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DEPARTMENT OF IMMIGRATION AND EMIGRATION
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SRI LANKAN IDENTITY OVERSEAS
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IMM IGAATION A ND EMIGRATION
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@6D~6IDID IDL6ljBo8'L(B , ~61l8'1J I ~6IDLl1JIT61TBo 8'1T6liraJlS!Jli? 6lli61ffi61l15TUULD
APPLICATION FOR A SRI LANKAN PASSPORT, EMERGENCY/ IDENTITY CERTIFICATE
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The data and information are fed into the computer in English. Hence the application must be filled in English. Please read the instruction sheet for further information.
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APPLICATION NO.
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ALLOCATED PASSPORT NO.
AC CODE
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,1.
Type of Service
2.
Type of Travel Document
3.
Present Travel Document No. (If any)
Normal
All Countries
D
D
OneDay
Middle East
Countries
D
D
4.
Emergency
Certificate
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D
Identity
Certificate
D
NMRP No. (If any)
I I I I I
}
5.
National Identity Card No.
6.
Surname
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7.
Other Names
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8.
Permanent Address
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I I 111111111111111111
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8.1 District
9.
Date of Birth
10. Birth Certificate
11. Place of Birth
12. Sex
13. Profession/ Occupation/ Job
}
}
}
}
}
Date
No.
Month
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District
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Female
I
D
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Male
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14. Have you obtained Dual Citizenship in Sri Lanka?
If Yes, Dual Citizenship No.
Year
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D
I
Yes
D
I
No
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D
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(Please fill up fields 17 and 18 in the next page)
15. Mobile/ Phone No. (to be notified via SMS when passport is ready for collection) }
16. E-maiiAddress
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Compulsory for Dual Citizenship Holders
17.
18.
19.
.
Fo reign Nationality
I
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I
I
Foreign Passport No.
If this application is for a child below the age of 16 years, following information must also be provided.
Father I Guardian
Nati o nal Id entity Card No. I Present Travel Document No.
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20.
21 .
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Mother I Guardian
National Identity Card No. I Present Travel Document No.
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I
I
I
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Applicant, Please place your signature insid e both cag es below. Signature should not touch the border.
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I Declaration of the Applicant
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I declare that I am a citizen of Sri Lanka and the above information provided by me and the documents attached hereto are true and
correct. Also, I am aware of the fact that producing forg ed / falsified documents and information is a puni shable offence.
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Controll er's Order
Minute Sheet Attached (If any)
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Signature of the Applicant
PPT No:
PPT Lost: Yes/ No
DC I AC Signature
Police Report /TTD I NMRP
Dual Citizen : Yes I No
BC No. & District:
NIC I DL I Posta liD
MC No. & District
F's PPT I NIC Copy & Concent Letter
Pending at Computer Division
M's PPT I NIC Copy & Concent Letter
DC I AC's Order: