SWORN AFFIDAVIT
I ___RAHAMAT ALI_______________________________________________holder of Indian Passport
No____L4698661__issued at _____PATNA________________________________
on ___08/10/2013_residing at ___NESMA PARTNERS SHUMAYSI CAMP MAKKAH___________________
do hereby solemnly affirm and declare the following:
1. Either of Parents are Non-Indian? Yes/No___NO_________
If, Yes (Attached copy of Passport) – Nationality ____________N/A___________________and passport
No: ___N/A____
2. Spouse is Non-Indian? – Yes /No ___NO_________
If, Yes (Attached copy of Passport) – Nationality ______________N/A__________________and passport
No: ___N/A____
3. Applied for any other nationality? – Yes /No ___NO_________
If, Yes (Country & application details) ________N/A_____________________
I also affirm that they have not applied for or acquired nationality of Pakistan or any other foreign
country.
If the information furnished above is found to be incorrect, I understand that I am liable to be
prosecuted, and my passport shall be impounded / revoked as per extant rules and regulations under
Passport Act.
Signature of the applicant
Mobile No: 0571489500
Place: Jeddah
Date: 18/06/2023
Classification | Internal