6/27/2014 Application Form

https://portal2.passportindia.gov.in/AppOnlineProject/secure/openPdfForApplReciept 1/1

Passport ApplicationGovernment of India, Ministry of External AffairsOnline Application Receipt

ATM facility available at PSK for all Bank Cards

Applicant Details:Application Reference No. 14-1003243545

Batch 10

Sequence No. 17

Reporting Time 11:30 AM

Service Type FRESHType of Application NormalApplication Submitted Date 09/05/2014Date of Birth 11/01/2014Gender FEMALEEmployment Type OTHERSMarital Status SINGLEPlace of Birth HYDERABAD,RANGAREDDY,ANDHRA

PRADESHGiven Name VEDATRAYEESurname CHAPPALLIFather's Name VENKATA RAGHAVENDRA DILEEP CHAPPALLIMother's Name GAYATRI CHAPPALLIPresent Address 316-B, ENVIRON TOWERS, NAGOLE, HYDERABAD, CYBERABAD, 500068, ANDHRA PRADESH,

INDIAApplicants References:First Reference Details SANGITA JHA, 308 B, ENVIRON TOWERS, NAGOLESecond Reference Details V. RAJYA LAKSHMI, 307 B, ENVIRON TOWERS, NAGOLE

Payment Details:#

Total Fee (Rs.) 1000.00Paid Fee (Rs.) 1000.00Date and Time 09/05/2014 09:56 PMTransaction Id IGU1334623 Appointment Details:

PSK LocationAmeerpet, ADITYA TRADE CENTRE, AMEERPET,HYDERABAD-500038

Date and Time ofAppointment

30/06/2014 & 11:45 AM

Appointment Id 100005521782014Reporting Time 11:30 AM Thanks for showing your interest in 'Passport Seva SMS Services' enrolment. Please pay Rs 30/- (THIRTY ONLY) in cash as theEnrolment Charges during your visit to Passport Seva Kendra. Note:

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

to avoid any hassles in issuance of token.

Applicant should bring all the originals and one set of photo copy, photo copies should be self attested by the applicant. In

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

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

Minor applicants only.

Applicant w ill not be issued token at Passport Seva Kendra, if they report after scheduled appointment time.

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

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

captured at the Passport Seva Kendra.

Carrying of corrosive substances or explosives, arms or any sharp objects which may cause physical harm or violence are

prohibited inside the PSK. Electronic item such as camera is prohibited inside the PSK.

Balance fee (if applicable) after editing the submitted form will be payable in cash at the Passport Seva Kendra.

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