APPLICATION FOR NOC  
         
         
                                    Date :    /     /        
                                     
        To,  
         
        ________________________ 
         
         
              Sub: Issue of No Objection Certificate (NOC) for obtaining 
                 Passport.  
         
                       ********** 
            
           The undersigned would like to request your kind authority to 
        Issue a "No Objection Certificate" (NOC) for obtaining Indian Passport.  
         
           Thanking you,  
         
                                  
                                 Yours faithfully,  
                                  
                            
                                   (                          ) 
                                     Signature 
                                         
                       Name:Shri/Smt/Ms._________________ 
                       Designation :______________________ 
                       Staff No. : ________________________ 
                       Department:______________________ 
                       Office/Station:____________________ 
                       Date: ___________________________ 
                                                                                                                       
                                                                                                ANNEXURE -I 
                                                     DECLARATION 
                     I hereby declare that in the event of issue of "No Objection Certificate" 
                     (NOC) for obtaining Indian Passport to me/my spouse/dependant:  
                      
                         I.      I /my spouse/dependant will not engage outside Indian in any 
                                 activities prejudicial to the sovereignty and integrity of India.  
                          
                         II.     My/spouse's/dependant's  departure  from  India  will  not  be 
                                 detrimental to the security of India. 
                      
                         III.    My/spouse's/dependant's  presence  outside  India  will  not 
                                 prejudice  the  friendly  relation  of  India  with  any  foreign 
                                 country.  
                          
                         IV.     I have/spouse/dependants' has at any time during the period 
                                 of five years not been convicted by a Court of India for any 
                                 offence  involving  moral  turpitude  and  sentenced  in  respect 
                                 thereof to imprisonment for not less than two years.  
                      
                         V.      No proceedings in respect of an offence alleged to have been 
                                 committed  by  me/spouse/dependent  is  pending  before  a 
                                 criminal court of India.  
                      
                         VI.     No warrant or summons for the appearance, or a warrant for 
                                 the arrest has been issued against me/spouses/dependant by 
                                 a court under any law for the time being in force or that an 
                                 order prohibiting the departure from India has been made by 
                                 any such Court against me/spouses/dependant.  
                                                              
                                                             Signature:________________________ 
                                                             Name:Shri/Smt/Ms._________________ 
                                                             Designation :______________________ 
                                                             Staff No. : _______________________ 
                                                             Department:______________________ 
                                                             Office/Station:____________________ 
                                                             Date: ___________________________ 
                                                                                                                       
                                                                                                                       
                                                                                                             ANNEXURE –II 
                        IN CASE OF APPLYING FOR SELF: 
                         
                         1    Full Name of the employee *   (In                       :    
                              Block Letters) 
                         2    Designation                                             :    
                         3    Staff No                                                :    
                         4    Identity Card No                                        :    
                         5    Office/Place of working                                 :    
                         6    Present Grade + G.P.                                    :    
                         7    Rate of Pay + G.P.                                      :    
                         8    Date of Birth                                           :    
                         9    Date of appointment to Railway                          :    
                              Service 
                        10  Date of superannuation                                    :    
                        11  Whether DAR/SPE/Vig. Case                                 :    
                              pending 
                        12  Contact number                                            :   a. Rly              b. (M) 
                        13  Name of Father/Spouse                                     :    
                        14  Present Address with Pincode                              :    
                                                                                           
                                                                                           
                        15  Permanent Address with Pincode                            :    
                                                                                           
                                                                                           
                        * Enclosed 03 Passport size Colour photograph & Attested Xerox copy of 
                        Identity  card.  The  employees of Division/W-Shop/Units - Must submit 02 
                        sets to their Controlling Authority & Diyision/W-ShopfUnits will forward 01 
                        set to Headquarter for NOC.  
                         
                        B. IN CASE OF APPLYING FOR DEPENDANT MEMBERS:  
                        1  Full Name (In Block Letters)                               :    
                        2  Date of Birth                                              :    
                        3  Place of Birth                                             :    
                        4  Educational Qualification                                  :    
                        5  Profession (Certificate from the                           :    
                              employer/ bonafide certificate from 
                              school/college to be attached) 
                        6  Identification Marks :                                     :   1. 
                                                                                          2. 
                        7  Identity Card No.                                          :    
                        * enclosed 03 Passport size Colour photograph & Attested Xerox 
                        copy of Identity certificate.  
                                                                      Signature:________________________ 
                                  Paste here the                      Name:Shri/Smt/Ms._________________ 
                                        recent                        Designation :______________________ 
                                   photograph of                      Staff No. : _______________________ 
                                 Setif Dependant                      Department:______________________ 
                                  (to be attested                     Office/Station:____________________ 
                                   by Controlling                     Date: ___________________________ 
                                       Officer)