fla wdlD;sh $ gbtk; Nf / FORM K

wd' ' 35 $ IM 35

fuu b,am;%h fkdf,a ksl=;a flf$ ,t;tpz;zg;gg;gj;jpuk;

,ytrkhf tpepNahfpf;fg;gLk;. /THIS APPLICATION IS ISSUED FREE

wd.uk yd s.uk fomd;fka;=j

FbtuT> Fbafy;Tj; jpizf;fsk;

;=kajk PdhdrEmh
fuys w,jkak

DEPARTMENT OF IMMIGRATION & EMIGRATION

* Y%S ,xld .uka n,m;%hla" yosis$ykd.ekSf iy;slhla i|yd b,a m;%h

* ,yq;if flTr;rPl;L> mtrufhy /Msilahs rhd;wpjopw;fhd tpz;zg;gk;

%d;whtJ epoy;
glj;ij ,q;Nf
xl;lTk;

* APPLICATION FOR A SRI LANKAN PASSPORT, EMERGENCY/ IDENTITY CERTIFICATE

fuu b,a m;%h imQK lsug fmr lreKdlr 04 iy 05 msgqj, i|yka Wmfoia n,kak'
tpzz
; g;gk; vt;thW epug;gg;gl Ntz;Lk; vd;gJ gw;wpa mwpTWj;jy;fs; 4 Mk; 5 Mk; gf;fj;jpy;
jug;gl;bUf;fpd;wd.

Affix the
third Photograph
here

Please follow all instructions given in page 04 and 05 before filling the application.

ldhd,hSh m%fhdackh i|yd $ mYtyf cgNahfj;jpw;F khj;jpuk; /For Office use only
APPLICATION No.

ALLOCATED PASSPORT No.

AC CODE

N
bx.%Sis NdIdfjka msru jvd;a iqiqf$ tpz;zg;gg;gbtj;ij Mq;fpyj;jpy; epug;GtNj rpwe;jJ.
1' oekg we;s .uka n,m;%fha wxlh/,g;Nghija gpuahzr; rPl;bd; ,yf;fk;
2'
mqoa., ye+kqm;a wxlh/ nrhe;j Njrpa Msilahs
Present Travel Document Number
ml;ilapd; ,yf;fk;/Personal Identity Card Number
3' jdi.u$fm<m;a k
Kjw; ngah;

Surname
4' jdi.u yer fjk;a k$Kjw;
ngah; jtph;e;j kw;iwa ngah;fs;

Names other than Surname

5' jdyhg fmr ku
fd;dpg; ngah;

Maiden Name
6' ia:sr ,smskh$ epue;ju tpyhrk;
Permanent Address
7' Wmka oskh $ gpwe;j jpfjp
Date of birth
8' Wmamekak iy;slfha

gpwg;G mj;jhl;rpg; gj;jpuk;

Birth Certificate

oskh $ jpfjp / Date

udih $ khjk; / Month

wxlh$,yf;fk;
Number

jIh$ tUlk; / Year

ia;%slalh

khtl;lk; / District

9' Wmka ia:dkh$gpwe;j ,lk;

Place of Birth
10' ia;%S mqreI Ndjh$
ghy;/Sex

mqreI $Mz; /Male

12' jdyl wjdyl ;;a;ajh

Fbapay; epiy /Civil Status

wjdyl

11'

ia;%S $ ngz; / Female

jdpikahdtH/Single

jdyl$ tpthfkhdtH
Married

Wi fikag$ cauk; nr.kP. /

Height in Centimeters

lalido$ tpthfuj;Jr;
nra;jth; / Divorced

jekaoUq $ jhukpoe;jth;
Widowed

13' jD;a;sh$/lshdj$;k;=r$ njhopy;rhh; gjtp

njhopy/; gjtp /Profession/Occupation/Job
14' wd' ' 35 iS wdlD;shg wkqj we;=<;a l<hq;= wjq' 16 g wvq <uhska ixLHdj ^Wmu yhls&$ F. .F. 35 rP gbtj;jpy; Nrh;;f;fg;gl Ntz;ba 16 tajpw;F cl;gl;l
gps;isfspd; vz;zpf;if (Mff; $baJ MW) /Number of Children under 16 of age to be included as per form I.M. 35 C (Maximum Six Children)
15' foaY rgl mqrjeisNdjh$Y%S ,xld oa;aj mqrjeisNdjh ,ndf.k ;sf o @

ePq;fs; ntspehl;L gpu[hThpik my;yJ ,yq;ifapy; ,ul;ilg; gpu[hTupik ngw;wtuh ?

Nkdpapd; epwk;

Complexion
of Skin

;o l $ fWg;G / Black
l $ fUik $ Dark
;f< $ nghJepwk; $ Fair
iq $ nts;is $ White

19' wjYH .uka ,sh,af,a j.h

Njitg;gLk; gpuahzg; gj;jpuj;jpd;
tif

Type of Travel Document requird

17' ysifliaj, mdg

rpifapd; epwk;

Colour of Hair

l $ fWg;G / Black
Uqre$nghd;dpwk;$ Blond
iq $eiu $ Gray

ke;

Yes

No

Mk;

Have you obtained Citizenship of a foreign country or Dual Citizenship in Sri Lanka ?
16' Yrfha mdg

l $ fWg;G / Black
ks,a $ ePyk; $ Blue
Colour of Eyes Uqre$kz;zpwk;$ Brown
ly $ kQ;;rs; $ Yellow

18' weiaj, mdg

fz;fspd; epwk;

ish,qu rgj,a$ rfy ehLfs;/All Countries

ksYa;^ueo fmr. rgj,a&$ Fwpg;gpl;l (kj;jpa fpof;F ehLfs;)/Specified (Middle East )Countries
yis iy;slh$ mtrufhyr; rhd;wpjo;/Emergency Certificate
ykd.ekSf iy;slh$ milahsr; rhd;wpjo;/Identity Certificate

20' .uka n,m;%h ,nd.kqfha$ flTr;rl

P ;L Njitg;gLtJ
Passport Required on

idudkH fiajh hgf;a / toik / Normal Service

tlak fiajh hgf;a / xNu ehs; /One Day Service

whlref.a w;aik$ tpz;zg;gjhuhpd; ifnahg;gk; /Signature of the Applicant

,y;i
; y

whlref.a m%ldYh

* wod< fkdjk jpk lmd ykak'

uu/ Y%S ,xldf mqrjeishl= nj m%ldY lr./uu ............ ^rf ku ,shkak& mqrjeisNdjh/Y%S ,xld oa;aj
mqrjeisNdjh ,nd we;af;'*
.uka n,m;%hla" yis iy;slhla fyda ykd.ekSf iy;slhla ud i;=j fkd;snqKq nj fyda tjekakla i|yd wh fkdlrk ,o nj;a"
fuhska iy;sl lr'*
f iu. bm;a lrkq ,nk wxl ork .uka n,m;%h$yis iy;slh$ ykd.ekSf iy;slh yer g fmr ud i;=j
;snqKq ishu .uka n,m;%$yis iy;sl yd ykd.ekSf iy;sl" wj,x.= lsu i|yd Y%S ,xld .uka n,m;% ms<sn| ksis ks,Odkag uiska
Ndr we;s nj;a" g wuqKd we;s .uka ,sh,a, ud fj; ksl=;a lsfuka miq tjekakla i|yd fjk;a wh m;%hla uiska bm;a
fkdlrk ,o nj;a m%ldY lr'*
fuu wh m;%hg wuqKd we;s ,shlsh,s i;H yd ksjer tajd nj;a" i;H f;dr;=re jika lsu fyda lafIam lsu i|yd tu ,shlsh,s
jHdc f,i fjkia lsj,g yd tl;=lsj,g Ndckh fkdlrk ,o nj;a iy;sl lr'
kh :

.....................
whlref.a w;aik
whlre ms<sn| iy;slh ^f i|yd .dia;=jla wh fkdl< hq;=h&

.......................................... mx
...... jk uu
whlre jk wjqre .. ld,hla ;siafia mqoa.,slj
ykk nj;a" Tyq$weh Y%S ,xld .uka ,sh,a,la ,eug iqiq wfhla nj;a iy;sl lr'
Tyq$weh iska we;s f;dr;=re i;H nj;a" iy;sl lrk w;r"
whlre ;u iqqmqre w;aik ud bmsg oS
iy;sl lr'

.. k oS ;enQ nj o

.....................
iy;sl lrkakdf.a w;aik

ks,h fyda ;k;=r

ks, uqdj

ie,lsh hq;=hs :
^1& whlrejka ms<sn| iy;sl lrkakjqka iska tfia l< yelafla whlre ms<sn|j fm!oa.,sl oekSula u; muKla nj ie<lsh hq;=h'
^2& by; i|yka iy;sl lsrSu l< yelafla Y%S ,xld mmd,k fiajfha$ wOHdmk mmd,k fiajfha$bxfkare fiajfha$.Kldld fiajfha$
ie,iq fiajfha ks,Odfhla" iqiql,;a ffjoHjrfhla fyda kS;s{jrfhla fyda iudodk ksYaphldrjrfhla" ;%sO yuqodf iy fmd,Sisfha
wld,;a ks,Odrfhla hk whg muKs'

tpz;zg;gfhuhpd; cWjpAiu
ehd; ,yq;if gpui[/ ,ul;ilg; gpu[hThpik ngw;Ws;Nsd;. ehd; ............. (ehl;bd; ngaiu vOjTk;) gpui[
MFk;.* ehd; xU ,yq;ifg; gpuirnad;W cWjp$Wfpd;Nwd;.* ehd; ,t;tpz;zg;gj;jpy; nfhLj;j tpguq;fs; ehd; mwpe;j tiuapYk; ek;Gfpd;w tiuapYk;
cz;ikahditnad;Wk; rhpahditnad;Wk; cWjp$WfpdN
; wd;. ,g;nghOJ ,izf;fg;gl;Ls;s..................... Mk; ,yf;f
flTr;rl
P ;L/ mtru fhyr; rhd;wpjo;/ milahsr; rhd;wpjioj; jtpu> ,jw;F Kd;G ehd; itj;jpUe;j rfy flTr;rl
P ;Lf;fSk; mtruf; fhyr; rhd;wpjo; /
milahsr; rhd;wpjo;fSk; ,yq;iff; flTr;rl
P ;L mjpfhhpfsplk; uj;Jr;nra;a xg;gilf;fg;gl;Ls;sd vd;Wk;> ,j;Jld; ,izf;fg;gl;bUg;gJ vdf;F
toq;fg;gl;lJ Kjy; NtW tpz;zg;gk; vd;dhy; rkh;g;gpf;fg;gltpy;iynad;Wk; ,j;jhy; rhd;W mspf;fpd;Nwd;.*
my;yJ ,jw;F Kd;dh; ehd; VjhtNjhh; flTr;rl
P ;L mtrufhyr; rhd;wpjo; my;yJ milahsr; rhd;wpjio itj;jpUf;fNth my;yJ tpz;zg;gpf;fNth
,y;iynad;W ,j;jhy; rhd;W mspf;fpd;Nwd;. ,izf;fg;gl;Ls;s Gifg;glk; vdJ ,aw;ifj; Njhw;wj;ij khWNtlkpy;yhkYk; kiwf;fhkYk; njspthff;
fhz;gpff
; pdw
; njd;Wk; mg;Gifg;glk; nrd;w %d;W khjq;fSf;Fs; vLf;fg;gl;lnjd;Wk; rhd;wspff
; pdN
; wd;. ,t;tpzz
; g;gj;Jld; ,izf;fg;gl;Ls;s Mtzq;fs;
cz;ikahditnad;Wk; rhpahditnad;Wk; khw;wq;fis> jpUj;jq;fis Nkhrbfisr; nra;J cz;ikia kiwf;ftpyi
; ynad;Wk; jphpGgLj;jtpyi
; ynad;Wk;
rhd;W mspf;fpd;Nwd;.
jpfjp :
* nghUj;jkw;wtw;iw fPwptpLf.

tpz;zg;gjhuhpd; ifnahg;gk;.
tpz;zg;gfhuh; gw;wpa rhd;wpjo; (,r; rhd;wpjo;fSf;F fl;lzk; mwtplg;glhJ)
............................................................................................................ ,y; trpf;Fk; ..................... vd;Dk; ngaUila
ehd; tpz;zg;gfhuuhfpa .......................................................................... I fle;j ................. tUl fhykhf Nehpy; njhpe;j
tifapy; tpz;zg;gfhuh; ,yq;ifg; gpuahzg; gj;jpuj;ijg; ngwj;jFe;jtnud;W ,j;jhy; rhd;wspf;fpd;Nwd;.
tpz;zg;gfhuh; vdJ Kd;dpiyapy; ............................................ vd;Dk; ,lj;jpy; 20...... Mk; Mz;L ............ Mk; khjk;
....... Mk; ehsd;W jdJ tof;fkhd ifnahg;gj;ij ,l;Ls;shh;.
gjtpepiy/ njhopy;rhu; gjtp :.
cj;jpNahf Kj;jpiu

................
mj;jhl;rpg;gLj;jpathpd; ifnahg;gk;

jaTnra;J ftdpff
; Tk; :
1. ,e;j mj;jhl;rpr; rhd;wpjiof; ifnahg;gkpLgth;fs; tpz;zg;gfhuiu Nehpy; njhpe;jpUe;jhy; khj;jpuNk mjpy; ifnahg;gkplyhk; vd;gijf; ftdpf;f
Ntz;Lk;.
2. Nkw;Fwpg;gplg;gl;l rhd;Wgfh;jy; ,yq;if murhq;f rptpy; epHthf cj;jpNahfj;jh;/ fy;tp/nghwpapay;/fzf;fhsH/rkhjhd ePjthd;/ jifik ngw;w
kUj;Jt cj;jpNahfj;jh;/ rl;lj;juzp/ jpl;lkply; Nrit cj;jpNahfj;jh;fs; MfpNahhpdhy; kl;Lk; nfhLf;fg;gl Ntz;Lk;.

DECLARATION OF THE APPLICANT

I declare that/ I am a citizen of Sri Lanka/ I hold Dual Citizenship of Sri Lanka/ I am a citizen of ...........
(write the name of the country).*
I certify that I have not previously held or applied for any Passport, Emergency Certificate or and Identity Certificate.*
I certify that all previous Passports, Emergency Certificates and Identity Certificates held by me have been surrendered to the Sri Lankan
Passport Authorities for cancellation, other than the Passport/Emergency Certificate/Identity Certificate No. ........
.................................................. which is now submitted and I have made no other application since the one attached was issued
to me.*
I certify that the documents attached to this application are true and correct and no alterations, modifications or falsifications were carried out to
them to hide or deflect true facts.
I certify that affixed photographs are depicting the natural status of myself without disguise or concealment and were taken within the last three
months.
I declare that the information furnished in this application is true and correct to the best of my knowledge and belief.

Date : ......................................

...............................................
Signature of the Applicant

* Please delete inapplicable words.

CERTIFICATE REGARDING THE APPLICANT (NO FEE IS CHARGEABLE FOR THIS CERTIFICATE)
I , ........................................................................................................................................................... of ............................................................
.................................................................................................................................................................... hereby certify that I have personally
known the Applicant ............................................................................................................................. for a period of .............................. years
and I can, and I, certify that the applicant as a suitable person.
To the best of my personal knowledge and belief, the information given by the applicant is true and the declaration made above by the applicant
is accurate. The applicant placed his/her usual signature before me on ........................................................................................................................
at ............................................................

Designation or Profession : ............................................................

Seal/Stamp/ Frank

...............................................
Signature of the Attestor

Please Note :
(1) The Persons signing this certificate of attestation should note that they can sign here only on the personal knowledge about the applicant.
(2) The above certification could be given only by a Sri Lanka Administrative Service/ Education Administrative Service/ Accountants Service
/ Planning Service / Commissioned Officer of Army, Navy, Airforce or Police/ Engineering Servic, Justice of the Peace, Qualified Medical
Practitioner or by an Attorney-at-Law.

wd.uk yd .uk fomd;fka;=j/ FbtuT> Fbafy;Tj; jpizf;fsk;

DEPARTMENT OF IMMIGRATION AND EMIGRATION

wd' ' 35 ^&

F.F. 35 (gp)

IM 35 (B)
ldhd,hSh m%fhdackh i|yd

mYtyf cgNahfj;jpw;F khj;jpuk;

PdhdrEm yd w;aika ldm;$epow;glKk; ifnahg;g ml;ilAk; /Photo and, Signature Card

For office use only

CA
fi.. 3.5 x 4.5 ^iq odrh rys;j& m%udKfha jK PdhdrEm folla my; oelafjk fldgqj, w,jkak' ialEka lrkq ,nk PdhdrEmh u;
lsisjla ,su fyda i,l=Kq ;eu fyda fkdl< hq;=h'
jaT nra;J 3.5 x 4.5 nr.kP. mstpyhd (nts;isf;fiu jtph;e;j) ,uz;L th;z epow; glq;fis fPNoAs;s ,lj;jpy; xl;lTk;. gjpg;gjw;fhd epow;glj;jpy;
vOjNth my;yJ vt;tpjkhd milahsNkh ,lf;$lhJ.

Please affix two colour photographs of size 3.5 cm x 4.5 cm (without white border) in the spaces below. Do not write or mark anything on the
photograph to be scanned.
jeo.;a '- ol=Kq mi w,jd we;s PdhdrEmh u; iy;sl lrkakd iska w;aika l< hq;=h'
Kf;fa
p khdJ .- tyJ gf;fj;jpy; xl;lg;gl;l epow;glj;ij mj;jhl;rpg;gLj;jy; Ntz;Lk;.
IMPORTANT .- THE PHOTOGRAPH AFFIXED AT THE RIGHT SIDE SHOULD BE CERTIFIED BY THE ATTESTOR.

PdhdrEmhla fuys
w,jkak.

PdhdrEmhla fuys
w,jkak.

epow;glj;ij ,q;Nf
xl;lTk;

epow;glj;ij ,q;Nf
xl;lTk;

AFFIX A
PHOTOGRAPH HERE

AFFIX A
PHOTOGRAPH HERE

uqdj

Kj;jpiu
my;yJ
ngaur;R

Stamp or
frank
ialEka lrkq ,nk PdhdrEmh

ii|d ne,Sf PdhdrEmh

PHOTOGRAPH TO BE SCANNED

VERIFICATION PHOTOGRAPH

rhpghh;f;Fk; Gifg;glk;

gjpg;gjw;fhd epow;glk;

my; oelafjk fldgq fol ;=< l bj, fkd.Efjk m Tf w;aik fjk fjku ;nkak'
fPNo cs;s ,uz;L $LfSf;Fs;Sk; jaT nra;J cq;fs; ifnahg;gj;ij ,lTk;. ifnahg;gk; $Lfspy; Kl;lf; $lhJ

Please place your signature inside both cages below. Signature should not touch the border.

f.a by; oelafjk

PdhdrEmh" fjia udre lsj,ska fyda ieZj,ska f;drj" whlref.a iajdNdl ;;a;ajh ms<sUq flfrk nj;a" by; i|yka w;aik
whlre iska ud bmsg ;nk ,o nj;a fuhska iy;sl lr' ta nj ikd: lsu i|yd by; oelafjk ii|d ne,Sf PdhdrEmh u; uf.a
w;aik iy i,l=K$uqdj ;nd we;s nj o iy;sl lr'
NkNyAs;s .................................................................... ,d; epow;glk; tpz;zg;gfhuhpd; ,aw;ifj;
Njhw;wj;ij khWNtlk; ,y;yhkYk; kiwf;fhkYk; njspthff; fhz;gpf;fg;gLfpd;wnjd;Wk; tpz;zg;gfhuh; vdJ Kd;dpiyapYk; ifnahg;gk; ,l;Ls;s hh;
vd;Wk; ehd; rhd;wspf;fpd;Nwd;. ,e;j cz;ikia cWjpg;gLj;Jtjw;fhf rhpghHf;Fk; Gifg;glj;jpd; NkNy ifnahg;gj;ijapl;L vdJ ngaur;R Kj; jpiuia
epow;glj;jpw;Ff; FWf;Nf ,l;Ls;Nsd;.

I certify that the above photograph of ............... is

depicting the natural status of the applicant without disguise or concealment and that the above signature is placed by the applicant before me. I have
signed over the verification photograph and placed my frank/stamp across the same photograph in confirming this fact.
kh/jpfjp /Date : .

................................................................
iy;sl lrkakdf.a w;aik
cWjpg;gLj;Jgthpd; ifnahg;gk;

Signature of the Attestor.

FOR USE OFFICE ONLY

APPROVED BY

ENTERED BY

SCANNED BY

PRINTED BY

FEE COLLECTED BY

AMOUNT

RECEIPT No.

PASSPORT TYPE

QA BY

Wmfoia
jeo.;a(
wi;H f;dr;=re iemhSu" l+g f,i ;ekQ fyda jHdc f,aLk bosrsm;a lsu" oekg we;s .uka ,sh,a, inkaOfhka ia;r fy<sor fkdlsrSu yd j,x.= .uka ,sh,a,la <
;ndf.k ;j;a .uka ,sh,a,la ,nd.ekSug W;aidy lsrSu ovqqj ,eh yels jrols' wimQKj fyda jer iys;j imQK l< fyda jHdc f,aLk iu bosrsm;a lrk
whm;a m%;sfam lrkq ,ef' whlre fm!oa.,slj meK whm; Ndrh hq;=h'
^w&

whm;%h imQK lsu i|yd Wmfoia(

^1& wjikajrg ,nd.;a .uka ,sh,af,a ^.uka n,m;%h$yosis iy;slh$ykd.ekSf iy;slh& wxlh fuys ,shkak' furg th ke;sjQfha
k fmd,Sishg lrk ,o meKs,af,a iy;sl msgm;la fyda foaYhl ke;sjQfha k furgg meKsu i|yd Nd;d lrk ,o
;djld,sl .uka ,sh,a, bm;a l<hq;=h' m<uqjrg whlrkakkag fuh wod< fkdf'
^2& mqoa.,hska ,shdmx lsf flduidrsia ksl=;a l< yekqmf;a wxlh ,shkak' jhi wjqre 16 g je iEu ;eke;af;lau tu
yekqm; bosrsm;a l< hq;=h'
^3& Tf jdi.u fyda fm<m;a kduh f,i Nd;d lrk ku tl fldgqjl tl wl=r ne.ska ,shkak' k w;r tla fldgqjl bvla ysiaj
;nkak'
^4& wxl 03 hgf;a fldgqj, ,shQ Tf jdi.u$fm<m;a ku yer Tf imQK kfuys b;sh fuu fldgqj, ,shkak'
^5& whldhla wehf.a iajd mqreIhdf.a jdi.u md lr .uka ,sh,a, ,nd.kafka k muKla jdyhg fmr ku fuys ,shkak'
^6& Tf iar ,smskh fuys ,shkak'
^7& Wmka kh
^8& Wmamekak iy;slfha wxlh yd ia;%slalh
^9& Wmka ia:dkh" Wmamekak iy;slfha oelafjk m i|yka lrkak'
^10& wod< fldgqj ;=< i,l=Kq lrkak'
^11& Tf Wi fika gj,ska i|yka lrkak' ^ w 1la fika g 30'4 ls'
w.Z,a 1la fika g 2'54 ls'&
^12& wod< fldgqj ;=< i,l=Kq lrkak'
^13& Tf /lshdj$jD;a;sh$;rd;sru fyda ;k;=r fuys ,shkak' jpk w;r tla fldgqjl bvla ysiaj ;nkak'
^14& wd'' 35 iS wdlD;s m;%h tys i|yka Wmfoia m imQKfldg <uhskaf.a jK PdhdrEm iu.Z brsm;a lrkak'
^15& Tn foaY rgl mqrjeisNdjh fyda Y%S ,xldf oa;aj mqrjeisNdjh fyda ,ndf.k we;ak wod< fldgqf i,l=Kq lrkak' Y%S
,xld oa;aj mqrjeisNdjh ,nd we;ak iy;slh brsm;a lrkak'
^16& wod< fldgqj ;=< i,l=Kq lrkak'
^17& wod< fldgqj ;=< i,l=Kq lrkak'
^18& wod< fldgqj ;=< i,l=Kq lrkak'
^19& .uka n,m;% ^i& ishu rgj,a i|ydo" ^ii& ueofmr. we;= ksYa; rgj,a - bkahdj" fkamd,h" nx.,dfoaYh" mlsia:dkh"
ud,jhska iuQydKavqj" brdkh" brdlh" f,nkkh" ishdj" fcdaodkh" ijq wrdh" tlai;a wrd t rdcHh" udkh" l=fgh"
lgd" nyfka" iy fhaukh hk rgj,a i|yd o" (iii) yis iy;sl - bkahdj iy fkamd,h i|yd o (iv) ykd .ekSf iy;sl
ishu rgj,g fyda ksYa; rglg j,x.=fldg ksl=;a flf' wod< fldgqj ;=< i,l=Kq lrkak'
^20& wdo< fldgqf i,l=Kq lrkak' tla k fiajd whm;% fm'j' 9'00 isg m' j' 1'00 olajd fld<U 04" m%Odk ldhd,fha
muKla Ndr.kq ,ef' idudkH fiajd whm;% fm'j' 9'00 isg m'j' 3'00 olajd m%Odk ldhd,hg fyda mosx m%foaYfha m%dfoaYsh
f,al ldhd,hg fyda Ndrh yelsh' foaY rgj, mxlrejka wdikak Y%S ,xld foaY ; uKav, u.Zska whl< hq;=h'

^wd& PdhdrEm (
udi 3la we;=,; ,nd.;a fika g 3'5 x 4'5 m%udKfha fyd| ;;a;ajfha jK PdhdrEm 3la" bka folla PdhdrEm yd w;aika ldmf;a
^wd'' 35 & w,jd ii|d ne,Sf PdhdrEmh u; whlre ms<sn|j iy;slh fok ;eke;a;d iska iy;sllr ;sh hq;=h' ;=kajk
PdhdrEmh whm;%fha uq,a msgqf fjkal< fldgqj ;=< w,jkak'
^we& brsm;a l< hq;= f,aLk (
whm; iu.Z my; i|yka ,sh,s tajdfha Pdhd msgm;a iu. bosrsm;a l< hq;=h' wjYH lghq;= lsfuka miq uq,a msgm;a wdmiq ,nd fokq
we;'
(i) Wmamekak iy;slh" (ii) mqoa., yekqm;" (iii) ,shdmx lsfuka mqrjeisNdjh ,enQfjla k mqrjeis iy;slh" (iv) fjk;a rgl
mqrejeisNdjh ,nd ;sf k Y%S ,xld oa;aj mqrjeis iy;slh" (v) iajd mqreIhdf.a jdi.u mds lrkafka k jdy iy;slh"
(vi) l,ska ,nd.;a .uka ,sh,a,la we;ak th iy tys PdhdrEmh yd o;a; igyka we;=<;a msgj
q , Pdhd msgm;a" (vii) jD;a;h
s $;k;=r$ks,h
ikd: lrk ,smsf,aLk" (viii) orejkaf.a k we;=<;a lrkafka k wd'' 35 iS wdlD;sfha i|yka ,sh,s" (ix) wjq' 16g wvq orejka i|yd
.uka n,m;a ,nd .ekSf my; i|yka ,shlsh,s bm;a l< hq;=h(^w& foumshkaf.a leue;a; m%ldYs; ,smsh"
^wd& foumshkaf.a .uka n,m;%j, msgm;a ^o;a; msgqj iy <uhska ia;r msgqj&
^we& foumshka .uka n,m;% ,ndf.k fkdue;s k th ;yjqre lsu i|yd jqre m%ldYh'
^wE& .dia;= (
ishu rgj,a i|yd
ueofmr. we;= ksYa; rgj,a

i|yd

idudkH fiajh re' 2"500 hs

tla

idudkH fiajh re' 500 hs

tla k fiajh - re' 2"000 hs

bkahdj iy fkamd,h i|yd yosis iy;slh

re' 500 hs

ishu rgj,a i|yd ykd .ekSf iy;slh

re' 2"500 hs

k fiajh - re' 5"000 hs

whlre wjidk jrg ,nd .;a .uka ,sh,a, ke;sjQfha k ( re' 10"000 l w;sfl .dia;=jls' ^jir 10la we;=<;&
.dia;= ixfYdaOkhkag hgf;a f' .dia;=j fjkqfjka ,m;la ksl=;a flf' miq lf,l uiS i|yd ,m;a iq/lsj ;nd .kak'

mwpTWj;jy;fs;
jtwhd jfty;fisf; nfhLg;gJk;> Nkhrb my;yJ Nghypahd gj;jpuq;fisr; rkh;g;gpg;gJk;> jw;nghOJ itj;jpUf;fk; gpuahzg;gj;jpuk; gw;wpa tpguq;fisf;
nfhLf;fj; jtWjYk;> nry;Ygbahd Xh; gpuahzg; gj;jpuj;ij itj;jpUf;Fk; NghJ gphpnjhU gpuahzg; gj;jpuk; ngWtjw;F vj;jdpj;jYk; jz;lidf;Fhpa
Fw; w q; f shFk; . G+h; j ; j pahfhj my; y J jtwhf epug; g g; g l; l tpz; z g; g q; f s; my; y J Nghypahd gj; j puq; f Sld; rkh; g ; g pf; f g; g Lk; tpz; z g; g q; f s;
Vw;Wf;nfhs;sg;glkhl;lhJ. tpz;zg;gk; tpz;zg;gjhhpahy; Neubahff; nfhLf;fg;gl Ntz;Lk;.
(m)

tpz;zg;gj;ij epug;Gtjw;Fhpa mwpTWj;jy;fs;

1. ePq;fs; itj;jpUf;Fk; filrpahfg; ngw;w gpuahzg; gj;jpuj;jpd; (flTr; rPl;L/ mtrufhyr; rhd;wpjo;/ milahsr;rhd;wpjo;) ,yf;fj;ij vOjTk;.
mJ fhzhky; Nghdhy; my;yJ fsthlg;gl;bUe;jhy; nghyp]; Kiwg;ghL rkh;gg; pff
; g;gl Ntz;Lk;. Kjd;Kjyhf tpzz
; g;gpfF
; k; tpzz
; g;gjhuh;fSf;F
,J nghUe;jhJ.
2. Ml;gjpTj; jpizf;fsj;jpd; Mizahsuhy; toq;fg;gl;l milahs ml;ilapd; ,yf;fj;ij vOjTk;. 16 tajpwF
; Nkw;gl;l xt;nthU tpzz
; g;gjhhpAk;
,t;tilahs ml;iliar; rkh;g;gpf;f Ntz;Lk;.
3. xt;nthU $l;bDs;Sk; xt;nthU vOj;ij vOjp cq;fs; Kjw; ngaiu vOJf. ngah;fSf;fpilapy; $l;il ntw;whf tplTk;.
4. NkNy (3) ,y; Fwpg;gplg;gl;l cq;fs; Kjw;ngah; jtph;e;j cq;fs; kw;iwa ngaiu vOJf.
5. Xh; ngz; fztdpd; Kjw;ngaiug; ghtpj;J Xh; gpuahzg; gj;jpuj;ijg; ngw tpUk;gpdhy; khj;jpuk; fd;dpg; ngaiuf; Fwpg;gplTk;.
6. cq;fs; epue;ju tpyhrj;ij vOjTk;.
7. gpwe;j jpfjpia vOjTk;.
8. gpwg;Gr; rhd;wpjopd; ,yf;fj;ijAk; khtl;lj;ijAk;
9. gpwg;Gr; rhd;wpjopd; gpwe;j ,lj;ijAk; vOJf.
10. nghUj;jkhd $l;ilf; FwpaplTk;.
11. cq;fs; cauj;ij nrd;hp kPl;lh;fspy; vOjTk;. (1 mb 30.4 nrd;hp kPl;lh;fs;. 1 mq;Fyk; 2.54 nrd;hp kPl;lh;fs;)
12. nghUj;jkhd $l;il epug;gTk;.
13. cq;fs; njhopy;/ njhopy;rhh; gjtp/ juk; my;yJ gjtp/ nrhw;fSf;fpilapy; Xh; $l;il ntw;whf tplTk;.
14. Kiwahf epug;gg;gl;l F. F. 35 rP mjpYs;s mwpTWj;jy;fSf;fika th;z epow;glq;fSld; rkh;g;gpf;fg;gl Ntz;Lk;.
15. nghUj;jkhd $l;ilf; Fwpg;gplTk;> ePq;fs; ,yq;ifapy; ,ul;ilg; gpurhThpik my;yJ ntspehl;Lg; gpurhThpik ngw;wpUe;jhy;. ePq;fs; ,yq;if
,ul;ilg; gpurhThpik ngw;wpUe;jhy; rhd;wpjio rkh;g;gpf;fTk;.
16. nghUj;jkhd $l;il epug;gTk;.
17. nghUj;jkhd $l;il epug;gTk;.
18. nghUj;jkhd $l;il epug;gTk;.
19. nghUj;jkhd $l;il epug;gTk;. (1) rfy ehLfSf;fhd flTr;rl
P ;L (2) kj;jpa fpof;Fk; Fwpg;gpl;l ehLfSk; ,e;jpah> Neghsk;> gq;fshNj\;>
ghfp];jhd;> khiyj;jT
P f; FbauR> <uhd;> <uhf;> nygdhd;> rphpah> N[hh;jhd;> rTjpmNugpah> If;fpa muG ehLfs;> Xkhd;> Fitj;> fl;lhh;> gh`;nuapd;>
N[h;kdp> (3) mtrufhyr; rhd;wpjo; ,e;jpah> Neghsk; (4) milahsr; rhd;wpjo; rfy ehLfSk; my;yJ Fwpg;gpl;l ehLfSk;.
20. Njitg;gl;l Nritapd; tpjj;ij Fwpg;gplTk;. nfhOk;G 04 ,y; khj;jpuk; K. g. 9.00 kzpKjy; gp. g. 1.00 kzptiu cs;s xNu ehs; Nrit K. g. 9.00
kzp Kjy; gp. g. 3.00 kzptiuAk; jiyik mYtyfj;jpYk; gpuNjr nrayfq;fspYk; cs;s toikahd Nrit ntspehLfspy; trpfF
; k; tpzz
; g;gjhhpfs;
mz;ikapYs;s ,yq;ifj; J}jufq;fs; %ykhf tpz;zg;gpf;f Ntz;Lk;.

(M) epow;glq;fs;
3.5 nr. kP. 4.5 nr. kP. mstpyhd 03 khjq;fSf;Fs; ngwg;gl;l ey;y jukhd 03 epow;glq;fs; epow;gl ifnahg;g ml;il F. F. 35gp apy; xl;lg;gl
Ntz;Lk;. rhpghh;f;Fk; epow;glk; tpz;zg;gj;ij cWjpg;gLj;Jgtuhy; cWjpg;gLj;jg;gl Ntz;Lk;. %d;whtJ epow;glk; 01 Mk; gf;fj;jpy; xl;lg;gl
Ntz;Lk;.
(,) rkh;g;gpf;fg;gl Ntz;ba gj;jpuq;fs;
gpdt
; Uk; gj;jpuq;fs; epow;glg; gpujpfSld; nghUj;jkhdtplj;J tpzz
; g;gj;Jld; rkh;gg; pff
; g;gl Ntz;Lk;. %yg;gpujpfs; ghh;itaplg;gl;l gpdG
; kPsspff
; g;gLk;.
(1) gpwg;Gr;rhd;wpjo; (2) nrhe;j milahs ml;il (3) gjpTg; gpui[ahdhy; gpurhThpikr; rhd;wpjo; (4) ,ul;ilg; gpurhThpikr; rhd;wpjo; (5) tpthfr;
rhd;wpjo; fztdpd; Kjw;ngaiug; ghtpg;gjhdhy; (6) jw;NghJ itj;jpUf;Fk; gpuahzg; gj;jpuKk; epow;glq;fSilaJk; juTg;gf;fq;fSilaJk;
epow;glg; gpujpfSlDk; (7) njhopy;rhh; gjtp/ gjtp/ gjtp epiy Mfpatw;iw ep&gpf;ff;$ba gj;jpuq;fs; (8) gps;isfs; Nrh;fg;gltpUe;jhy; F.F. 35rP
apd; gb rk;ge;jg;gl;l gj;jpuq;fs; (9) taJ 16 f;F cl;gl;lth;fs; flTr;rl
P ;ilg; ngw Ntz;Lkhapd; gpd;tUk; Mtzq;fis rkh;g;gpf;f Ntz;Lk;:(m) ghJfhtyHfspd; tpUg;gf; fbjk;
(M) ghJfhtyh;fspd; flTr;rl
P ;bd; Gifg;glg; gpujp (juTg; gf;fKk; gps;isfSila gf;fKk;)
(,) ghJfhtyh;fSf;F flTr;rl
P ;L ,y;yhj gl;rj;jpy; rj;jpaf; fljhrp rkh;g;gpj;jy; Ntz;Lk;.
flTr;rl
P ;L rfy ehLfs;

&gh 2>500.00 (toikahd Nrit)

&gh 5>000.00 (xNuehs;)

&gh 2>000.00 (xNuehs;)

flTr;rl
P ;L Fwpg;gpl;l ehLfs; (kj;jpa fpof;F cl;gl)

&gh 500.00 (toikahd Nrit)

mtrufhyr; rhd;wpjo; ,e;jpahTk; NeghsKk;

&gh 500.00

milahsr; rhd;wpjo; rfy ehLfs;

&gh 2>500.00

cq;fs; flTr;rl
P ;L njhiye;jpUe;jhy; Nkyjpf fl;lzkhf &gh 10>000.00 mwtplg;gLk;. (10 tUlq;fSf;Fs;)
fl;lzq;fs; khw;wj;jpw;Fhpad. gw;Wr;rPl;L toq;fg;gLk;. vjph;fhy njhlHGfSf;F mjid itj;jpUf;fTk;.

N.B. :
It is a punishable offence to furnish false information, to forward fraudulent or forged documents, to abstain from declaring particulars
regarding the Travel Document presently held, and to attempt to obtain another Travel Document while being in possession of a valid
Travel Document. Incomplete or erroneously filled applications or applications forwarded with forged documents will be rejected. The
applicant should hand over the application in person .
INSTRUCTIONS
(A)

Instructions for completing the application:

(1) Enter the number of latest Travel Document (Passport/Emergency Certificate/Identity Certificate) held by you. A police report
should be produced if it is lost or stolen. This is not applicable for the applicants applying for the first time.
(2) Enter the number of your Identity Card issued by the Commissioner for Registration of Persons. All applicants above 16 years of
age should produce the Identity Card.
(3) Write your surname using one cage for each letter. Leave a blank cage between names.
(4) Write the rest of your name other than your surname stated in (3) above.
(5) Write the maiden name, only, if a female wishes to obtain a husbands surname.
(6) Write your permanent address.
(7) Write date of birth.
(8) Number of the birth certificate and district.
(9) Place of birth as per birth certificate.
(10) Tick relevant cages.
(11) Enter your height in centimeters. ( 1 foot = 30.4 centimeters. 1 inch = 2.54 centimeters.)
(12) Tick relevant cages.
(13) Write your occupation/profession/rank or post. Leave a blank cage between words.
(14) Duly completed form I.M. 35 C according to Instructions therein should be forwarded with colour photographs.
(15) Tick the relevant cage, if you have obtained Sri Lankan dual citizenship or citizenship of a foreign country. Forward the certificate, if you have obtained Sri Lankan dual citizenship.
(16) Tick relevant cages.
(17) Tick relevant cages.
(18) Tick relevant cages.
(19) Tick the relevant cage. (i) Passport for All Countries, (ii) Middle-East and specified countries India, Nepal, Bangladesh, Pakistan, Republic of Maldives, Iran, Iraq, Lebanon, Syria, Jordan, Saudi Arabia, United Arab Emirates, Oman, Kuwait, Qatar,
Baharain and Yemen, (iii) Emergency Certificate - India and Nepal, (iv) Identity Certificate - all countries or for specified
countries.
(20) Tick the service type required, same day service available from 9.00 a.m. to 1.00 p.m. only at Head Office, Colombo 04. Normal
service available from 9.00 a.m. to 3.00 p.m. at Head Office and Divisional Secretariats. Applicants living overseas should apply
through the nearest Sri Lankan Mission.

(B) Photographs :
03 colour photographs, size 3.5 c.m. x 4.5 c.m. taken within 03 months and in good quality should be pasted on the photo/signature
card I.M. 35B. Verification photograph should be certified by the person who attests the application. The third photograph should be
pasted on page 01.
(C) Documents to be forwarded :
Following documents together with photo copies, if applicable, should be forwarded with the application. Originals will be returned
after perusal:(i) Birth Certificate (ii) Personal Identity Card (iii) If Citizen by registration the Citizenship Certificate (iv) Dual Citizenship Certificate
(v) Marriage Certificate, if using husbands surname (vi) Travel Document presently held with photocopies of photographs and Data
page of same (vii) Documents in proof of profession/post/designation, (viii) If children are to be included relevant documents as per
I.M. 35 C. (ix) If this application is submitted for a child whose age is under 16, the following documents should be produced:(a) The letter of consent from the parents
(b) Photocopy of parents Passports (Data page and Children Page)
(c) An affidavit should be produced if the parents do not Posses the Passports.
(D)

Fees :
Passport - All Countries

Rs. 2,500.00 (Normal Service)

Rs. 5,000.00 (Same Day)

Passport - Specified Countries including middle east

Rs. 500.00 (Normal Service)

Rs. 2,000.00 (Same Day)

Emergency Certificate - India/Nepal

Rs. 500.00

Identity Certificate All Countries

Rs. 2,500.00

An extra charge of Rs. 10,000.00 will be levied, if your Travel Document is lost. (within ten years)
Fees are subject to revision. A receipt will be issued. Please retain same for future reference.

ldhd,Sh m%fhdackh i|yd $ mYty cgNahfj;jpw;F khj;jpuk; /For Office use only

POST PRODUCTION REPORT

Photographs, personal ID card, birth certificate checked and tallies with the details on Passport.

..............................................................

Date : ........................................

Signature of Checking Officer

ISSUING INFORMATION
(1)

(2)

Dispatched by registered post by

..............................................................

Date : ........................................

..............................................................

Handed Over to applicant by

Passport Received by

..............................................................

Date : ........................................

..............................................................

fuu whm; www.documents.gov.lk fj wvfhka ,nd .; yel'

H 21690-1"50"000 ^2004$08& YS% ,xld rcfha uqK fomd;fka;=j