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Passport Correction Form
1.
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I cvm‡cvU© Awa`ßi Z_¨ cwieZ©b/ms‡kvab Av‡e`b dig Information Alteration/Correction Application Form G digwU †KejgvÎ †gqv` DËx©Y nqwb, Giƒc cvm‡cv‡U© cÖ`wk©Z Z_¨ cwieZ©b/gy`ªYRwbZ fzj ms‡kvab msµv‡š— e¨eüZ n‡e| This form will be used only to change shown information/rectify printing errors of the valid passport. wb‡`©kbv t digwU Bs‡iwR‡Z (CAPITAL LETTERS) c~iY Kiæb Ges AbyMÖnc~e©K Avcbvi Av‡e`‡bi mg_©‡b Dchy³ cÖgvYvw` mshy³ Kiæb| Instruction : Please fill up the form, in ENGLISH (CAPITAL LETTERS) and attach relevant papers in favour of your application. Av‡e`bKvixi bvg (evsjvq) Name of Applicant (In Bangla) Av‡e`bKvixi bvg (Bs‡iwR‡Z) Name of Applicant (in English) PvwnZ ms‡kvab Required Correction cvm‡cv‡U© eZ©gv‡b cÖ`wk©Z Z_¨ Information presently shown in the passport cwiewZ©Z/ms‡kvwaZ Z_¨ Changed/Corrected nformation - 1 -Iftee AvÂwjK cvm‡cvU© Awdm/wgk‡bi bvg Name of Regional Passport Office/Mission wd cÖ`vb msµvšÍ Z_¨ Payment of Fees wdÕi cwigvY ($/US$) Amount of Fee ($/US$) e¨vsK/wgk‡bi bvg Bank/Mission kvLv Branch iwk` bs Receipt No. ZvwiL Date M„nxZ cvm‡cv‡U©i Z_¨ Received Passport’s Details cvm‡cvU© b¤^i Passport No. Bmy¨i ¯’vb I ZvwiL Place & Date of Issue ‡gqv` DËx‡Y©i ZvwiL Date of Expiry cvm‡cvU© weZi‡Yi cÖK„wZ Type of delivery mvaviY Riæix Regular Express
2.
ZvwiL Date Av‡e`bKvixi/Awffve‡Ki (Av‡e`bKvix cÖvßeq¯‹ n‡j)
¯^v¶i Applicant’s/Guardian’s (if the applicant is a minor) Signature - 2 -Iftee
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mshyw³mg~n Enclosures 1. 6. 2.
7. 3. 8. 4. 9. 5. 10. - 3 -Iftee 1. Z_¨ msMÖnKvix (Acv‡iUi) Gi bvg AvB wW ¯^v¶i 2. Av‡e`b MÖnYKvix Awdmv‡ii bvg AvB wW ¯^v¶i 3. cvm‡cvU© Bmy¨/Aby‡gv`bKvix Kg©KZ©vi bvg AvB wW ¯^v¶i Awd‡mi e¨env‡ii Rb¨ For Official Use
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