Bangladesh Application For Passport
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3EMBASSY OF THE PEOPLE’S REPUBLIC OF BANGLADESH
3510, International Drive, NW
Washington, DC 20008
Tel: (202) 244-0183 Fax: (202) 244-5366
APPLICATION FOR PASSPORT: FORM A
(PLEASE READ INSTRUCTIONS ON
THE THIRD PAGE AND FILL OUT
FIRST TWO PAGES)
Place passport size
Photo here.
I, the undersigned, hereby apply for an
International/Special passport and
provide the required information below.
1. Full name (in BLOCK LETTERS) with all/previous names (if any): _____________
_____________________________________________________________________
2. Name (the way applicant wishes it to be copied in the passport): _______________
_____________________________________________________________________
3. Father’s/Husband’s name: _____________________________________________
4. Mother’s name: _____________________________________________________
5. Profession: _________________________________________________________
6. Place of birth: _________________ Date of birth: (M/D/Y)__________________
7. Color of eyes: _________________ Color of hair: _________________________
8. Height: _____________________ Visible distinguishing mark: _______________
______________________________________________________________________
9. Marital status: Single (
) Married (
) Divorced (
)
10. Bangladesh national by:
(Birth)______(Reg.nationalization)______(Descent)______(Migration)__________
11. Countries for which passport is required: __________________________________
12. Purpose of visit: ______________________________________________________
13. Present address (BLOCK LETTERS) with Tel no:
_____________________________
_______________________________________________________________________
14. Permanent address in Bangladesh (BLOCK LETTERS): _______________________
_______________________________________________________________________
15. Children/Ward to be included in parent’s/legal guardian’s passport:
Sl no Full name
Date of birth (M/D/Y) Sex: Male/Female
____ ______________________________ _______________
____________
____ ______________________________ _______________
____________
____ ______________________________ _______________
____________
____ ______________________________ _______________
____________
(Page-1)
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Parent category: Life