�वदशे म�ंालय भारत सरकार

Ministry of External Affairs Government of India

Online Appointment Receipt

Applicant Details:

Application Reference No.(ARN)

15-1001439793

Service Type REISSUE

Type of Application NORMAL

Given Name YUVARAJ

Surname GOVINDARAJAN

Father's Name GOVINDARAJAN PARTHASARATHY

Mother's Name KALAVATHY GOVINDARAJAN

Spouse's Name VANITHA YUVARAJ

Date of Birth 23/04/1981

Place of Birth CHENNAI,CHENNAI,TAMIL NADU

Gender MALE

Marital Status MARRIED

Employment Type SELF EMPLOYED

Application Submitted Date 18/02/2015

Present Address NO 43 SUNDARAM PILLAI STREET,PURASAWALKAM, CHENNAI, 600007,TAMIL NADU, INDIA

Applicants References Details:

First ReferenceMR AMSA BAI NO 57 CSN COMPLEXJERMIAH ROAD VEPERY CHENNAI600007

Second ReferenceMR DILLI BABU 32 SUNDARAM PILLAISTREET PURASAWALKAM CHENNAI600007

Payment Details#

Total Fee (Rs.) 1500.00

Paid Fee (Rs.) 1500.00

Date and Time 18/02/2015 04:25 PM

Transaction Id CP14992325

Appointment Details:

Passport Seva KendraAddress

SALIGRAMAM, NO. 1, BHANUMATHI RAMAKRISHNA ROAD,SALIGRAMAM, CHENNAI

Appointment Id 100006316307215

Appointment Dateand Time

23/02/2015 & 03:30 PM

Reporting Date andTime

23/02/2015 & 03:15 PM

Batch 22

Sequence No. 41

Previous Passport Details

Old Passport No. F1963583

Passport Issue Date 24/02/2005

Passport Expiry Date 23/02/2015

Place of Issue CHENNAI

Please Read Carefully:

Please reach Passport Seva Kendra (PSK) at 03:15 PM as mentioned above and carry the printed copy of this appointment receipt.Check Document Adv isor on website 'www.passportindia.gov .in' to know the documents required at PSK.Carry original documents and theirself attested photocopies. Final decision with regard to documents required is at the discretion of RPO staff at PSK.In case of minor applicants (below 4 years of age), carry the recent passport size photograph (4.5 X 3.5 cm) with white background.Only applicant is allowed inside the PSK. However, in case of exceptions such as Senior Citizen / Physically Challenged / Il l i terate / Minorapplicants, one person from the family may be allowed to accompany inside PSK.At PSK, a paper token will be issued to you after checking of documents.Your application will be processed at Counter A followed by countersB and C. 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 acknowledgement slip from the Exit counter before leaving PSK. Also,you are requested to fi l l the feedback form at the exitcounter.Corrosive substances, explosives, weapons and any sharp objects are not allowed inside the PSK. Please co-operate with security staff forfrisking before entry in PSK. Your security is our primary concern.Take care of your belongings inside the PSK.Keep your mobile in silent mode inside PSK. Also video / photography is not allowed inside.You have not opted for 'Passport Seva SMS Services'. To enrol, please go to 'Enrol for SMS Services (Optional)' l ink available at 'ApplicantHome' Page of the website.Balance fee (if applicable) after editing the submitted form will be payable in cash at the Passport Seva Kendra.ATM facil ity available at PSK for all Bank Cards.Help us to serv e you better.

# Details as per the Payment Date. Payment once made for av ailing passport serv ices will not be refunded.

The following table lists Applicant Categories along with the Documents to be Submitted. The Document No. mentioned inDocuments to be Submitted column is the reference given to the document mentioned in List of Documents table.

Applicant Categories Documents to be Submitted

Additional Booklet (Exhaustion of Visa pages) 1 (if address is dif f erent f rom old Passport), 4

Expiry of old passport

1. Within the time period of one y ear bef ore expiry and three y ear af ter expiry of

old Passport1 (if address is dif f erent f rom old Passport), 4

2. Af ter three y ears of expiry of old passport 1 (if address is dif f erent f rom old Passport), 4

3. Renewal of Short Validity Passport (SVP) 1 (if address is dif f erent f rom old Passport), 4, 14

4. Gov ernment/ Public Sector/ Statutory body employ ees (Still serv ing) 1 (if address is dif f erent f rom old Passport), 4, 11

5. Retired gov ernment of f icial 1 (if address is dif f erent f rom old Passport), 4, 6

6. Students going f or higher studies abroad upto 2 y ears f rom expiry of Passport 1 (if address is dif f erent f rom old Passport), 4, 15

Damaged Passport (Passport number is readable, name is legible and Photo is

intact)1 ( if address is dif f erent f rom old Passport ), 2, 4, 16

Lost/ Damaged bey ond recognition/ Stolen Passport

1, 2, 16, 17, 18 (if av ailable)

Note: Other documents which hav e to be submitted are as per the case, as in the

case of f resh Passport.

Change in Particulars

1. A woman apply ing f or change of name/ surname in existing Passport due to

marriage

(i) 4, 19 (if he has Passport)

(ii) 8 or 12 or 13

2. Div orcees/ Separated apply ing f or change of name OR f or deletion of

spouse's name in existing Passport

(i) 4, 30

(ii) if div orced, 20 or 21 (issued by Qazi)

(iii) if separated, 12

3. Re-married applicants apply ing f or change of name/ spouse's name

(i) 4, 19 (of present husband, if he has Passport)

(ii) 8 (Re-marriage certif icate) or 12 or 29

(iii) 13 or 21 (as the case may be in respect of f irst spouse)

4. Change of name in other circumstances (minor change in name-both male and

f emale i.e. spelling discrepancy between Passport and documents which

phonetically does not result in total change in name)

4, 30

5. Major change in name (cases dif f erent f rom minor change case) 4, 7, 30

6. Change in name in case of Gov ernment/ Public Sector/ Statutory body

employ ees4, 9, 10, 30

7. Change in Sex 4, 22, 23

8. Change of Appearance 4, 24

9. Change/ Correction of DoB2, 4, 25 ( if change in DoB is more than 2 y ears or in case of conf licting

documents), 31

10. Change/ Correction of place of birth4, 25 (if change in place of birth inv olv es State change or Country change), 26,

32

11. Change in Current Address 1 (changed address), 4

12. Change in Signature 4

13. Addition of Spouse Name(i) 4

(ii) 8 or 12 or 29

14. Change of Father/ Mother name 4, 5 (of f ather/mother with changed name - if av ailable) or 27 or 28

15. ECR Deletion 1 ( if address is dif f erent f rom old Passport ), 3, 4

DocumentNo.

List of Documents

1.

Proof of Present Address. For Proof of Address attach one of the f ollowing documents:

a. Water bill/ Telephone (landline or post paid mobile bill)/ Electricity bill (at least 2 bills are required - One bill should of be of last y ear and

the other bill of current y ear)

b. One y ear statement (with transactions)/ Passbook of running bank account (Public Sector Banks only )

c. Income Tax Assessment Order

d. Election Commission Photo ID card

e. Gas connection bill

f . Certif icate f rom Employ er of reputed and widely known companies on letter head (Only public limited companies can giv e address proof

on company letter head along with seal. Computerised print-outs shall not be entertained)

g. Spouse's passport copy (First and last page including f amily details), (prov ided the applicant's present address matches the address

mentioned in the spouse's passport)

h. Applicant's current and v alid ration card

NOTE 1: If any applicant submits only ration card as proof of address, it should be accompanied by one more proof of address out of

the giv en categories.

i. Parent's passport copy , in case of minors (First and last page)

j. Aadhaar Letter/ Card (If aadhaar card issuance date is less than a y ear f rom passport application processing date at PSK, it should be

accompanied by one more proof of address out of the giv en categories)

k. Registered Rent Agreement (f or a period of more than one y ear)

2.

Proof of Date of Birth. For Proof of Date of Birth attach one of the f ollowing documents:

a. Birth certif icate issued by a Municipal Authority or any of f ice authorized to issue Birth and Death Certif icate by the Registrar of Births &

Deaths

b. School leav ing certif icate / Secondary School leav ing certif icate/ Certif icate of Recognized Boards f rom the school last attended by the

applicant or any other recognized educational institution

c. Af f idav it sworn bef ore a Magistrate/Notary stating date/place of birth as per the specimen in Annexure "A" by illiterate or semi-illiterate

applicants (Less than 5th class).

For applicants born on or af ter 26.01.89, only Birth Certif icate issued by the Municipal Authority or any of f ice authorized to issue Birth and Death

Certif icate by the Registrar of Births & Deaths is acceptable. The Birth Certif icate should ordinarily contain the name of child, name of f ather and

mother, date of birth, place of birth, sex, registration number and date of registration. If the Birth Certif icate doesn't contain the name of child, a

declaration on plain paper signed by parents, is required to be submitted specif y ing the name of the child.

3.Documentary proof f or any one of the Non-ECR (prev iously ECNR) categories, Ref er Column 2.15 under Section-B of passport instruction

booklet

4.Old Passport in original with self -attested photocopy of its f irst two and last two pages, including ECR/Non-ECR page (prev iously ECNR) and the

page of observ ation (if any ), made by Passport Issuing Authority and v alidity extension page, if any , in respect of short v alidity passport

5.Passport of parents in original with self -attested photocopy of its f irst two and last two pages, including ECR/Non-ECR page (prev iously ECNR)

and the page of observ ation (if any ), made by Passport Issuing Authority and v alidity extension page, if any , in respect of short v alidity passport

6. Pension Pay ment Order

7.Paper clipping of two leading daily newspapers in original (one daily newspaper should be of the area of Applicant's Permanent Address and the

other at Current Address or nearby area)

8. An attested copy of marriage certif icate issued by Registrar of Marriage

9. Gazette Notif ication changing name in applicant's department

10. Fresh ID Certif icate in changed name

11. No Objection Certif icate (NOC) (as per Annexure 'M')

12.

Af f idav it sworn bef ore First Class Judicial Magistrate or Executiv e Magistrate on Non-Judicial stamp paper f or re-issue of passport (which was

obtained prior to marriage) by married applicants who are unable to prov ide the prescribed marriage certif icate or joint af f idav it with spouse due to

marital discord, separation or without f ormal div orce decree by the Court or due to total desertion by the spouse as per specimen at Annexure 'K'

13.A joint af f idav it f rom husband and wif e along with a joint photograph, (Specimen at Annexure "D") When joint af f idav it is not possible the af f idav it

should indicate the reason f or it. If apply ing f or passport f or the f irst time, this af f idav it is required only if there is a change in the f irst name.

14. Proof of documents which eliminate the cause of issuance of Short Validity Passport (SVP)

15. Proof of going abroad f or studies like Copy of college admission letter or Copy of application submitted f or v isa or Copy of bank loan paper etc

16. Af f idav it stating how and where the Passport got lost/ damaged (Annexure 'L')

17. Police report in original

18. Self -attested photocopy of f irst two and last two pages, including ECR/Non-ECR page of old Passport

19. Self attested photocopy of the spouse's Passport

20. Court certif ied copy of Div orce decree

21. Self attested copy of Div orce certif icate

22. Sworn af f idav it regarding change of sex

23. Certif ication f rom hospital where he/she underwent sex change operation successf ully

24.Recent photograph (required only in case of DPC/SPC/CSC applications). The photo should be most recent showing the latest appearance. A

notarised statement is required in case of request f rom Sikhs who want to change f rom turban photo to clean shav en ones or the other way .

25.

First class judicial magistrate/ Sub-div isional magistrate civ il court order (if change in date of birth is more than 2 y ears/ in case of conf licting

documents/ if change in place of birth inv olv es change of State or Country ) (In case change of place of birth inv olv es change of country , also

attach Document No. 7)

26. Af f idav it stating the reason f or change in Place of Birth

27. Proof such as serv ice record/ pension order/ property documents showing that parents had changed their name

28. If parents are deceased , such proof that they had changed their name during lif etime

29.A joint af f idav it f rom husband and wif e along with a joint photograph, (Specimen at Annexure "D") When joint af f idav it is not possible the af f idav it

should indicate the reason f or it. If apply ing f or passport f or the f irst time, this af f idav it is required only if there is a change in the f irst name.

30. Deed poll/sworn af f idav it as per Annexure "E"

31. Af f idav it stating the reason f or change in Date of Birth

32. Proof of Place of Birth

Note: The list of documents provided in the table above is indicative. The decision of APO/RPO shall be considered final.