Page 234 - STATE v ARIF & ORS. SC-NO-540-2022 PART 1

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7. '* ~ f.tbl• ~ (6) iJ ~ ~ tM .; .. ~ t ;'!~hill! U, ,._ a:r ltiFII• -M aftum~ ~
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-~ · · ~ &:! till ill I If the applicant has not resided at the Address given against para (6) c:antlnuously for the last
two ~ease fumlsh 111e other add111Ss(esl wllh duration whera he/she has resided dullng t11a period.
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't I Fo;om .. ::.~ ............... lllli I to .................. ~ Date) 111 From ...................... W/ID .................. ~I Date) •
~ 'lA I :t. 1 Hause f>.!ame/No. .............................. 'lfm lli! 'IPI/ 't./ House Name/No. ......................... ...
1ft
·'11111/r'<fl/a I vtn./Street .... ~........... .................................. 'lllllt.re\t Vl8.,rStr,lltl .................................................. :
lllli'IR I Post Office., ........ ; ........................................... .. 'ltilillt I Posl Office,,,, ...................................... - .... - ......... .
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~ IIRII-Poi!Oit Station .............................................. . '!l,lmllll'll/ Pollee Stallon ............................................ _
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~I Distt ..... C~::t ................... - ••••••••.•.. _, ..................... . ~I ;'Jist! ................................................................... ..
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~I ... ,e ... ~ ................................................................ . ~I State .......................................................... ""'''~ ••
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PIN Code · J PIN Code
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~ Tel. No .......................................... :.l:.; ,. • ... .• ~ Tel. No .............................................. ..
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&. ~I Proftlaton ................... a~.~\ ..... ;:; .................................... ~: .................. -.............. _.,, ....... , ... _,u ..... .
3I'R ~~~ li'MI& t w ~ 'JIIIlVI-~ ~ ~~ 11 Govi./PSU Employee, auacn NOC.
9. ~ ~ Educ:nllonal Quallfl(;lllions: ....... 13:.~-~: ..... J~;t..T-~·': .......................................................... ..
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10. (I) ~ 1ft '~~'1ft<~; t 1 Applicant Is a citizen or India by:.
QJ D 0 D- . .,
'{.,ce~
·fil\fl
111'11 ii ~ ~ ~, .... i(Gj i•::: . e' sQo<t 0 1.\
1RI
Bitlh Descent Registration . Nalurallsalfon t>!>s' (\~ ~~~~a'l~
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(ii) ~ ~ t.I-A'~ t \\1 ~ If the applicant ever possessad cltlzenahl~_,~.
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give clelalls: . ~
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11. 11111 .. ~ 1li'ft mn '1111 ~ llt lRI'IIT ~ (~ IS ·~ 7 til 1 H the appiiOant ever changed hlaf
her name, give details: (see pera 7 for instructlons)
........ ; .................................................................... ,;,t ............................................. - ................................................ . ·• .
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12. ~ ~ ~ iiiR .a ~ IS flmul 1 Particulars of children tci'-be lrduded In applicant's •
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~"'PP!t:,~in~A..r Date of Blrth/UPII fllflf Place ol Blrth/QPII 1llll'! Sell/Mit
"'''""""''' .-;,,.o.,oooouoooo.#1Jfoo.,.ooooooooooooooooo.o~oO ••~••••••.;,..,,,,..,,¥••••••nooooooooo••• oooo•uo~ooooooo9(•••ooooo<Oooo.oono•oo•o o •oooo~oooo•oo•••••
............................... 'X .......... :................ .. ................. ~ ........ ~... ......... .. .............. ~......................... • .... ~ ............ .
...... -........................ ~......................... . ................... )S!.................... .. ............... oe........................ .. ...... '!!~ ........ ... .
13. n ~" qol- li'll 11lrilt'lm ~ ~ ~ ~ ~ 1111? -at 'Fil ~ -.ftu ~11 The detalla of
111
fil;lu
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passj!()ltllravel document lleldii!Ppliad for, If" any: . • · '
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{l) 'lRI'i!t lilllfwf 1lil(a :to 1 Passport OffiCe File Number: ................................................................................. ~ . ...
(ill ~ ~ lll!mt Passpori/Travat Document Number: ................................................................... .. ,.._,
.. ..
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(iii) 1iiRI ~ <1\\ dl Date of tssue/AppiiClltlon: ............................................................... : ................................ .
(!vi'IIRI V\ 'Iii ~ Place of mue/A~on: ........... ................................................ : ............... ~ ......... ..
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(v) .u 'llrilt ~ t? I Whether Passport valid?: · Yes/NO .
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14. w ~ ''armfl * ~ t· 11\T 'llll t? ~ m m ~ 1llllfUm ~ ~
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(f.lbi 151 fnJ 4 ~). -.i 0 Yes
Is applicant enlltled for ·''Emigration Check Not Req..tlred (ECNR)?" H Yea. allaoh "'f0No
atlestad coplf of the dooument (see para 4 of instruc~ons)
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