| [Form 'A'] For persons above 12 years. |
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1. Name |
First |
Middle |
Surname |
| Mr./Mrs./Miss |
|
day |
month |
year |
| 2. Date of Birth | (in words) |
| 3. Place of Birth |
Vill/Town |
Tehsil |
District |
Province |
Country |
| 4. Father's/Husband's name: | 5. Nationality: |
| 6. Religion: | 7. Qualification: | 8. Profession: |
| 9. Whether Pakistani (Tick the box applicable) |
By Birth | By Descent | By migration on (date)................... |
By registration/naturalisation
No................... |
| 10. National Identity Card |
- |
- |
| 11. Place of Issue: | 12. Date of Issue: |
| Place | Period | |
| 15. FOR AJ&K
Applicant (Applicant's Father/Husband) |
................................................ | ........................................ |
| No. | Full Name (Block letters) | Place/Date of Birth | Sex |
| 1. | ....................................................................... | ........................................................ | ............. |
| 2. | ....................................................................... | ........................................................ | ............. |
| 3. | ....................................................................... | ........................................................ | ............. |
| 4. | ....................................................................... | ........................................................ | ............. |
| i) In
person/A/L.......................................... ii) P.V./Exempted......................................... iii) N.I.C. seen and punched/already punched..... (photocopy attached) iv) Int/appear to be Pak National.............. Authority Name |
Signature & thumb
impression
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DECLARATION
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| 17. | I declare on solemn affirmation as under :- |
| (1) | To the best of my knowledge and belief the information given in this application is correct. | |
| (2) | I have not previously held or applied for a passport of any description or been refused passport facilties. | |
| (3) | All previous passports granted to me have been surrendered other than the passport or travel document noted below which is now attached and that I have made no other application for a passport since the attached passport or travel document was issued to me. | |
| (a) No. of the attached passport/travel
document ................................................ (b) Date of Issue......................................... (c) Place of Issue: ................ | ||
| Note: | If the applicant had a passport which has been lost, he should furnish particulars as per sub para (4) below. | |
| (4) | The passport as per details given below has been lost. In the event of its coming again into possession I undertake to return it to the Regional Passport Office. | |
| (a) | Passport No: .................................................... (b) Date of Issue: ............................... | |
| (c) | Place of Issue:............................................................ | |
| (d) | Circumstances in which passport was lost or destroyed and measures taken to recover it .................... | |
| (5) | I have never been repatriated at Government expenses. | |
| (6) | I am/am not a Government servant, an employee of a semi-Government body a municipality, any other local body or a State-owned Industry. | |
| (7) | I have/have not served in the Armed Forces. | |
| (8) | I am/am not reservist in the Armed Forces. | |
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DECLARATION IN CASE OF MUSLIMS |
I,
................................................................. S/o
............................................................... Aged
.........
years, adult Muslim, Resident of
................................................................................................
hereby solemnly declare
that :-
(i) I am Muslim and believe in the
absolute and unqualified finality of the prophethood of Muhammad (peace be upon
him) the last of the prophets.
(ii) I do not recognise any person who claims
to be a prophet in any sense of the word or of any description whatsoever after
Muhammad (peace be upon him)
or recognise such a claimant as prophet or a
religious reformer as a Muslim.
(iii) I consider Mirza Ghulam Ahmad Quadiani
to be an imposter nabi and also consider his followers whether belonging to the
Lahore or Quadiani group to be
non-Muslim.
| Date: ........................ |
Siganture & thumb impression (with name
in block letters of applicant in indelible ink) |
......................................................................................................................................................................................................................................................
Applicable in cases of persons who have not attained the age of
18 years and are not issied with Identity Card under the National Registration
Act, 1973.
I, as Father/Guardian/Attestor hereby attest that the information
given above is correct to the best of my knwledge and belief that the photograph
on page 1 of this application bearsthe true like of the
applicant.
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Signature of
Father/Guardian/Attestor Address: ................................................... Identity Card No...................................... Date............................................................ Place of issue............................................ |
FOR OFFICIAL USE ONLY
1. No. of Passport issue.............................................
2. Date of issue ..........................................................
3. Date upon which Passport is valid............................
Authority....................................................................
Name .......................................................................