Appointment Reciept

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Ministry of External Affairs Government of India
Online Application Receipt
Payment Details#

Applicant Details:
Application Reference
No.(ARN)

15-1002562437

Payment Status

Service Type

FRESH

Appointment Details:

Type of Application

NORMAL

Passport Seva Kendra Address

Given Name

SIVA PRASAD

Surname

CHIRIKI

Father's Name

SATYANARAYANA CHIRIKI

Appointment Id
Appointment Date and Time
Reporting Date and Time

Mother's Name

ALIVELAMMA CHIRIKI

Date of Birth

16/04/1988

Place of Birth

CHODAVARAM,VISAKHAPATNAM
RURAL,ANDHRA PRADESH

Gender

MALE

Marital Status

SINGLE

Employment Type

SELF EMPLOYED

Not paid

Batch
Sequence No.

Application Submitted Date 20/03/2015

Present Address

4-239, 2ND FLOOR, SUNDARNAGAR

OLD DAIRY FM, OLD DAIRY FARM,
VISAKHAPATNAM URBAN, 530040,
ANDHRA PRADESH, INDIA

Applicants References Details:

First Reference

B PRAVALLIKA, 4-206/5, SUNDAR

NAGAR, OLD DAIRY FARM,STREET NO
04, VSKP-40, 8978165492

Second Reference

M.V RAMANA, 4-239, SUNDAR NAGAR,

OLD DAIRY FARM, STREET NO -5,
VSKP-40, 9849654531

Please Read Carefully:

Please carry printed copy of this ARN slip.
Check Document Advisor on website 'www.passportindia.gov.in' to know the documents required at PSK.Carry original documents and their self
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 / Illiterate / Minor applicants, 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 counters B 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 fill the feedback form at the exit counter.
Corrosive substances, explosives, weapons and any sharp objects are not allowed inside the PSK. Please co-operate with security staff for frisking 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.
Thanks for showing your interest in 'Passport Seva SMS Services' enrolment. Please pay Rs 35/- (THIRTY FIVE ONLY) in cash as the Enrolment Charges
during your visit to Passport Seva Kendra.
Help us to serve you better.
# Details as per the Payment Date. Payment once made for availing passport services will not be refunded.

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

Applicant Categories

Documents to be Submitted

Ordinary Case (Citizen of India by birth)

Citizen of India by Registration/ Naturalization (Granted citizenship by MHA)

1, 2, 3 (if the applicant is eligible for Non ECR)

(i) 1, 2, 3 (if the applicant is eligible for Non ECR)
(ii) 4 or 5 or 6
1, 2, 3 (if the applicant is eligible for Non ECR), 7

Applicants repatriated from abroad at Government cost

1, 2, 3 (if the applicant is eligible for Non ECR), 5 (if available), 8, 9

Applicants deported to India/ Emergency Certificate cases

1, 2, 3 (if the applicant is eligible for Non ECR), 5 (if available), 8 (if any), 9

Government/ Public Sector/ Statutory body employees

(i) 1, 2
(ii) 21 (if No Police Verification is required) or 20 (if Post Police Verification is
required)

Dependent family members of Government/ Public Sector/ Statutory body

employees (For J&K children in age group 10-15 years are covered. For rest of
India children in age group 18-21 are covered)

1, 2, 3 (if the applicant is eligible for Non ECR), 21 (of dependent) and 24 if No
Police Verification is required

Citizen of India by Descent (Born to Indian parent(s) outside India)

Retired government officials

1, 2, 10 (if Post Police Verification is required)

(i) 1, 2 , 11 (12 if surrender certificate is not available)
Applicants having Diplomatic/ Official Passport and applying for ordinary Passport
(ii) 21 or 20 if applicant is Government/Public Sector/Statutory body employee
while in service
Note: In case the applicant submits "12", "2" is not required
Dependent family members of Diplomatic/ Official Passport holders who are not
government servants (For J&K Children in age group 10-15 years are covered)

1, 2, 3 (if the applicant is eligible for Non ECR), 26

Owner, partners and directors of Companies which are members of CII, FICCI &
ASSOCHAM.

(i) 1, 2
(ii) 24 and 25 if Post PV is required

Minor change in name

1 (in new name), 2 (in old name), 3 (if the applicant is eligible for Non ECR Documents in old name are allowed ), 23

Major change in name

1 (in new name), 2 (in old name), 3 (if the applicant is eligible for Non ECR Documents in old name are allowed ), 13, 23

Change/ Addition in surname due to marriage

(i) 1, 2, 3 (if the applicant is eligible for Non ECR)

(ii) 14 or 22

Change in name in case of Government/ Public Sector/ Statutory body employees 1, 2, 15, 16, 23
Nagaland Residents

1, 2, 3 (if the applicant is eligible for Non ECR)

Note: Additional PV required from Guwahati through MHA.

Naga origins residing outside Nagaland

1, 2, 3 (if the applicant is eligible for Non ECR)

Note: Additional PV required from Guwahati through MHA.

Jammu and Kashmir Residents

1, 2, 3 (if the applicant is eligible for Non ECR)

Jammu and Kashmir Residents staying outside J&K for more than five years

1, 2, 3 (if the applicant is eligible for Non ECR)

Students staying away from their parent's current residence

Senior Citizens (For J&K: Men - 65+ years, Women - 60+ years; For rest of India
65+ years)

1, 2, 3 (if the applicant is eligible for Non ECR), 17, 18

1, 2, 3 (if the applicant is eligible for Non ECR), 19 (if Post Police Verification is
required)

Document
No.

List of Documents
Proof of Present Address. For Proof of Address attach one of the following documents:

1.

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 year and the
other bill of current year)
b. Photo passbook of running Bank Account (Scheduled Public Sector Banks, Scheduled Private Sector Indian Banks and Regional Rural
Banks only)
c. Income Tax Assessment Order
d. Election Commission Photo ID card
e. Gas connection bill
f. Certificate from Employer of reputed and widely known companies on letter head (Only public limited companies can give 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 family details), (provided the applicant's present address matches the address
mentioned in the spouse's passport)
h. Applicant's current and valid 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
given 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 year from passport application processing date at PSK, it should be
accompanied by one more proof of address out of the given categories)
k. Registered Rent Agreement (for a period of more than one year)
Proof of Date of Birth. For Proof of Date of Birth attach one of the following documents:

2.

a. Birth certificate issued by a Municipal Authority or any office authorized to issue Birth and Death Certificate by the Registrar of Births &
Deaths
b. School leaving certificate / Secondary School leaving certificate/ Certificate of Recognized Boards from the school last attended by the
applicant or any other recognized educational institution
c. Affidavit sworn before 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 after 26.01.89, only Birth Certificate issued by the Municipal Authority or any office authorized to issue Birth and Death
Certificate by the Registrar of Births & Deaths is acceptable. The Birth Certificate should ordinarily contain the name of child, name of father and
mother, date of birth, place of birth, sex, registration number and date of registration. If the Birth Certificate doesn't contain the name of child, a
declaration on plain paper signed by parents, is required to be submitted specifying the name of the child.

3. Documentary proof for any one of the Non-ECR (previously ECNR) categories, Refer Column 2.15 under Section-B of passport instruction booklet
4. Birth Registration Certificate issued by Embassy/ High Commission/ Consulate of India
5.

Old Passport in original with self-attested photocopy of its first two and last two pages, including ECR/Non-ECR page (previously ECNR) and the
page of observation (if any), made by Passport Issuing Authority and validity extension page, if any, in respect of short validity passport

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Passport of parents in original with self-attested photocopy of its first two and last two pages, including ECR/Non-ECR page (previously ECNR) and
the page of observation (if any), made by Passport Issuing Authority and validity extension page, if any, in respect of short validity passport
7. Citizenship Certificate issued by Ministry of Home Affairs
6.

8. Proof of refund of repatriation /deportation cost (if any) to Ministry of External Affairs
9. Original Emergency Certificate/Seizure Memo issued by Airport Immigration Authorities on applicant's arrival in India
10. Pension Payment Order
11. Proof of surrender or cancellation of Diplomatic/official Passport
12. Cancelled Passport (if surrender certificate is not available), with a letter explaining why surrender certificate is not available
13.

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)

14. An attested copy of marriage certificate issued by Registrar of Marriage

15. Gazette Notification changing name in applicant's department
16. Fresh ID Certificate in changed name
17. Student Identity Card issued by Government Recognized Educational Institutions, in respect of full time courses
18. Bonafide Letter from authorized signatory of college (On official letter head of UGC recognized College)
19. Copy of child's (Age>18) Passport , who is staying abroad (with page having parent's name)
20. No Objection Certificate (NOC) (as per Annexure 'M')
21. "Identity Certificate" in original as per Annexure "B"
22.

A joint affidavit from husband and wife along with a joint photograph, (Specimen at Annexure "D") When joint affidavit is not possible the affidavit
should indicate the reason for it. If applying for passport for the first time, this affidavit is required only if there is a change in the first name.

23. Deed poll/sworn affidavit as per Annexure "E"

24. Standard Affidavit as per Annexure "I"
25. Verification Certificate as per Annexure "J"
26. Photocopy of Diplomatic/ Official Passport

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

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