Staple one photo here Embassy of India Muscat Website: http:// www.indemb-oman.org E-mail : cons.muscat@mea.gov.in or indiamct@omantel.net.om APPLICATION FOR INDIAN PASSPORT (EAP-I) The application EAP-1 can be used for re-issue of passport due toA) EXPIRY OF 10 YEARS VALIDITY -R.O. 29.900 B) EXHAUSTION OF PAGES IN THE EXISTING PASSPORT- R.O. 29.900 C) ANY CHANGE IN THE LAMINATION PORTION OF THE EXISTING PASSPORT LIKE CORRECTION OF DATE/PLACE OF BIRTH INVOLVING ISSUE OF NEW PASSPORT BOOKLET R.O. 29.900 D) NEW PASSPORT IN LIEU OF LOST /STOLEN-R.O. 58.800 (PLEASE SUBMIT DOCUMENTS AS PER LIST ATTACHED) E) NEW PASSPORT IN LIEU OF DAMAGED PASSPORT -R.O. 58.800 F) PASSPORT FOR NEW BORN CHILDREN - R.O.29.100 (PLEASE SUBMIT DOCUMENTS AS PER LIST ATTACHED) (JUMBO BOOKLET NORMAL CASES- R.O. 39.500) (JUMBO BOOKLET Damaged CASES- R.O. 68.400) (Minors below 18 years- R.O. 20.300) (Tatkal Fee (Additional)-58.100) PASTE A PHOTO HERE Plain white back ground and dress in dark colour (3.5X3.5 cm without border) don't sign the photo Signature inside the box with Black Ink Ball pen NOTE Applicant should come personally or the documents should have been verified by the Honorary Consular Agent authorized by the Embassy. FILL IN USING BLOCK LETTERS WITH BLUE/ BLACK INK ONLY AND ALL THE COLUMNS SHOULD BE FILLED PROPERLY OTHER WISE THE APPLICATION MIGHT BE REJECTED. 1. FULL NAME (EXPANDED INITIALS) ________________________ (SURNAME NAME) _________________________ (GIVEN NAME) _______________________ (MIDDLE NAME) 2. IF YOU HAVE EVER CHANGED YOUR NAME, WRITE YOUR PREVIOUS NAME/Maiden name in case of a married woman: 3. PLACE OF BIRTH 4. COUNTRY OF BIRTH 5. DATE OF BIRTH 6. SEX: Male / Female (DD) / (/MM) / (YYYY) 8. FULL NAME OF FATHER NATIONALITY 9. FULL NAME OF MOTHER NATIONALITY 10. FULL NAME OF SPOUSE (HUSBAND/WIFE) NATIONALITY 11. PROFESSION Company/Office Designation 12. PRESENT ADDRESS IN OMAN TEL. NO. 13. PERMANENT ADDRESS IN INDIA GSM. NO. E-MAIL 7.Educational Qalification: 14. PRESENT PASSPORT NO. DATE OF ISSUE II) PLACE OF ISSUE III) DATE OF EXPIRY 15. ADDRESS OF PERSONS TO BE INTIMATED IN THE EVENT OF DEATH OR ACCIDENT ONE IN OMAN AND ONE IN INDIA: OMAN INDIA 16.HEIGHT COLOUR OF EYES COLOUR OF HAIR 17. VISIBLE DISTINGUISHING MARKS, IF ANY i) Birth ii) Descent iii) Naturalization / Registration 18. ARE YOU A CITIZEN OF INDIA BY 19. DID YOU EVER POSSESS ANY OTHER NATIONALITY OR TRAVEL DOCUMENT OF ANY OTHER COUNTRY? If so, please give details No Yes 20. IF THIS APPLICATION IS FOR DUPLICATE PASSPORT, WAS THE PREVIOUS PASSPORT LOST DAMAGED (If damaged, please attach damaged passport & if lost, then attach the requisite documents as per list) 21. a.) WERE YOU EVER REFUSED A PASSPORT? Yes NOT APPLICABLE No b.) WAS YOUR PASSPORT EVER ORDERED TO BE IMPOUNDED OR REVOKED? Yes No IF ANSWER TO ANY OF THESE QUESTIONS IS “YES,” PLEASE ENCLOSE A COPY OF THE OFFICIAL COMMUNICATION RECEIVED BY YOU AND GIVE OTHER DETAILS. 22.LABOUR CARD/HEALTH CARD/DRIVING LICENCE NO.& DATE AND PLACE OF ISSUE 23.EMIGRATION STATUS: ECR/ECNR 24. ARE ANY CRIMINAL PROCEEDINGS AGAINST APPLICANT IN ANY COURT IN INDIA? IF SO, PLEASE GIVE DETAILS 25. HAS APPLICANT EVER BEEN REPATRIATED FROM ABROAD TO INDIA AT THE EXPENSE OF THE GOVT. OF INDIA? IF SO, DETAILS PLEASE 26. NO. OF LOST/DAMAGED PASSPORT ____________ PLACE OF ISSUE _____________ DATE OF ISSUE _________________ VALID UNTIL __________________________ 27.Briefly state circumstances of loss/theft/damage of passport on a plain paper and attach copy of report lodged with local police in case of loss/theft’ 28. Give details of restriction, if any, imposed on applicant’s damaged/lost passport 29. Did applicant avail himself/herself of transfer of residence, foreign travel scheme or any other facility like gold/silver import on lost/damaged passport? If so, details please _______________________________________ SPECIMEN SIGNATURE OF APPLICANT ONLY (THUMB IMPRESSION (T.I), IN CASE OF AN INFANT) Left hand T.I. if male and right hand T.I. if female SELF DECLARATION : I OWE ALLEGIANCE TO THE SOVEREIGNTY & INTEGRITY OF INDIA AND HAVE NOT VOLUNTARILY ACQUIRED THE CITIZENSHIP OR TRAVEL DOCUMENT OF ANY OTHER COUNTRY. I HAVE NOT LOST, SURRENDERED OR BEEN DEPRIVED OF CITIZENSHIP OF INDIA. THE INFORMATION GIVEN BY ME IN THIS FORM AND ENCLOSURES IS TRUE AND I AM SOLELY RESPONSIBLE FOR ITS ACCURACY. I AM AWARE THAT IT IS AN OFFENCE UNDER PASSPORT ACT, 1967 TO FURNISH ANY FALSE INFORMATION OR TO SUPPRESS ANY MATERIAL INFORMATION WITH A VIEW TO OBTAINING PASSPORT OR ANY OTHER TRAVEL DOCUMENT. I FURTHER DECLARE THAT I HAVE NO OTHER PASSPORT / TRAVEL DOCUMENT. ________________________________________ (Signature or thumb impression of applicant) Declaration by Parents/Legal Guardian in case of Minor: 1) 2) 3) 4) Information given above in respect of _____________________________ of whom I am the parent / legal guardian is true. I undertake to be entirely responsible for his / her expenses. I solemnly declare that he / she has not lost, surrendered or been deprived of his/her citizenship of India. I hereby declare that ________________________________ born in Oman has not applied for or acquired Omani/ any other citizenship/travel document. Should I approach the Omani or any other authorities for such a travel document, I undertake to inform the Embassy of India, Muscat immediately so that Indian travel document may be withdrawn. Place: _________________________ Date: __________________________ Signature of both the Parents / Legal guardian * Copies of passports of both parents to be enclosed in the case of Minor applicants