This document is an application form for altering or correcting information in a valid Bangladeshi passport. The form must be filled out in capital English letters and relevant documents must be attached to support the application. It requests information such as the applicant's name, passport details, required correction, and payment details. Signatures of the applicant and official are needed, as well as enclosures to support the requested change.

1. MYcÖRvZš¿x evsjv‡`k miKvi
ewnivMgb I cvm‡cvU© Awa`ßi
Z_¨ cwieZ©b/ms‡kvab Av‡e`b dig
Information Alteration/Correction Application Form
G digwU †KejgvÎ †gqv` DËx©Y nqwb, Giƒc cvm‡cv‡U© cÖ`wk©Z Z_¨ cwieZ©b/gy`ªYRwbZ fzj ms‡kvab
msµv‡š— e¨eüZ n‡e|
This form will be used only to change shown information/rectify printing errors of the valid passport.
wb‡`©kbv t digwU Bs‡iwR‡Z (CAPITAL LETTERS) c~iY Kiæb Ges AbyMÖnc~e©K Avcbvi
Av‡e`‡bi mg_©‡b Dchy³ cÖgvYvw` mshy³ Kiæb|
Instruction : Please fill up the form, in ENGLISH (CAPITAL LETTERS) and attach relevant papers in favour of your
application.
AvÂwjK cvm‡cvU© Awdm/wgk‡bi bvg Name of Regional Passport cvm‡cvU© weZi‡Yi cÖK„wZ
Office/Mission Type of delivery
mvaviY Riæix
Regular Express
Av‡e`bKvixi bvg (evsjvq) wd cÖ`vb msµvšÍ Z_¨
Name of Applicant (In Bangla) Payment of Fees
Av‡e`bKvixi bvg (Bs‡iwR‡Z)
Name of Applicant (in English) wdÕi cwigvY ($/US$)
Amount of Fee ($/US$)
M„nxZ cvm‡cv‡U©i Z_¨
Received Passport’s Details e¨vsK/wgk‡bi bvg
Bank/Mission
cvm‡cvU© b¤^i Passport No. Bmy¨i ¯’vb I ZvwiL kvLv
Place & Date of Issue Branch
iwk` bs
‡gqv` DËx‡Y©i ZvwiL Date of Expiry Receipt No.
ZvwiL
PvwnZ ms‡kvab Required Correction Date
cvm‡cv‡U© eZ©gv‡b cÖ`wk©Z Z_¨ cwiewZ©Z/ms‡kvwaZ Z_¨
Information presently shown in the passport Changed/Corrected nformation
- 1 -Iftee

2. ZvwiL
Date
Av‡e`bKvixi/Awffve‡Ki (Av‡e`bKvix cÖvßeq¯‹
n‡j) ¯^v¶i
Applicant’s/Guardian’s (if the applicant is a minor) Signature
- 2 -Iftee

3. mshyw³mg~n Enclosures
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.
Awd‡mi e¨env‡ii Rb¨ For Official Use
1. Z_¨ msMÖnKvix (Acv‡iUi) Gi AvB ¯^v¶i
bvg wW
2. Av‡e`b MÖnYKvix Awdmv‡ii AvB ¯^v¶i
bvg wW
3. cvm‡cvU© ¯^v¶i
AvB
Bmy¨/Aby‡gv`bKvix Kg©KZ©vi
wW
bvg
- 3 -Iftee

4. mshyw³mg~n Enclosures
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.
Awd‡mi e¨env‡ii Rb¨ For Official Use
1. Z_¨ msMÖnKvix (Acv‡iUi) Gi AvB ¯^v¶i
bvg wW
2. Av‡e`b MÖnYKvix Awdmv‡ii AvB ¯^v¶i
bvg wW
3. cvm‡cvU© ¯^v¶i
AvB
Bmy¨/Aby‡gv`bKvix Kg©KZ©vi
wW
bvg
- 3 -Iftee

5. mshyw³mg~n Enclosures
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.
Awd‡mi e¨env‡ii Rb¨ For Official Use
1. Z_¨ msMÖnKvix (Acv‡iUi) Gi AvB ¯^v¶i
bvg wW
2. Av‡e`b MÖnYKvix Awdmv‡ii AvB ¯^v¶i
bvg wW
3. cvm‡cvU© ¯^v¶i
AvB
Bmy¨/Aby‡gv`bKvix Kg©KZ©vi
wW
bvg
- 3 -Iftee

6. mshyw³mg~n Enclosures
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.
Awd‡mi e¨env‡ii Rb¨ For Official Use
1. Z_¨ msMÖnKvix (Acv‡iUi) Gi AvB ¯^v¶i
bvg wW
2. Av‡e`b MÖnYKvix Awdmv‡ii AvB ¯^v¶i
bvg wW
3. cvm‡cvU© ¯^v¶i
AvB
Bmy¨/Aby‡gv`bKvix Kg©KZ©vi
wW
bvg
- 3 -Iftee