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Application Form

Passport Application Government of India, Ministry of External Affairs Online Application Receipt
Applicant Details : Application Reference No 13-1000429091 Batch 24 Service Type REISSUE Type of Application Normal Sequence No. 1 Application Submitted Date24/01/2013 Date of Birth 15/07/1998 Reporting Time 03:45 PM Gender MALE Employment Type STUDENT Marital Status SINGLE Place of Birth BAHRAIN,BAHRAIN Given Name WASEEM SHAMSUDHIN Surname Father's Name SHAMSUDHIN KADAVATH MADATHUMKEEZHIL PADAYAN Mother's Name HAFSA SHAMSUDHIN Present Address NOORMAHAL, NEAR FIRESTATION, PAZHANKAVE VATAKARA KOZHIKODE RURAL - 673104 KERALA , INDIA Applicants References : First Reference Details MANESH, ANUGRAHA, PAZHANKAVU, NEAR FIRESTATION, VADAGARA, 673104 , 9446521458 Second Reference Details SOUDA, KOHINOOR MAHAL, PAZHANKAVU, NEAR FIRESTATION, 673104 , 04962524432 Previous Passport Details : Old Passport No. G5439761 Passport Issue Date 08/01/2008 Passport Expiry Date 07/01/2013 Place of Issue KOZHIKODE Appointment Details : VADAKARA, GROUND FLOOR AND FIRST PSK Location FLOOR OF KOYENCO ENCLAVE VATAKARA KOZHIKODE ROAD, VADAKARA, KOZHIKODE - 673101 Date & Time of 04/02/2013 & 04:00 PM Appointment Appointment ID 100003602293413 Reporting Time 03:45 PM
Note: The passport & related application fee has been revised w ith effect from 1st October 2012. Please visit w ebsite w w w .passportindia.gov.in and use Fee Calculator option on the hom e page before visiting the PSK to know the revised applicable fees. You m ay also check the notification on the w ebsite in this regard. Applicant should reach the Passport Seva Kendra by the reporting tim e m entioned above for pre-checking of docum ents to avoid any hassles in issuance of token. Only in the case of Senior Citizens, Physically Challenged, Illiterate Applicants and Minor cases, one accom panying person from the fam ily w ill be allow ed along w ith the applicant. Applicant w ill not be issued token at Passport Seva Kendra, if they report after scheduled appointm ent tim e. Minor applicants below 4 years of age need to carry a passport size photograph (w ith a w hite background) w hile visiting Passport Seva Kendra (PSK). Other applicants need not carry any photograph as photograph w ill be captured at the Passport Seva Kendra (PSK). Carrying of corrosive substances or explosives, arm s or any sharp objects w hich m ay cause physical harm or violence are prohibited inside the PSK. Electronic item such as cam era is prohibited inside the PSK. *ARN w ill be valid for 90 days.

https://portal2.passportindia.gov.in/AppOnlineProject/secure/openPdfForApplReciept

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