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An application for issue/renewal of a PIO Card shall be made in the prescribed form and shall be accompanied by documentary evidence to show that the applicant is a person of a Indian origin as defined.
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EMBASSY OF INDIA ____________________________
CONSULATE GENERAL OF INDIA __________________
HIGH COMMISSION OF INDIA ____________________
Consular Wing
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APPLICATION FORM FOR THE GRANT/RENEWAL OF PIO CARD |
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(TO BE FILLED IN DUPLICATE)
Please read the instructions including the eligibility criteria carefully before filling the form. The Embassy/ Consulate is not responsible for any error, which may lead to the non-accept-ance of the application. |
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| 1. |
a. Name of the applicant : ..............................................
b Surname at birth (if any) : ..................................................
c Other names (where applicable) : ..........................................
d Date of birth : .............................................................
e Place of birth : (town, city & country) :....................................... |
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| 2. |
Father's / Mother's / Spouse's name & Nationality :
a. Father : .......................................................................
b. Mother : .......................................................................
c. Spouse : ......................................................................
(where applicable)
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| 3. |
Address :
a. Present ..............................................................................
b. Permanent : ...........................................................................
c. Address in India (verifiable) ..........................................................
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4.
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6.
7.
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Profession or Occupation : ............................................................
Male / Female : .................................................................
Marital status : Married/Unmarried : .............................................
Nationality (at the time of birth) : ................................................ |
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8. |
a. Present Nationality (if different) : .............................................
b. Date on which acquired : ......................................................... |
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9. |
Passport particulars of applicant :
a. Passport Number : ..................................................................
b. Date of issue : ........................................................................
c. Date of expiry: .......................................................................
d. Country which issued the passport : ..........................................
e. Place of issue : ......................................................................... |
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10. |
Does the applicant hold dual nationality :
(If so, give details including the details of all the passports held etc.) |
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11. |
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 : |
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12. |
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:
a. Passport Number : ...................................................................
b. Date of issue : ..........................................................................
c. Please of issue : ........................................................................
(enclose photocopy of relevant documents) |
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13. |
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). |
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14. |
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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15. |
Details of previous PIO Card (wherever applicable) :
a. Date of issue : ...................................................................
b. Date of expiry : .................................................................
c. Place of issue : ................................................................... |
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16. |
Name & complete addresses of two persons known to the applicant living in India :
a. Name : ....................................................................
b. Full postal address : .....................................................
c. Telephone No. : ............................................. |
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17. |
Details and mode of payment of fee : ................................................. |
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| DECLARATION:- |
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I hereby declare that the above statements are true to the best of my knowledge and belief.
SIGNATURE OF THE APPLICANT
Date : .........................................................
Place : ........................................................
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Two specimen signature of the applicant
* 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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