Fill the following Details
1. Name of the Teacher:
3. Name of the School:
4. Date of Birth:
5. Residential Postal Address:
6. Details of first appointment:
b) Date of appointment:
7. Classes handing in the School for VII & X Classes
Class Subject No.of periods
8. Date from which he/she is working in the school.:
9. Details of dependents as per Service Book entry with Page No.:
10.Details of Cases pending:
a) Whether there are any allegation pending against him/her:
b) Whether any disciplinary proceedings are pending or contemplated against the individual:
c) Whether any Vigilance cases are or contemplated against the individual :
d) Whether there are grounds to believe that the applicant could adversely on the Security records of the Government:
11. Details of Government Loans/Dues:
a) House building loan with interest:
b) Motor Car / Cycle Loan:
c) Any other loans from Government:
d) House rent arrears towards Govt. quarters.:
e) Other Government Dues:
12. Place of Visiting Country:
13. Duration of visit:
14. Purpose of Visit:
15. Contact Address in Visiting Place”
I, ————————- declare that the above particulars furnished by me are true and correct.
This is to certify that the above particulars are verified from the records of the individual and found correct.
Certified that Sri /Smt—————————————–, School Assistant ———— is a permanent Employee of ———————————————————————– Chittoor [dt] and is at present holding the post of school Assistant ——————— Sri. —————————————————————————————————————————————————————————————- are the dependents family members of Sri / Smt.———————————— and her identify is certified. This department has No objection to their acquiring Indian passport. The under signed is duly authorized to sign this identify certificate I have read the provision of section 6  of the passports Act., 1967 and certify that there are not attracted in case of this applicant. I recommend issue of an Indian passport to him/her. It is certified that this organization is State Government body. The identify Card No. of Sri/Smt. ——————————–
ALL CENTRAL GOVERNMENT EMPLOYEES STATE GOVERNMENT EMPLOYEES OF SATUTORY BODIES AND PUBLIC SECTOR UNDERTAKINGS AND THEIR DEPENDENT FAMILY MEMBERS ARE REQUIRED TO PRODUCE A INDENTITS CERTIFICATE (STRIKET OUT ARE NOT APPLICABLE)
(To be given in Duplicate in Original Stationery)
Certified that Sri/Smt———————————————————————————————————————-S/o /Wife/ of ——————————————————– of is temporary/permanent employee of this School Education Department from ————– to till date and is at present holding the post of School Assistant Sri/Smt——————————————————is are a dependent family members of Sri/Smt————————————-and their identity is certified. This Ministry/Department/Organization has no objection to their acquiring Indian passport. The undersigned is duly authorized to sign this Identity Certificate. I have read the provisions of Section 6 of the Passport Act., 1967 and certify that these are not attracted in case of this applicant. I recommend issue of an Indian passport to him/her. It is certified that this organization is a central State Government . The Identity Card Number of Sri/Smt [Employee] ————————————– is —————————
Affix recent passport size photo duly attested by MEO / HM
INTIMATION BY AN EMPLOYEE TO HIS EMPLOYER OF HIS INTENTION TO APPLY FOR A PASSPORT
Certified that I ————————————————————– I am a permanent employee of this ————————————————————- Chittoor District from ————— and I am it present holding the post of School Assistant ———— I intend to apply for an Indian Passport.
Name and Designation
1. Name of the Teacher and Designation:
2. Name of the School and Address:
3. Whether there are any allegations Pending against him/her :
4. Whether any disciplinary proceedings or pending contemplated against the individual :
5. Whether any Vigilance Cases or contemplated against the individual :
6. There are any dues against the individual :
Instructions to the Candidates:
1. Application should be submitted in 4 (four) sets.
2. Application must be forwarded by MEO/HM with covering letter.
3. 2 passport size photos should be affixed in the application and another 2 photos should be pinned to the first copy of the application.
4. Passport size photos which affixed in the application must be attested by MEO/HM.
5. Attach ration card Xerox copy or Aadhar Card with the application.