High Commission of India |
APPLICATION FORM FOR THE GRANT/RENEWAL OF PIO CARD |
(TO BE FILLED IN DUPLICATE)
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1. | 1.1 Name of the applicant | _________________________________________________ |
1.2 Surname at birth (if different) | _________________________________________________ | |
1.3 Other names (if applicable) | _________________________________________________ | |
1.4 Date of birth | _________________________________________________ | |
1.5 Place of birth: (town, city & country) | _________________________________________________ | |
2. | Family Details: 2.1 Father's Name & Nationality |
_________________________________________________ |
2.2 Mother Name & Nationality | _________________________________________________ | |
2.3 Spouse Name & Nationality | _________________________________________________ | |
3. | 3.1 Present Address | _________________________________________________ |
3.2 Permanent Address | _________________________________________________ | |
3.3 Address in India (verifiable) | _________________________________________________ | |
4. | Profession or Occupation | _________________________________________________ |
5. | Business/Office Address | _________________________________________________ |
6. | Sex | Male / Female ________________________ |
7. | Marital status | Married/Unmarried _____________________________ |
8. | Nationality (at the time of birth) : | ____________________________________ |
9. | 9.1 Present Nationality (if different) : | ____________________________________ |
9.2 Date on which acquired | ____________________________________ | |
10. | Passport particulars of applicant | |
10.1 Visible Distinguishing Marks | ____________________________________ | |
10.2 Passport Number | ____________________________________ | |
10.3 Date of issue | ____________________________________ | |
10.4 Date of expiry | ____________________________________ | |
10.5 Country which issued the passport | ____________________________________ | |
10.6 Place of issue | ____________________________________ | |
11 | Does the applicant hold dual nationality : (If so, give details including the details of all the passports held etc.) |
_________________________________________________ |
12 | Did the applicant at any time held the nationality of any country other than the present nationality, if so, please give details including the period : |
_________________________________________________ |
13 | Whether the applicant or either of his/her parents or grand parents or great grand parents held an Indian passport at any time, if so details thereof: (enclose photocopy of relevant documents) |
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13.1 Passport Number | _________________________________________________ | |
13.2 Date of issue | _________________________________________________ | |
13.3 Please of issue | _________________________________________________ | |
14 | Whether the applicant or either of his/her parents or any of his/her grand parents or great grand parents was born and was permanently resident in India as defined in the Government of India Act, 1935* at any time. If so, following details may be indicated: i) Date & Place of birth : ii) Proof of residence etc : (Enclose photocopy of relevant documents) |
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_________________________________________________ _________________________________________________ |
15. | Has the applicant ever been refused Indian passport / travel document or visa for visiting India, if so, give complete details: (i.e. place & date of application, purpose, reasons for refusal etc.) |
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16. | Details of previous PIO Card (if applicable) | |
16.1 Date of issue | _________________________________________________ | |
16.2 Date of expiry | _________________________________________________ | |
16.3 Place of issue | _________________________________________________ | |
17. | Name & complete addresses of two persons known to the applicant living in India | |
17.1 Name | _________________________________________________ | |
17.2 Full postal address | _________________________________________________ | |
17.3 Contact Phone No. | _________________________________________________ | |
18. | Details and mode of payment of fee | _________________________________________________ |
Space for additional Information if any you would like to give:
____________________________________________________________________ ____________________________________________________________________ |
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DECLARATION : I hereby declare that the above statements are true to the best of my knowledge & belief. |
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Place: ________ Date: _________ |
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NOTE: 1) Please attach relevant documents substantiating your claim as person of Indian origin. 2) Original Passport and Photocopy of Birth Certificate required. 3) Attach 4 recent passport size photographs. 4) Attach self addressed courier envalope to return your passport. 5) Furnishing of false information will result in summary rejection of the application. 6) Acceptance of application forms does not confer any right on the applicant to the PIO card. 7) Registration with FRRO/FRO required if continous stay in India exceeds 180 days. Expression 'India' as given in sub-section (1) of the section 311 of the Government of India act,1935 means British India together with all territories of any Indian ruler under the suzerainty of His Majesty, all territories under the suzerainty of such an Indian ruler, the tribal areas, and any other territories which His Majesty in Council may, from time to time, After ascertaining the views of the federal Government and the Federal legislature, declare to be part of India. |
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© 2003, Indian High Commission, New Zealand. All rights reserved. |