Apply for Damaged Passport

Apply for Damaged Passport Application Form 2

Applicant Details
Profession and Qualification & Emergency Contact
Family Details
Present Residential Address
Previous Passport Details
Other Details
Selected documents

Passport Type

Fields marked with asterisk (*) are mandatory

Passport Application

Normal Type of Damaged Passport Application

Tatkaal Type of Damaged Passport Application

Has your passport expired?

Yes

Number of pages in Booklet

36 Pages

60 Pages

Applicant Details

Fields marked with asterisk (*) are mandatory

First Name

Middle Name

Last Name

Have you ever changed your name?

Enter other names (Optional)

Have you ever been known by other names (aliases)?

Enter your change name (Optional)

Gender

Marital Status

Date of Birth (DD/MM/YYYY)

Is your Place of Birth out of India?

Citizenship of India by

Place of Birth (Village/Town/City)

Place of Birth State/UT

Place of Birth District

PAN (if available)

Voter Id (if available)

Aadhaar Number

Visible distinguishing mark

Profession and Qualification

Fields marked with asterisk (*) are mandatory

Employment Type

If employed in Government/Statutory Body/PSU, specify Organisation name (Optional)

Is either of your parent (in case of minor)/spouse, a government servant? *

Educational Qualification

Is applicant eligible for Non-ECR category? (Minimum 10th pass and above)

Emergency Contact

Fields marked with asterisk (*) are mandatory

Emergency Contact Person Name (First Name + Middle Name + Surname)

Emergency Contact Person Address

Address Line 1

Address Line 2

City

State

Pin Code

Country

Emergency Contact Person Phone/Mobile

Family Details

Fields marked with asterisk (*) are mandatory

Father’s/Legal Guardian’s Given Name (First Name + Middle Name + Surname)

Mother’s Given Name (First Name + Middle Name + Surname)

Legal Guardian’s Given Name (First Name + Middle Name + Surname)

Spouse’s Given Name (First Name + Middle Name + Surname)

Present Residential Address

Fields marked with asterisk (*) are mandatory

Is your present address out of India?

Yes

Present Residential Address

Address Line 1

Address Line 2

City

State

Pin Code

Country

Police Station

Is Permanent Address available?

Yes

Is your permanent address same as present address?

Yes

Phone/Mobile

Email ID

Identity Certificate/Passport Details

Fields marked with asterisk (*) are mandatory

Passport Number

Date of Issue

Date of Expiry

Place of Issue (Village/Town/City)

File Number

File Upload Passport Front Side

Choose File

File Upload Passport Back Side

Choose File

Details of Previous/Current Diplomatic/Official Passport

Details Not Available / Never Held Diplomatic/Official Passport

Details Available

Have you ever applied for passport, but not issued?

Yes

Other Details

1) Provide the following details if there are any criminal proceedings pending against the applicant.

Are any proceedings in respect of an offence alleged to have been committed by you pending before a criminal court in India?*

Yes

Has any warrant or summons for your appearance been issued & pending before a court under any law for the time being in force?*

Yes

Has a warrant for your arrest been issued by a court under any law for the time being in force?*

Yes

Has an order prohibiting your departure from India been made by any court?

Yes

2) Provide the following details if the applicant has been convicted by a court in India.

Have you at, any time during the period of five years immediately preceding the date of this application been convicted by a court in India for offence involving moral turpitude and sentenced in respect thereof to imprisonment for not less than two years?*

Yes

3) Provide the following details if the applicant has been refused/denied passport.

Have you ever been refused/denied passport?

Yes

Has your passport ever been impounded?

Yes

Has your passport ever been revoked?

Yes

4) Provide the following details if applicant has applied for or been granted foreign citizenship.

Have you ever been granted citizenship by any other country?

Yes

Have you ever held the passport of any other country at any time?

Yes

Have you ever surrendered your Indian passport?

Yes

Have you ever applied for renunciation of Indian citizenship?

Yes

5) Provide the following details if applicant has returned to India on Emergency Certificate.

Have you ever returned to India on Emergency Certificate (EC)?

Yes

Have you ever been deported from any region/country?

Yes

Have you ever been repatriated from any country back to India?

Yes

The selected documents (not shared through DigiLocker) need to be submitted at PSK/Passport Office for verification.

Proof of Date of Birth (DOB)

File Upload Proof of Date of Birth

Choose File

Proof of Address

File Upload Proof of Address

Choose File

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