Embassy of the People's Republic of Bangladesh
Anderstorpsvägen 12, 1 Tr. Three
171 54 Solna, Sweden photographs
Phone: + 46 8 730 5850, Fax: + 46 8 730 5870 of the applicant
Application Form for Bangladesh Passport
1. Name in full (block letters): ________________________________________________________ 2. Name (exactly in the form in which the applicant wishes to be copied in the passport:
_______________________________________________________________________________ 3. National ID/Birth Registration No. (if any): _____________________________________ 4. Profession of the applicant: _________________________
5. Date of birth: ____________________________________
6. Place of birth (district): ____________________________
7. Height: _______meter and _______c.m./_______feet and __________inches
8. Colour of hair: ___________________________________
9. Colour of eyes: ___________________________________
10. Visible distinguishing mark, if any: __________________________________________________ 11. Father's name and his citizenship: ___________________________________________________ 12. Father's profession and voter identity No. (if any): ______________________________________ 13. Mother's name and citizenship: _____________________________________________________ 14. Mother's profession and voter identity No. (if any):______________________________________ 15. Husband's/Wife's name and citizenship (in English): ____________________________________
_______________________________________________________________________________ 16. Name of the legal guardian and citizenship: ___________________________________________ 17. Relation with the legal guardian:____________________________________________________ 18. Whether Bangladeshi national- by birth/ by descent/ by migration/ by registration, if so date of
19. Marital status: single/married/widower/widow/divorced (please tick the correct one) 20. Permanent address in Bangladesh: ___________________________________________________
_______________________________________________________________________________ 21. Present address (with telephone number and email id): ___________________________________
_______________________________________________________________________________ 22. Number of pages of the passport (applies for):_____________
23. For child/children to be endorsed in parents/legal guardian's passport: (Please note that a joint
passport can not be used by the child/children if they travel unaccompanied by parents/legal
guardian. Max. 02 (two) minor children may be endorsed in the parent's/legal guardian's passport)
Sl. No. Name in full (block letters) Date of birth Sex
1. _____________________________________ _____________ _______
2. _____________________________________ ______________ _______
24. I declare that-
a) To the best of my knowledge and belief the information given in this application is correct. I am
fully aware that by making a statement, which is not true I will render myself liable to
prosecution under the law.
b) I have/ have not served in the Armed Forces.
c) I am/ am not a reservist in the Armed Forces.
d) I have not lost the status of Bangladesh national.
e) I have not previously held or applied for a passport of any description or been refused passport
f) All previous passports granted to me have been surrendered other than the passport or travel
document noted below which is not attached, and that I have made no other application for a
passport since the attached passport or travel document was issued to me.
(i) Number of the attached passport/travel document: _____________________
(ii) Date of issue: _________________ (iii) Place of issue: __________________________.
g) The passport as per details given below has been lost. In the event of its coming again into my
possession I undertake to return to the issuing authority (i) Number of the passport:
____________(ii) Date of issue: _________________ (iii) Place of issue:_________________.
iv) Circumstances in which passport was lost or destroyed and measures taken to recover it:
Signature of the applicant: __________________________
Telephone: __________________________ Email: _______________________________
For Official Use Only
No. ______________________________ Date: _______________________________
Passport No. _______________________ issued at _________________on _______________________ as fresh/duplicate/additional booklet. The holder of this passport has travelled previously on passport No. ____________________ issued at __________________on ______________ which has been cancelled on expiry of 10 years duration as the pages are exhausted/reported lost/damaged by the holder and returned to the holder/retained in the office.
(Name and Designation of the issuing authority with seal)
Specimen signatures of the applicant: