8/12/2019 Application Form of Dewasi Besararam

1/1

1/10/14 Application Form

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

Passport Application

Government of India, Ministry of External Affairs

Online Application Receipt

ATM facility available in PSK

for all Bank Cards

Applicant Details :

Application Reference No 14-1000304107Batch 12

Sequence No. 33

Reporting Time 12:00 PM

Service Type FRESH

Type of Application Normal

Application Submitted Date10/01/2014

Date of Birth 08/08/1983

Gender MALEEmployment Type SELF EMPLOYED

Marital Status MARRIED

Place of Birth KUSHALPURA,JALORE,RAJASTHAN

Given Name DEWASI

Surname BESARARAM

Father's Name PATAJI BESARARAM

Mother's Name SAGANA DEVI BESARARAM

Spouse's Name DSADO DEVI BESARARAM

Present Address FLAT 302 CHOUDHARY MANSION JAGADISHCOMPLEX, SERILINGAMPALLY, CYBERABAD - 500019,

ANDHRA PRADESH, INDIA

Applicants References :

First Reference Details BALARAM CHOUDHARY,FLAT NO 301,CHOUDHARY MANSION JAGDISH COMPLEX,TARA

NAGAR,SERILINGAMPALY,LINGAMPALLI., 8096152791Second Reference Details NILESH KUMAR,SRI ANAND COLLECTION,BALLAS COMPLEX,TARA

NAGAR,SERILINGAMPALLY,RANGA REDDY,AP 500019, 8143581364

Payment Details:#

Total Fee (Rs.) 1500.00

Paid Fee (Rs.) 1500.00

Date and Time 10/01/2014 04:34 PM

Transaction Id CP03990440

Appointment Details :

PSK Location

Ameerpet,

ADITYA TRADE CENTRE, AMEERPET,

HYDERABAD-500038

Date & Time of

Appointment15/01/2014 & 12:15 PM

Appointment Id 100005038112013

Reporting Time 12:00 PM

Thanks for showing your interes t in 'Passport Seva SMS Services' enrolment. Please pay Rs 30/- (THIRTY ONLY) in cash as the

Enrolment Charges during your visi t to Pass port Seva Kendra.

Note:Applicant should reach the Passport Seva Kendra by the reporting time mentioned above for pre-checking of documents

avoid any hassles in issuance of token.

Applicant should bring all the originals and one se t of photo copy, photo copies s hould be s elf atteste d by the applicant. In ca

of minor either of the parents has to sign on all photo copies.

One accompanying person from the family will be allowed along with Senior Citizens, Physically Challenged, Illiterate and Min

applicants only.Applicant will not be issue d token at Passport Seva Kendra, if they repor t after scheduled appointment tim e.

Minor applicants below 4 years of age need to carry a recent coloured passport size (4.5 x 3.5 cm) photograph with a whi

background while visiting Passport Seva Kendra. Other applicants need not carry any photograph as photograph will b

captured at the Passport Seva Kendra.

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prohibited inside the PSK. Electronic item such as came ra is prohibited inside the PSK.

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# Details as per the Payment Date. Payment once made for availing passport services will not be refunded.