Information Alteration/Correction Application Form

This form will be used only to change shown information/rectify printing errors of the valid passport.

(CAPITAL LETTERS)
Instruction : Please fill up the form, in ENGLISH (CAPITAL LETTERS) and attach relevant papers in favour of your
application.

Name of Regional Passport Office/Mission

Type of delivery

Regular Express

Name of Applicant (In Bangla) Payment of Fees

 US$
Name of Applicant (in English)
Amount of Fee US$)

Received Passport’s Details Bank/Mission

Passport No. Branch
Place & Date of Issue

Date of Expiry Receipt No.

Date

Required Correction

Information presently shown in the passport Changed/Corrected nformation

Date

Applicant’s/Guardian’s (if the applicant is a minor) Signature

- 1 -Iftee
 Enclosures

For Official Use

- 2 -Iftee