CONSULAR SERVICES
EMBASSY OF INDIA
HANOI
APPLICATION FOR MISCELLANEOUS SERVICES
IT IS AN OFFENCE UNDER THE INDIAN PASSPORT ACT OF 1967 TO DELIBERATELY
FURNISH FALSE INFORMATION OR SUPPRESS INFORMATION.
For use of (a) Child Inclusion / Deletion (b) Registration of Child (c) Change of Name & Address (d) PCC
(e) Life / Birth / Marriage Certificate (f) Emigration Waiver (g) Any other services(Specify)
________________________________
1. Full Name:________________________________________________________________________
(First)
(Middle)
(Last)
2. Permanent Address in India
_____________________________________________________Tel._________________________
3. Permanent Address in Vietnam
______________________________________________________Tel._________________________
4. Profession & Business Address
______________________________________________________________________________
______________________________________________________________Tel._____________________
5. Place of Birth_________________________ Date of Birth_______________________________
(Day) (Month) (Year)
6. Current Passport No.__________________________ Place of Issue______________________________
Date of Issue _______________________________ Valid until ________________________________
8. Full Name of Father__________________________Mother:___________________________________
9. Name & Nationality of Spouse
_______________________________________________________________________________
Declaration (To be signed by Indian Citizens only)
I solemnly affirm that :
i) I owe allegiance to the sovereignty and integrity of India.
ii) Information given above is correct and nothing has been concealed and I am aware that it is an offense under the
Passport Act 1967 to knowingly furnish false information or suppress material information, and
iii) I undertake to be entirely responsible for expenses of my son/daughter/ward
iv) I solemnly declare that I have not lost, surrendered or been deprived of my Indian citizenship
v) I further declare that I have not voluntarily acquired citizenship of any other country and I have no other passport
or travel document in my possession.
* This declaration has to be notarized by a Notary Public only in case of an applicant whose passport expired more
than six months before the date of submission of this application
.
TYPE OF SERVICE(S) REQUIRED; PLEASE CHECK RELEVANT SECTION(S);
(1). Kindly register the following Child/Children's name(s) and issue Birth Certificate(s) to them as Indian citizens.
child's name in the Register of the Embassy;
Child's Name Date & Place of Birth Sex (M/F)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
NOTE: The passport of both the parents and the photocopy of the Birth Certificate(s) of the above child /
children should be sent. Declaration of both parents that they have not taken any other nationality for the
child/children.
(2). Kindly enter / delete my Child / Children's name(s) in/from my passport. Particulars of child/children
to be included/deleted/registered.
Child's Name Date & Place of Birth Sex (M/F)
_____________________________________________________________________________________________
___________
_____________________________________________________________________________________________
___________
_____________________________________________________________________________________________
___________
(3). Kindly change my name from
_______________________________________________________________________
to: ______________________________________________________________________
Reason___________________________________________________________________________________
(4). Kindly change my permanent address as recorded in the passport
(a) Address as in passport __________________________________________________________________
(b) New permanent address __________________________________________________________________
(5). Kindly issue me
1. Emigration Clearance waiver
(Please attach photocopy of University degree or green Card/Resident card)
2. Birth Certificate
3. Police Clearance Certificate
(Issued only on clearance from authorities in India)
4. Marriage Certificate
(Please attach passports of both husband and wife)
5. Life Certificate
6. Attestation for adoption (in duplicate)
7. Attestation for property (Power of Attorney) (in duplicate)
8. Attestation for Commercial Documents (in duplicate)
9. Attestation for documents for sale, purchase of ship, vessel (in duplicate)
10. No Obligation to Return to India
11. Waiver
Note: If power of Attorney and Life Certificate are sent by mail, the signatures of the applicant should be
notarized.
PLEASE SEND YOUR PASSPORT(S) WITH APPLICATION FOR ANY OF THE ABOVE SERVICES
AND GIVE REASONS FOR REQUESTING THE CERTIFICATES / SERVICES.
Place : ______________
_____________________________________________________
Date : _______________ (Signature)
Requirements
1. For endorsement of child's name, on either parent's passport, it is necessary to send passports of both parents
and a photocopy of the child's birth certificate. A child may be endorsed in parent's passport only if the father was
an Indian national at the time of the child's birth and if the child does not hold a passport of another country.
2. For change to married name, please enclose a copy of the marriage certificate, sworn affidavit giving maiden
and married name duly notarized by a Notary Public and husband's passport. If first name also changes after
marriage, requirements mentioned at section no. 4 are to be adhered to.
3. For change of full name, please submit applicant's passport along with application form duly filled and
supported by :
(a) court order/affidavit;
(b) newspaper clippings of notice in city of applicant's domicile in India
(c) newspaper clipping of notice in state of applicant's domicile in India.
4. For attestation of documents, please have each document notarized by a notary public and send each document
in duplicate as one copy will be retained by this Consulate. Also please enclose your valid passports.
6. APPLICATION FOR CHANGE OF DATE OF BIRTH NOT ENTERTAINED UNLESS ACCOMPANIED BY
A COURT ORDER FROM INDIA.
Important
The Embassy of India/Consulate General of India has the discretion to request production of satisfactory
additional evidence before a particular service is given.