FORM EA (P) 6
Application of India/Sri Lanka Passport
(For repatriating 1964 and 1974 agreements)

(Three unmounted passport-size bust photographs, taken full face, of the applicant, should be enclosed with application. The photographs should have on the reverse, the certificate “true photo of - “ signed by the Estate Superintendent in the case of applicants from estates, and by D.R.O., Gram Sevaka or M.P. for the n area in the case of others.)
Caution
Applicants are warned that ff any of the information supplied by them below is foundto be false or inaccurate, not only win their applications be liable to be rejected or their passports, if already granted be liable to be cancelled but they will render themselves liable to prosecution.
1.         (i) Full name with Aliases if any (in block letters):
(ii) Have you ever changed your name? If so, what was your previous name?
2. Are you married or single?
3. If married woman/widow state maiden name.
4. Place (village, town district, etc.) and date of birth (attach documents in support, if possible).
5. Profession.
6. Educational qualifications.
7. Present occupation.
8.         (i) Personal particulars of applicant.
(a) Height M. Cm.
(b) Colour of eyes.
(c) Colour of hair.
(d) Visible distinguishing marks, if any.
(ii) Of children below 15 years if to be included in the passport.

 

 

Full name	Sex	Date of birth
1.
2.
3.
4.
5.

9. Father’s name and place and date of birth.
10. If married woman or widow, husband’s or late husband’s nationality, name and place of birth.
11. How long have you been continuously residing in Sri Lanka ?
12. Have you at any time resided in any other country including Pakistan ? State countries and period ?
13. What was your occupation while residing in the countries mentioned in            Col.12 ?
14. Have you ever applied for travel document which had been refused? Ifso, when and under what circumstances ?
15. Have you ever been issued with a passport, which was later impounded or cancelled ? If so, give particulars
16. Present address in Sri Lanka.
17.  Names and addresses of two responsible -persons in India who would be prepared to vouch for you:
(1)____________
(2)____________
18.Whether applicant prefers an India-Sri Lanka passport or an emergency certificate ?
Two specimen signatures                        Two specimen signatures or thumb impressions
or ‘thumb-impressions of                           of wife if to be included in passport.
Applicant
I solemnly declare that I am an Indian citizen and ‘that I have not lost, surrendered or been deprived of my Indian citizenship and that the information given by me in reply to the questionnaire is true.
Place:
Date:
Signature or thumb-impression of applicant.
I, the undersigned ------------- residing at ------------------ holder of India-Sri Lanka Passport/Emergency Certificate No. -
-------dated --------hereby apply for the grant of
passport to -whose parent/legal guardian I am. I undertake to be entirely responsible for all his/her expenses.
Signature/thumb-impression of parent/guardian.
This certificate is required only when the application is made on behalf of a person below 18 years of age.
1. Form EA. (P) 9, omitted by the Passport (Second Amendment) Rides, 1985, vide G.S.R M-9 (E), dated Ist November 1965 (w.e.f. lst November 1985).
2. Form EA (P) 10 omitted by GS.R.100 (E) dated 14tyh March, l991)(w.e.f. 4th March 1991).
3. Form EA. (P) 11omitted by the Passport and Amendment Rules, 1985, vide G.S.R.360 (E), dated 1st November, 1985 (w.e.f. lst November, [u1]1985.