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Form 2
Form 2
Permanent Address : House No. 18-7-198/A/214, Murad Mahal, Talab Katta, Hyderabad, Andhara Pradesh, India Tel No. 00919885173128
5.
Present Address in KSA : Al-Wazaraat (HARA), Taj Ad Din Al Malki Street, Opp Lane Riyadh Bank ATM, Riyadh, KSA. Tel No. 0559905423
6. 7. 8.
New Name : (if application is for change of name) New Address : (if application is for change of address) Details of current passport : Passport No. : F6767075 Place of Issue : Hyderabad Details of previous passport : Passport No. : Place of Issue :
Date of Issue : 20/02/2006 Valid Until : 19/02/2016 Date of Issue : Valid Until :
9.
Service Required : Please tick and strike out the others. a. Renewal upto full validity b. ECNR Stamp c. Inclusion of spouses name: NUZHAT SULTANA d. Change of Name/Maiden Name e. Police Clearance Certificate (for : please write name of country) f. Change of Address g. Any other Please specify :
[Photo is to be affixed for (a) (if passport is not issued from Riyadh, (e) and (f)]
____________________________________________ Signature of Applicant For Official Use Only To : PASSEM/HICOMIND/INDEMBASSY/CONGENDIA No. RIY/C/
Please confirm/verify the passport particulars/new address mentioned above in order to enable us to render the requested service.