HIGH COMMISSION OF INDIA Photograph of the
Applicant
INDIA HOUSE, ALDWYCH
LONDON, WC2B 4NA
APPLICATION FORM FOR MISCELLANEOUS CONSULAR SERVICES
Please specify the service applied for:
[a) Life Certificate b) Sponsorship Certificate c) Attestation of document
(s) d) NRI Certificate e) Attestation of Power of Attorney f) Attestation
of Affidavit / Will g) Other service (Please specify)]
1. Full Name :
2. Date of Birth :
3. Place of Birth :
4. CURRENT Passport Particulars: Passport No.: Place of Issue :
Date of Issue: Date of
Expiry:
5. Visa Status :
6. Residential Address:
In India In UK
Tel No.:
Email:
7. Professional / Business Address:
8. Name of Spouse, Nationality, Passport Particulars:
9. I solemnly declare that the information given above is correct and nothing
has been concealed and I am aware that it is an offence to knowingly furnish
false information or suppress material information.
I have not lost, surrendered or deprived of my Indian citizenship and I am not
in possession of any other passport or travel documents (applicable for Indian
Passport Holder).
Place:
Date: Signature
of the Applicant