuracy, and I am liable to be penalized or prosecuted if found
otherwise. I am aware that under the Passports Act, 1967 it is a criminal offence to furnish any false information or to suppress any
material information with a view to obtaining passport or travel document.
Place SURATHKAL
Date 28/01/2011
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