Please select your

Indian Mission as
per Jurisdiction.

Surname as
per passport.

If any change in name

then previous name
details is required.

Please select your

service of re issue or
renewal.

Given/middle
Name as per
passport.

USA address with

proof of address.
If need Indian
address then need to
submit the proof of
same.

Please click to go to
next page.

Please write
permanent
address of India.

Local number
Local mobile no

All details in family

information will be
as per passport.
If married then
please write new
name of the
applicant.
Parents born in
Pakistan before 15
Aug 1947 may write
undivided India
Pakistan (UDIP)

Please write web

file number
mention on the
last page of the
passport.

Please enter your

passport details as
on passport.

Please click to go to
next page.

You can upload you photo

as per specification and click
on save & continue.
If you do not want then you
can skip this stage & click on
save & continue.

Please click on
generate pdf to take
print out of your
application form.
Its compulsory to
click on this tab.

Applicant
Signature

Passport fee as per category. Please fill

the amt excluding BLS fee

Please enter details

in terms of
emergency.

Please enter details with

black pen in column 7 to 29.

Enter the date when you

left India for the first
time for USA.

Emigration check
required (If non
graduate)

Enter details when visited

India last time.

Emigration check not

required (if graduate)

Please provide 1 reference

from India & 1 from USA.

Please enter details of

children needs to delete
from existing passport.

Applicant signature & in case of

minor thumb print as per
specification.

Please provide both

parents details in case of
minor.

In case of minor both of

parents signature is
mandatory.

Applicant need to sign in the

above box provided.