Surname
Surname/Family Name (As in Passport)
Given Name/s*
Given Name/s,Middle Name (As in Passport)
Have you ever changed your name? If yes, click the box and give details.
Sex *
Date of Birth *
Open Calender (DD/MM/YYYY) Date of Birth as in Passport in DD/MM/YYYY format
Town/City of birth *
Province/Town/City of birth
Country of birth *
Citizenship/National Id No. *
If not applicable Please Type NA
Religion *
If Others .Please specify
Visible identification mark *
Educational Qualification *
Nationality *
Did you acquire Nationality by birth or by naturalization?*
Prev. Nationality
If you have acquired Nationality by naturalization
specify Previous Nationality
Passport Details
Passport No. *
Applicant Passport Number
Place of Issue *
Date of Issue *
Open Calender (DD/MM/YYYY) In DD/MM/YYYY format
Date of Expiry *
Open Calender (DD/MM/YYYY) In DD/MM/YYYY format.Minimum Six Month Validity is Required.
Any other valid Passport/Identity Certificate(IC)/Dual Nationality held ,Yes / No If Yes Please give Details
Country of Issue
Passport/IC No.
Date of Issue
Open Calender (DD/MM/YYYY)
Place of Issue
Nationality mentioned therein
Access Code
Develped by NIC, New Delhi
Enter Access Code