| 17.1 |
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 facilities. |
| (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. |
Date..........
Same type of declaration on a proforma is required by authorities for issuance of a National Identity Card. Ed.