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10/16/2015 AppointmentReciept

MinistryofExternalAffairsGovernmentofIndia
OnlineAppointmentReceipt

ApplicantDetails: PaymentDetails#
ApplicationReferenceNo. TotalFee(Rs.) 500.00
151009165571
(ARN)
PaidFee(Rs.) 500.00
ServiceType PCC
DateandTime 13/10/201511:55AM
GivenName IRFANABDULBARI
TransactionId 19788240
Surname
Gender MALE AppointmentDetails:
Father'sName MOHAMMEDABDULHAMEED PassportSevaKendra BANGALORE,LALBAGH,
Mother'sName QAMARUNNISA Address PRESTIGELIBRA,#45,LALBAGHROAD,
Spouse'sName ZUNERIYASULTANA NEARURVASHITHEATRE,BANGALORE
DateofBirth 25/09/1981 AppointmentId 100007358461615
PlaceofBirth HUMNABAD AppointmentDate 20/10/2015&03:30PM
andTime
MaritalStatus MARRIED
ReportingDateand 20/10/2015&03:15PM
EmploymentType NOTEMPLOYED Time
ApplicationSubmittedDate 12/10/2015

PCCappliedfor BAHRAIN
PresentResidential H.NO:1202/122/51,NEARMADRESA Batch 26
Address ZIAULULOOM,KALABURAGI,
KALABURAGI585104,KARNATAKA,
INDIA SequenceNo. 54
ApplicantsReferencesDetails:
ABDULMUQEEMGOGINEARRING

FirstReference
ROADZAFARABADCROSS
ZAFARABADROADKALABURAGI,
PassportDetails:
9845496061
PassportNo. H0938059
ABDULHALEEMBAHADURH.NO:5
993/31/48,AHMEDNAGARCOLONY PassportIssueDate 07/10/2008
SecondReference
AZADPURROADKALABURAGI, PassportExpiryDate 06/10/2018
9845298091 PlaceofIssue BANGALORE

PleaseReadCarefully:
PleasereachPassportSevaKendra(PSK)at03:15PMasmentionedaboveandcarrytheprintedcopyofthisappointmentreceipt.
CheckDocumentAdvisoronwebsite'www.passportindia.gov.in' to know the documents required at PSK.Carry original documents and their
selfattestedphotocopies.FinaldecisionwithregardtodocumentsrequiredisatthediscretionofRPOstaffatPSK.
Incaseofminorapplicants(below4yearsofage),carrytherecentpassportsizephotograph(4.5X3.5cm)withwhitebackground.
Only applicant is allowed inside the PSK. However, in case of exceptions such as Senior Citizen / Physically Challenged / Illiterate / Minor
applicants,onepersonfromthefamilymaybeallowedtoaccompanyinsidePSK.
AtPSK,apapertokenwillbeissuedtoyouaftercheckingofdocuments.YourapplicationwillbeprocessedatCounterAfollowedbycounters B
andC.Atallstages,pleasebealertandwatchthetokendisplayscreenstoknowthecounteratwhichyourapplicationwillbeprocessed.Please
collectacknowledgementslipfromtheExitcounterbeforeleavingPSK.Also,youarerequestedtofillthefeedbackformattheexitcounter.
Thanksforshowingyourinterestin'PassportSevaSMSServices'enrolment.PleasepayRs35/(THIRTYFIVEONLY)incashastheEnrolment
ChargesduringyourvisittoPassportSevaKendra.
Balancefee(ifapplicable)aftereditingthesubmittedformwillbepayableincashatthePassportSevaKendra.
ATMfacilityavailableatPSKforallBankCards.
Helpustoserveyoubetter.
#DetailsasperthePaymentDate.Paymentoncemadeforavailingpassportserviceswillnotberefunded.

https://portal2.passportindia.gov.in/AppOnlineProject/secure/openPdfForApplReciept 1/2
10/16/2015 AppointmentReciept
Documentlistismentionedinthefollowingtable:

Document(s)RequiredforPCC
OldpassportinoriginalwithselfattestedphotocopyofitsfirsttwoandlasttwopagesincludingECR/NonECRpageandpageofobservation(if
any).

ProofofPresentAddress

ListofAcceptableDocuments:
(i)WaterBill/Telephone(landlineorpostpaidmobilebill)/Electricitybill
(ii)PhotopassbookofrunningBankAccount(ScheduledPublicSectorBanks,ScheduledPrivateSectorIndianBanksandRegionalRuralBanks
only)/IncomeTaxAssessmentOrder/ElectionCommissionPhotoIDcard/ProofofGasConnection
(iii)CertificatefromEmployerofreputedcompaniesonletterhead(Onlypubliclimitedcompaniescangiveaddressproofoncompanyletterhead
alongwithseal.Computerisedprintoutsshallnotbeentertained.)
(iv)Applicant'scurrentandvalidrationcard(Ifanyapplicantsubmitsonlyrationcardasproofofaddress,itshouldbeaccompaniedbyonemore
proofofaddressoutofthegivencategories.)
(v)Parent'spassportcopy,incaseofminors(Firstandlastpage)
(vi)Applicant'sAadhaarcard(IfyourAadhaarcardissuancedateislessthanayearfrompassportapplicationprocessingdateatPSK,itshouldbe
accompaniedbyonemoreproofofaddressoutofthegivencategories.)
(vii)RegisteredRentAgreement(foraperiodofmorethanoneyear)

Note:

1. Thisdocumentisapplicableonlyifapplicant'spresentaddressisdifferentfromthatintheexistingpassport

2. Applicantsarerequiredtosubmittheproofofaddressofthepresentaddressonly,irrespectiveofthedatefromwhichhe/shehasbeen
residingatthegivenaddress.However,he/sheisrequiredtomentionalltheplaceofstayduringpreviousoneyearinthePassport
applicationform.

Note:Thelistofdocumentsprovidedinthetableaboveisindicative.ThedecisionofAPO/RPOshallbeconsideredfinal.

https://portal2.passportindia.gov.in/AppOnlineProject/secure/openPdfForApplReciept 2/2