Annexure E — Specimen Declaration of the Applicant on a Plain Paper

What is Passport Annexure E?

Annexure E is Passport Seva's specimen of a self-declaration by a passport applicant. It is not a form with boxes but a page of statements you copy onto plain paper, fill in and sign: your name, your father's or husband's name, your address and date of birth, the names of your parents and spouse, and how long you have lived continuously at your address.

The rest of the page is a list of solemn statements. You affirm that you are a citizen of India and haven't taken another citizenship, that you haven't been convicted in India in the last five years of an offence involving moral turpitude with a sentence of two years or more, that no criminal case, warrant, summons or travel ban is pending against you, how any government-paid repatriation was settled, and that your travel won't harm India's sovereignty, security or foreign relations.

FileIt prints your details on the specimen's own dotted lines, fitting the address and the residence period onto the lines they belong on, and saves the page in your vault. You print it on plain paper, strike out the alternatives that don't apply and sign it by hand.

Who needs to fill out Passport Annexure E?

• Passport applicants whose Passport Seva Kendra or the passport application instructions ask for a self-declaration in the Annexure E format.
• Applicants who need to state in writing how long they have lived at their present address.
• Married applicants giving their spouse's name alongside their parents'.

When to use Passport Annexure E

• When Passport Seva tells you to bring Annexure E with your passport application.
• Before your appointment at the Passport Seva Kendra, so the signed original is ready.
• Only if every statement on it is true for you.

What you need before you start

• Your full name, date of birth and present address as in your passport application.
• Your father's (or, for a married woman, husband's) name, and your father's, mother's and spouse's names.
• The date or month and year from which you have lived continuously at your address.
• Plain paper to print on, and a pen to sign.

What’s on Passport Annexure E

The 2019 edition has 1 page. FileIt asks for it in 4 parts:

1. The applicantApplicant
2. 1. Names of parents and spouseApplicant
3. 2. Continuous residenceApplicant
4. 3–10. Declaration and signatureApplicant

How to fill out Passport Annexure E, step by step

1 Opening paragraph

Your name, whose son, daughter or wife you are (strike out the others by hand), that person's name, your address and your date of birth.

2 1. Parents and spouse

The names of your father, your mother and, if you are married, your wife or husband.

3 2. Residence

Since when you have been a continuous resident at the address above.

4 3–10. Statements

Citizenship, criminal record, pending proceedings, warrants and court orders, repatriation, and loyalty to India. In item 3 strike out the ways of acquiring citizenship that don't apply, and in item 7 the alternative that doesn't apply.

5 Signature

The place and date, and your signature by hand.

Common mistakes to avoid

• Signing a statement that isn't true for you: you solemnly affirm every one of them.
• Forgetting to strike out the words that don't apply in the opening line, item 3 and item 7.
• Giving an address or date of birth that doesn't match the passport application.
• Leaving the place and date blank.

After you fill it out

Print the declaration from FileIt on plain paper, strike out what doesn't apply, and sign it by hand.

Take the signed original to your Passport Seva Kendra appointment with your application and documents. FileIt does not submit anything for you.

Keep a scan in the applicant's vault folder with the passport application.

Passport Annexure E: frequently asked questions

Official sources

• Blank form (PDF), published by Ministry of External Affairs (Passport Seva), Government of India: https://www.passportindia.gov.in/AppOnlineProject/pdf/AnnexureE.pdf
• Official instructions and guidance: https://www.passportindia.gov.in/AppOnlineProject/pdf/AnnexureE.pdf
• Edition shown on this page: Annexure 'E' (specimen, PDF dated June 2019) (checked 2026-10-19).

FileIt is not affiliated with or endorsed by Ministry of External Affairs (Passport Seva), Government of India or any government. This page explains the form in general terms and is not legal, tax or immigration advice. Always read the official instructions, and check that you are using the edition the recipient accepts. Page last reviewed 2026-10-19.

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