Application Form for Person of Indian Origin (Pio) Card - Bogota D.C. Colombia

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APPLICATION FOR
PERSON OF INDIAN ORIGIN (PIO) CARD
(This form may also be used for issue of duplicate/renewal of PIO card)
EMBASSY OF INDIA
BOGOTA
Tel.(57-1)6373259, 279, 280, 289
Fax (57-1) 6373451, 516
Calle 116 #7-55 Int. 2 Of 301,
Torre Cusezar, Santa Barbara,
Bogota.D.C., Colombia
E-mail: indembog@cable.net.co
Note: This application can be used at the Embassy of India, Bogota
(IN BLOCK LETTERS WITH BLUE/BLACK INK ONLY)
Paste a
PHOTO here
1) Name of the applicant:____________________________ _______________________
_______________________
(Expanded Initials) (First Name) (Middle Name) (Last Name)
Date of birth: _______/________/______Place of birth: (town, city & country):____________
(dd)
(mm)
(yyyy)
2) Male/Female:________ 3) Married/Unmarried:________ 4. Profession/Occupation:_________
3) Father’s Name__________________________________Nationality:________________
4) Mother's Name: _________________________________Nationality: ________________
5) Spouse Name: __________________________________Nationality: ________________
6) Address _______________________________________________________
___________________ _________________ __________
Telephone No.: Home:(_____)____-_______ Work: (_____)_____-______
7) Address in India (verifiable):
________________________________________________________________________
_____________________________________________________________________________
__________________________________________________________________________
Telephone No.:______________________________
8) Nationality (at the time of birth):__________________ Present Nationality:______________
APPLICATION FOR
PERSON OF INDIAN ORIGIN (PIO) CARD
(This form may also be used for issue of duplicate/renewal of PIO card)
EMBASSY OF INDIA
BOGOTA
Tel.(57-1)6373259, 279, 280, 289
Fax (57-1) 6373451, 516
Calle 116 #7-55 Int. 2 Of 301,
Torre Cusezar, Santa Barbara,
Bogota.D.C., Colombia
E-mail: indembog@cable.net.co
Note: This application can be used at the Embassy of India, Bogota
(IN BLOCK LETTERS WITH BLUE/BLACK INK ONLY)
Paste a
PHOTO here
1) Name of the applicant:____________________________ _______________________
_______________________
(Expanded Initials) (First Name) (Middle Name) (Last Name)
Date of birth: _______/________/______Place of birth: (town, city & country):____________
(dd)
(mm)
(yyyy)
2) Male/Female:________ 3) Married/Unmarried:________ 4. Profession/Occupation:_________
3) Father’s Name__________________________________Nationality:________________
4) Mother's Name: _________________________________Nationality: ________________
5) Spouse Name: __________________________________Nationality: ________________
6) Address _______________________________________________________
___________________ _________________ __________
Telephone No.: Home:(_____)____-_______ Work: (_____)_____-______
7) Address in India (verifiable):
________________________________________________________________________
_____________________________________________________________________________
__________________________________________________________________________
Telephone No.:______________________________
8) Nationality (at the time of birth):__________________ Present Nationality:______________
9) Visible Distinguish Mark: ______________________________
10) Current Passport Number: ______________________________Date of issue:
________________________________
Place of Issue: _________________________Date of expiry: ________________________
Country which issued the Passport:______________________________________________
11) Does the applicant hold dual nationality: (If so, give details including the details of all the
passports held etc.)
_____________________________________________________________________________
_________________
12) Did the applicant at any time hold the nationality of any country other than the present
nationality, if so, please give details including the period:
_______________________________________________________________________
Previous Passport Number:________________ Date of issue:________________ Place of issue:
_________________
13) Whether the applicant’s parents or grand parents or great grand parents held an Indian
passport at any time, if so details thereof: (enclose photocopy of relevant documents)
Passport Number:______________________ Date of issue:________________ Place of issue:
__________________
14) Whether the applicant or either of his/her parents or any of his/her grand parents or great
grand parents was born and was permanently resident in India as defined in the Government of
India Act, 1935 * at any time. If so, following details may be indicated:
Date of birth: __________________________Place of
birth_______________________________________________
Proof of residence etc: _____________________________ (Enclose photocopy of relevant
documents; Note: If applicant is the spouse of a citizen of India or a person of Indian origin,
his/her particulars should be indicated).
15) Has the applicant ever been refused Indian passport/travel document or visa for visiting India,
if so, give complete details: (i.e. place & date of application, purpose, reasons for refusal etc.)
16) Details of previous PIO Card (wherever applicable): Number:
____________________________________________
Date of issue: _________________ Place of issue: ______________________Date of expiry:
_____________________
17) Name & complete addresses of two persons known to the applicant living in India:
Name:________________________________________________________
Relationship:________________________
Address:______________________________________________________________________
____________________
__________________________________________________________Telephone
No:___________________________
Name:________________________________________________________
Relationship:________________________
Address:______________________________________________________________________
____________________
__________________________________________________________Telephone
No:___________________________
18) Fee details and mode of payment: ________________________;
AMOUNT US $/PESOS_____________
DECLARATION
I hereby declare that the above statements are true to the best of my knowledge and belief and I
have read the above mentioned instructions fully.
_________________________________________
SIGNATURE OF THE APPLICANT / LEGAL
GUARDIAN OR PARENT IN CASE OF MINORS
Date: ___________________________
Place: ___________________________
Two specimen signatures of the applicant ONLY (Thumb impressions, in case of an infant)
Expression ‘India’ as given in sub-section (1) of the section 311 of the Government of India act,
1935 means British India together with all territories of any Indian ruler under the suzerainty of His
Majesty, all territories under the suzerainty of such an Indian ruler, the tribal areas, and any other
territories which His Majesty in Council may, from time to time, After ascertaining the views of the
federal Government and the Federal legislature, declare to be part of India.
Note: Please include return mailing charges wherever applicable. The service will not be
rendered without mailing charges.
GUIDELINES
1) Application to be filled in DUPLICATE (TO BE FILLED IN BLOCK LETTERS IN
BLUE/BLACK INK ONLY)
2) Please enclose all relevant documents substantiating your claim as a person of Indian origin.
(also see 12 & 13 in the application)
3) Attach 4 recent identical passport size photographs (Front pose with light background only)
4) Appropriate PIO Card fee (US $ 368.00 or Col Pesos 993,000/- for adult; US $ 188.00 or Col
Pesos 507,600/- for children below the age of 18 year) should be
deposited along with the application. The fee should be paid by bank transfer/deposit to Embassy
of India Account. PERSONAL CHEQUES/CREDIT CARDS NOT ACCEPTED.
Embassy account details for bank transfer/deposit are :
USD A/c No.1516, HELM BANK, Carrera 7, No.27-18, Bogota, Colombia.
Correspondent Bank – Citi Bank, New York
Swift Code CITIUS33
ABA – 021000089
Beneficiary Bank – HELM BANK,
Account No.109 53817
Swift Address : BCTTOCO88
COL PESO A/c with the above bank is : Account No.007396807.
5) Enclose old Indian passport and photocopy of first two pages & last two pages or copy
of cancelled Indian passport and Colombian/Ecuadorian/Costa Rican passport in original,
Photocopy of birth certificate in case of applicants under 18 years along with PIO Card
application.
6) Photocopies of both parent’s passport are required in case applicant never held Indian
nationality. In case of requirement the original passports requested should be produced.
7) Photocopy of 2 documents as a proof of current address (for example: Driver’s
License/Telephone bill/Utility bill/lease agreement etc.)
8) The processing time for PIO Card application is 15 business days from the date of receipt at
the Embassy.
9) NOTE: Furnishing of false information will result in summary rejection of the application.
Acceptance of application does not confer any right on the applicant to the PIO Card.

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