Get Nationality Status Verification Form

Paste one passport size photograph here 2 X 2 PERFORMA FOR VERIFICATION OF NATIONALITY STATUS/ANTECEDENTS PLEASE TYPE OR PRINT 1. FULL NAME 2. ALIASES IF ANY 3. a FULL NAME OF FATHER b FULL NAME OF MOTHER c FULL NAME OF SPOUSE 4. DATE AND PLACE OF BIRTH DD-MM-YYYY VILLAGE DISTRICT PRESENT OCCUPATION NATIONALITY PRESENT ADDRESS IN USA COMPLETE PERMANENT ADDRESS IN INDIA DETAILS OF PASSPORT PASSPORT NO DATE OF ISSUE PLACE OF ISSUE DATE OF EXPIRY VISBILE DISTINGUISHING MARKS IF ANY DATE OF LEAVING INDIA PERIOD OF STAY ABROAD DATE OF LOSS OF PASSPORT NAME ADDRESS OF TWO RELATIVES / FRIENDS AT THE PLACE OF PERMANENT RESIDENCE IN 15. NAME ADDRESS OF TRAVEL AGENT INVOLVED IN SENDING THE INDIVIDUAL ABROAD INDIA Given In Sr. 8 Above NOTE Please Complete all entries Legibly and fully Incomplete Information will only lead to delay in the process of issuing passport. FULL NAME 2. ALIASES IF ANY 3. a FULL NAME OF FATHER b FULL NAME OF MOTHER c FULL NAME OF SPOUSE 4. DATE AND PLACE OF BIRTH DD-MM-YYYY VILLAGE DISTRICT PRESENT OCCUPATION NATIONALITY PRESENT ADDRESS IN USA COMPLETE PERMANENT ADDRESS IN INDIA DETAILS OF PASSPORT PASSPORT NO DATE OF ISSUE PLACE OF ISSUE DATE OF EXPIRY VISBILE DISTINGUISHING MARKS IF ANY DATE OF LEAVING INDIA PERIOD OF STAY ABROAD DATE OF LOSS OF PASSPORT NAME ADDRESS OF TWO RELATIVES / FRIENDS AT THE PLACE OF PERMANENT RESIDENCE IN 15. DATE AND PLACE OF BIRTH DD-MM-YYYY VILLAGE DISTRICT PRESENT OCCUPATION NATIONALITY PRESENT ADDRESS IN USA COMPLETE PERMANENT ADDRESS IN INDIA DETAILS OF PASSPORT PASSPORT NO DATE OF ISSUE PLACE OF ISSUE DATE OF EXPIRY VISBILE DISTINGUISHING MARKS IF ANY DATE OF LEAVING INDIA PERIOD OF STAY ABROAD DATE OF LOSS OF PASSPORT NAME ADDRESS OF TWO RELATIVES / FRIENDS AT THE PLACE OF PERMANENT RESIDENCE IN 15. NAME ADDRESS OF TRAVEL AGENT INVOLVED IN SENDING THE INDIVIDUAL ABROAD INDIA Given In Sr. 8 Above NOTE Please Complete all entries Legibly and fully Incomplete Information will only lead to delay in the process of issuing passport. FULL NAME 2. ALIASES IF ANY 3. a FULL NAME OF FATHER b FULL NAME OF MOTHER c FULL NAME OF SPOUSE 4. DATE AND PLACE OF BIRTH DD-MM-YYYY VILLAGE DISTRICT PRESENT OCCUPATION NATIONALITY PRESENT ADDRESS IN USA COMPLETE PERMANENT ADDRESS IN INDIA DETAILS OF PASSPORT PASSPORT NO DATE OF ISSUE PLACE OF ISSUE DATE OF EXPIRY VISBILE DISTINGUISHING MARKS IF ANY DATE OF LEAVING INDIA PERIOD OF STAY ABROAD DATE OF LOSS OF PASSPORT NAME ADDRESS OF TWO RELATIVES / FRIENDS AT THE PLACE OF PERMANENT RESIDENCE IN 15. NAME ADDRESS OF TRAVEL AGENT INVOLVED IN SENDING THE INDIVIDUAL ABROAD INDIA Given In Sr. 8 Above NOTE Please Complete all entries Legibly and fully Incomplete Information will only lead to delay in the process of issuing passport. .