Application form for Nepali Passport/ Travel Document
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Embassy of Nepal Photo
2nd Neopalimovsky Per. 14/7 Moscow, Russia.
Application form for Nepali Passport/ Travel Document
I, the undersigned: apply for Passport/Travel Document with my following particulars. I will fully comply with the Passport Act. 2024 and Passport Regulations 2050.
1. Applicant's full name (in English Block Letters) Mr./Mrs./Miss………………………………………………………………
(in Nepali) Mr./Mrs./Miss………………………………………………………………………………………………………
2. Permanent address in Nepal: Block no. ……..Ward no. …VDC/Municipality…………District………………
3. Temporary address (Your address in Foreign Countries) Street:……………………Appart.no:……….City…………......State:………..Zip code: ………. Tel/Email:………
4. Date of birth………………(BS)……………….(AD)'s 5. Place of Birth:……………………Country:……………
6. Father's name:……………………………………Nationality:………………Address: Block no…… Ward no Tole/Gaon………………Municipality/VDC…………..District………………………
7. Nationality:………………. 8 Applicant's Profession…………….9 Married/Unmarried…..10. Male/Female………
11. Guardian's name:………………………………….Relations……………………………………
12. Color of eyes:…………Color of hair……………Complexion:……………Height………Special Particulars……
13. If you are a Nepalese government employee: Please specify position:……………………………………………
14. Emergency contact address of your next of kin in Nepal: Name: Mr./Mrs./Miss…………………………Relation………………Ward no…… ………..Tole/Gaun:…………
Municipality/VDC………………………….District………………………………Tel.no…………………………....
15. Your Citizenship no:……………………Date of issue:………………………...District:……………………
16. Your Current Passport no:…………………Date & Place of issue:……………………………………………
17. Please give the following details of the minor and disabled child traveling with you:
Full name: Date of birth Relation:
……………………………………………………………………………………………………………………………
I solemnly declared that the information provided above is correct:
Signature of the applicant……………………………….Date………………………………………………
For official purpose only
No. of Passport/Travel Document issued……………………Type…………………. Date of issue……
Valid until………………….Passport/Travel permit fee US$..................................Gratis:……………