Apply for Damaged Passport Application Form 2Applicant DetailsProfession and Qualification & Emergency ContactFamily DetailsPresent Residential AddressPrevious Passport DetailsOther DetailsSelected documentsPassport TypeFields marked with asterisk (*) are mandatoryPassport Application Normal Type of Damaged Passport Application Tatkaal Type of Damaged Passport ApplicationHas your passport expired? Yes NoNumber of pages in Booklet 36 Pages 60 PagesApplicant DetailsFields marked with asterisk (*) are mandatoryFirst NameMiddle NameLast NameHave you ever changed your name? – Select –YesNoEnter other names (Optional)Have you ever been known by other names (aliases)?– Select –YesNoEnter your change name (Optional)Gender– Select –FemaleTransgenderMaleMarital Status– Select –SingleMarriedDivorcedWidow/ WidowerSeparatedDate of Birth (DD/MM/YYYY)Is your Place of Birth out of India?– Select –YesNoCitizenship of India by– Select –BirthRegistration/ NaturalizationDescentPlace of Birth (Village/Town/City)Place of Birth State/UT Place of Birth District PAN (if available)Voter Id (if available)Aadhaar NumberVisible distinguishing markPreviousSave to NextProfession and QualificationFields marked with asterisk (*) are mandatoryEmployment Type– Select –GovernmentHomemakerNot employedOthersOwners, Partners & Directors of companies which are members of CII, FICCI & ASSOCHAMPrivatePSURetired Government ServantRetired- Private ServiceSelf EmployedStatutory BodyStudentIf employed in Government/Statutory Body/PSU, specify Organisation name (Optional)Is either of your parent (in case of minor)/spouse, a government servant? *– Select –YesNoEducational Qualification – Select –7th pass or lessBetween 8th and 9th standard10th pass and aboveGraduate and aboveIs applicant eligible for Non-ECR category? (Minimum 10th pass and above)– Select –YesNoEmergency ContactFields marked with asterisk (*) are mandatoryEmergency Contact Person Name (First Name + Middle Name + Surname)Emergency Contact Person AddressAddress Line 1Address Line 2CityStatePin CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweEmergency Contact Person Phone/MobilePreviousSave to NextFamily DetailsFields marked with asterisk (*) are mandatoryFather’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)PreviousSave to NextPresent Residential AddressFields marked with asterisk (*) are mandatoryIs your present address out of India? Yes NoPresent Residential Address Address Line 1Address Line 2CityStatePin CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwePolice StationIs Permanent Address available? Yes NoIs your permanent address same as present address? Yes NoPhone/MobileEmail IDPreviousSave to NextIdentity Certificate/Passport DetailsFields marked with asterisk (*) are mandatoryPassport NumberDate of IssueDate of ExpiryPlace of Issue (Village/Town/City)File NumberFile Upload Passport Front SideChoose File File Upload Passport Back SideChoose File Details of Previous/Current Diplomatic/Official Passport Details Not Available / Never Held Diplomatic/Official Passport Details AvailableHave you ever applied for passport, but not issued? Yes NoPreviousSave to NextOther Details1) 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 NoHas any warrant or summons for your appearance been issued & pending before a court under any law for the time being in force?* Yes NoHas a warrant for your arrest been issued by a court under any law for the time being in force?* Yes NoHas an order prohibiting your departure from India been made by any court? Yes No2) 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 No3) Provide the following details if the applicant has been refused/denied passport.Have you ever been refused/denied passport? Yes NoHas your passport ever been impounded? Yes NoHas your passport ever been revoked? Yes No4) 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 NoHave you ever held the passport of any other country at any time? Yes NoHave you ever surrendered your Indian passport? Yes NoHave you ever applied for renunciation of Indian citizenship? Yes No5) Provide the following details if applicant has returned to India on Emergency Certificate.Have you ever returned to India on Emergency Certificate (EC)? Yes NoHave you ever been deported from any region/country? Yes NoHave you ever been repatriated from any country back to India? Yes NoPreviousSave to NextThe selected documents (not shared through DigiLocker) need to be submitted at PSK/Passport Office for verification.Proof of Date of Birth (DOB)– Select – List of acceptable documentsAadhaar Card/E-AadhaarBirth Certificate issued by the Registrar of Births and Deaths or the Municipal Corporation or any other prescribed authority,whosoever has been empowered under the Registration of Birth and Deaths Act, 1969 to register the birth of a child born in IndiaTransfer/School leaving/Matriculation Certificate issued by the school last attended/recognised educational boardPolicy Bond issued by the Public Life Insurance Corporations/Companies having the DOB of the holder of the insurance policyCopy of an extract of the service record of the applicant (only in respect of Government servants) or the Pay Pension Order (in respect of retired Government Servants), duly attested/certified by the officer/in-charge of the Administration of the concerned Ministry/Department of the applicantElection Photo Identity Card (EPIC) issued by the Election Commission of IndiaPAN Card issued by the Income Tax DepartmentDriving License issued by the Transport department of concerned state GovernmentA declaration given by the Head of the Orphanage/Child Care Home on their official letter head of the organization confirming the DOB of the applicantFile Upload Proof of Date of Birth Choose File Proof of Address– Select – List of acceptable documentsAadhaar CardWater BillTelephone (landline or post paid mobile bill)Electricity billIncome Tax Assessment OrderElection Commission Photo ID cardProof of Gas ConnectionCertificate from Employer of reputed companies on letter headParent’s passport copy, in case of minors(First and last page)Rent AgreementPhoto Passbook of running Bank Account (Scheduled Public Sector Banks, Scheduled Private Sector Indian Banks and Regional Rural Banks only)Spouse’s passport copy (First and last page including family details mentioning applicant’s name as spouse of the passport holder), (provided the applicant’s present address matches the address mentioned in the spouse’s passport)File Upload Proof of AddressChoose File I have read and agree to the Terms and Conditions , Refund Policy, Fees & Charges, Privacy Policy, and All Other Policy.PreviousSubmit Form