APPLICATION FORM FOR ISSUE OF NO OBJECTION CERTIFICATE FOR THE PURPOSE OF APPLYING FOR PASSPORT

CERTIFICATE FOR THE PURPOSE OF APPLYING FOR PASSPORT

PART-I

1. ( a) Name and designation

( b) Father /Husband’s name

(c) Present post

2. Whether Temporary /Permanent

3. Date of Birth

4. Date of entry in service

5. Date of superannuation

6. Educational qualifications

7. Countries proposed to be visited

8. Purpose of visit

9. Period of visit with duration

10. Name and full address while abroad

11. If the stay is not on own arrangement,

name of the person with whom the

applicant will stay and the relationship

with that person

12. Any other information which the

applicant like to add

13. Identity card Number

I understand that the issue of a “ No Objection Certificate “ does

not entitle me to the grant of leave, which is to be decided by the

appropriate leave granting authority. Two copies of recent Passport

size photos are submitted herewith.

Place

Date

Signature of applicant

PART II

RECOMMENDATION OF THE DIVISIONAL SUPERINTENDENT

Photo to be

attested by

Divisional

superintendent on it

1. Whether any disciplinary/vigilance

case is Pending against the applicant

2. Whether there are any outstanding dues

From the applicant which cannot be

Recovered from his normal entitlements of

Pay and allowances

3. Whether the application is recommended

by the Divisional Superintendent

Certified that items 1 to 6 & 13 of the application format is

verified from the records and found correct.

Smt./ Shri / Miss…………………………………………..is a dependent

family member of Shri. /Smt…………………………………………….and his / her

identity is certified

I have read the provisions of Section 6(2) of the Passports

ACT 1967 and certify that these are not attached in the case of the

applicant

Place

Date

Divisional Superintendent