High Commission of India
Wellington, New Zealand








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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)
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) _________________________________________________


(Note : If applicant is the spouse of a citizen of India or a person of Indian origin, his/
her particulars should be indicated).

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.) _________________________________________________


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:



I hereby declare that the above statements are true to the best of my knowledge & belief.
Place: ________
Date: _________



Signature of the applicant






Specimen signatures of the applicant

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.