CONSULATE GENERAL OF INDIA

540, ARGUELLO BOULEVARD, SAN FRANCISCO, CA-94118 PHONE NO. (415) 668-0662 / 668-0683 FAX No. (415) 668-9764 http://www.cgisf.org Info@cgisf.org

APPLICATION FORM FOR THE GRANT / RENEWAL OF A PIO CARD
(TO BE FILLED UP IN DUPLICATE)

1.

(a) Last Name :________________________________________ (b) First Name :_______________________________________ (c) Surname at birth (if any) : ___________________________ (d) Other names (where applicable) :_____________________ (e) Date of birth (dd/mm/yy) :___________________________

PASTE 2" x 2" PHOTO HERE FRONTAL VIEW (COLOR or B&W)

(f) Place of birth : (Town, City & Country) :____________________________ 2. Father’s/Mother’s/Spouse’s name & nationality :
Father Name Mother Spouse (where applicable)

Nationality

3.

Address : (a) Present :_______________________________________________________ (b) Phone No.:_____________________________________________________ (c) Permanent Address in India (verifiable) :___________________________

4.

Profession or occupation :___________________________________________
Last updated: Aug. 29, 2007 1

5. 6. 7. 8. 9.

Business/office address :_____________________________________________ Male / Female Married / Unmarried

Marital Status :

Nationality (at the time of birth) : ____________________________________ (a) Present nationality (if different) : _________________________________ (b) Date on which acquired (dd/mm/yy)________________________________

10.

Passport particulars of applicant :
Passport No. Date of issue Expiry date Country which issued Passport Place of issue

11.

Does the applicant hold dual nationality? (If so, please give details including the details of all the passports held etc.) _____________________________________________________________________ _____________________________________________________________________ Did the applicant at any time hold the nationality of any country other than the present nationality ? if so, please give details including the period : _____________________________________________________________________ _____________________________________________________________________ Whether the applicant or either of his/her parents or grand parents or great grand parents held an Indian passport at any time ? if so, details thereof : a. Name & relationship with the applicant: ________________________________ b. Passport Number : (c) Date of issue :____________________________________ d. Place of issue : (e) Date of expiry(dd/mm/yy) :_____________________________ (Enclose photocopy of relevant documents)

12.

13.

14.

Whether the applicant or either of his/her parents or any of his/her grand parents or great grand parents was born and was permanently resident in India as defined in the Government of India Act, 1935 * at any time ? if so, following details may be indicated : i. ii. Name & relationship with the applicant : __________________________ Date & place of birth(dd/mm/yy) : _________________________________
2

Last updated: Aug. 29, 2007

iii.

Proof of residence etc : (Enclose photocopy of relevant documents)

(Note: If applicant is the spouse of a citizen of India or a person of Indian origin, his/her particulars should be indicated). 15. Has the applicant ever been refused Indian passport/travel document or visa for visiting India ? if so, give complete details (i.e. Place & date of application, purpose, reasons for refusal etc.) Details of previous PIO Card (wherever applicable) : Date of expiry Place of issue

16.

Date of issue

17.

Name & complete address of two persons known to the applicant living in India : Complete postal address Telephone No.

Name/relationship

18.

Details & mode of payment of fee :

DECLARATION
I hereby declare that the above statements are true to the best of my knowledge and belief.

________________________ Signature of the applicant Two specimen signatures with of the applicant (within the box)

Last updated: Aug. 29, 2007

3

Instructions
Q: What documents are required to be submitted for issue of a PIO Card? A: Required documents are listed below:1. Completed application form – in duplicate (for very young children, thumb impression in place of signatures) 2. Photographs- 4 (four) latest, preferably in color, front facing, 2" x 2" 3. Indian Passport in original (the last one acquired by applicant), with copy of first 3 and last 3 pages only. 4. Copy of U.S. Passport (notarized copy) [Page with particulars only] 5. Proof of permanent address in India as per Indian Passport. If there has been a change of address, documentary evidence to support it, duly notarized. 6. In respect of children born in USA: a. Notarized copy of Parents Indian Passports [First 3 and Last 3 pages Only] b. Notarized copy of the Child US Passport [First 3 and Last 3 pages Only] c. Photocopy of birth certificate in case of applicants under 18 years 7. Fees of $ 370 ( for adults) or $ 185 (for children up to the age of 18 years) Mail back charges (preferably $20 for return by overnight mail which is more reliable and safe. Consulate can not take responsibility for delay in receipt or loss of documents sent by certified mail. No self addressed envelope necessary. Fees for PIO Card + mailing charges can be sent together through a single money order or cashier’s check. Please note that payments by mail can only be made through money order or cashier's check in favour of the Consulate General of India.

Last updated: Aug. 29, 2007

4

Sign up to vote on this title
UsefulNot useful