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Simple Bio Data Form

This document is a biographical data form and affidavit completed by an applicant. It collects personal information such as name, addresses, passport details, education, profession, marital status, and previous agreements signed. The applicant declares they were sponsored by the Government of India or state government for an exchange program, have not signed any agreements requiring their return to India, have no loans outstanding, are not required for any legal proceedings, and have not deserted their family if married.

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Jan Michael Lagon
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Download as PDF, TXT or read online on Scribd
180 views

Simple Bio Data Form

This document is a biographical data form and affidavit completed by an applicant. It collects personal information such as name, addresses, passport details, education, profession, marital status, and previous agreements signed. The applicant declares they were sponsored by the Government of India or state government for an exchange program, have not signed any agreements requiring their return to India, have no loans outstanding, are not required for any legal proceedings, and have not deserted their family if married.

Uploaded by

Jan Michael Lagon
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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BIO‐DATA FORM

Name__________________________________________________
Current
address_____________________________________________________________________
___________________________________________________________________________
_______________________
Telephone No._______________________________________
Passport No. __________________________________
Date of Issue _________________________________________
Place of Issue _____________________________________
Permanent address____________________________________________________________
___________________________________________________________________________
_____________________________________________
Educational Qualifications (please indicate subject in the case of Ph.D.)
___________________________________________________________________________
_______________________
Profession ________________________________________________________________
Name & Address of Next‐of‐kin in India ________________________________________
Tel. No. ___________________
Are you married? ______________.
If yes, give below name and address of your wife/husband and children.
___________________________________________________________________________
___________________________________________________________________________
______________________________________________
Are you divorced or separated from your wife/husband? _______________
If yes, indicate below the present status of your wife/husband and who has the custody of the
children.____________________________________________________________________
_______________________
Have you signed any agreement with Government Organization or a University or any public
organization or banks or any other Institution from which you have enjoyed monetary benefit
in the form of passage money, scholarship or otherwise and have specifically or by
implication undertaken to return to India or the amount received? _____________ If yes,
give details on a separate sheet.
Have you been sponsored and provided with certain privileges, such as admission into
colleges, Universities or employment with Government of India/Government of any State in
India? ____________. If yes, give details below.
Have you given any definite undertaking to return to India as a condition of the issuance of
the passport or for the entitlement of some other privileges like scholarship, leave benefits,
etc?_______________. If yes, give details below”.
Is your presence required in India in connection with a civil or criminal
proceedings?______________. If yes, give details on a separate sheet.
Please indicate below the name of the scheme under which you proceeded abroad.
___________________________________________________________________________
_______________________.

________________________
Signature of the applicant
Date:
Place:

______________________________________________
Signature and Seal of Notary Public with date and Seal
AFFIDAVIT
I, __________________________________________ holder of Indian Passport No.
______________________________ dated _________________________________ issued
at ___________________________________________________ expiring on
___________________________ now residing at _________________________________
___________________________________________________________________________
_______________________ hereby declare that
1. The exchange programme was sponsored by the Government of India/State
Government of __________________________________ in India / Agency of the
Government of _________________________________ and financed by the Government of
/ Agencies of the Government of _____________________ / other
______________________________.

2. “I have not signed any agreement/contract with Government of India or a State


Government or Quasi Government Organization or a University or any public organization in
India or any banking or other organization in India by which I have enjoyed any monetary
benefit in the form of passage money, stipend, scholarship, study leave or otherwise, I have
undertaking to return to India after completion of my studies/training in USA.
Or
I took a scholarship/loan of Rs._________________ from (Name of the institution)
______________________ under National Loan Scholarship Scheme or
_____________________________ (any other scheme) during the year ______ , when I was
a student at ______________________ (college/Institution) and I have fully repaid the
amount due from me, or I have yet to repay the amount of Rs. _________________”.
3. I have not taken any loan from any person or agency in India.
4. My presence is not required in India in connection with civil or criminal proceedings.
5. I am unmarried/married and have not deserted my spouse or children in India.
________________________
Signature of the applicant
Date:
Place:

____________________________________________
Signature and Seal of Notary Public with date and Seal

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