GOVERNMENT OF INDIA, MINISTRY OF EXTERNAL AFFAIRS

Appeal Nomination Form

Note: Paste nominee's

unsigned recent
Furnishing of incorrect information would lead to rejection of the appeal. colour photograph
with white
Please produce all the required documents at the time of appeal submission.
background of size
4.5 cm X 3.5 cm.

1) Applicant name

2) File number

3) Appeal number

4) Nominee complete name

5) Photo identity card number

6) Photo identity card type

(Aadhaar/Passport/PAN/Voter ID card)

7) Nominee age

8) Nominee gender

9) Relation with applicant

10)Present address of nominee

Place and Date Applicant Signature