Portuguese Passport Client Details
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Personal Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Your Existing Process No
If Applicable
Are you already our client
*
Yes
No
Details of Registrant
Full Name of Registrant
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Is the place of birth of Registrant in Goa, Daman, Diu, Dadra or Nagar Haveli?
*
Yes
No
Are you married or living in a civil partnership with a Portuguese national?
*
Yes, I am married to a Portuguese national
Yes, I am living in a civil partnership with a Portuguese National
No, I am not married or living in a partnership with Portuguese national
Since when are you married or in a civil partnership?
-
Month
-
Day
Year
Place of Marriage (Registrant)
Is your marriage registered in Portugal?
*
Yes
No
Not applicable
Do you have Portuguese children?
*
Yes
No
Parent's Details
Father's Full Name
*
First Name
Last Name
Father's Date of Birth
*
-
Month
-
Day
Year
Father's Place of Birth
*
Goa, Daman, Diu, Dadra or Nagar Haveli
Maharashtra
Other
Is your Father alive?
*
Yes
No
Mother's Full Name
*
First Name
Last Name
Mother's Date of Birth
*
-
Month
-
Day
Year
Mother's Place of Birth
*
Goa, Daman, Diu, Dadra or Nagar Haveli
Maharashtra
Other
Is your Mother alive?
*
Yes
No
Date of Marriage (For Parents)
*
-
Month
-
Day
Year
Place of Marriage for Parents
*
Goa, Daman, Diu, Dadra or Nagar Haveli
Maharashtra
Other
Is any of your parents registered in Portugal?
*
Yes
No
I don't know
Details of Grandparents
When was your Paternal Grandfather born?
*
Before December 20, 1961
Between December 20, 1961 and September 9, 1975
After September 10, 1974
Was your Paternal Grandfather born in Goa, Daman, Diu, Dadra or Nagar Haveli?*
*
Yes
No
When was your Paternal Grandmother born?
*
Before December 20, 1961
Between December 20, 1961 and September 9, 1975
After September 10, 1974
Was your Paternal Grandmother born in Goa, Daman, Diu, Dadra or Nagar Haveli?*
*
Yes
No
When was your Maternal Grandfather born?
*
Before December 20, 1961
Between December 20, 1961 and September 9, 1975
After September 10, 1974
Was your Maternal Grandfather born in Goa, Daman, Diu, Dadra or Nagar Haveli?*
*
Yes
No
When was your Maternal Grandmother born?
*
Before December 20, 1961
Between December 20, 1961 and September 9, 1975
After September 10, 1974
Was your Maternal Grandmother born in Goa, Daman, Diu, Dadra or Nagar Haveli?*
*
Yes
No
Other Personal Details
Do you reside in Portugal?
*
Yes
No
Since when do you reside in Portugal?
-
Month
-
Day
Year
Date
Documento Para Viagem Available?
*
Please Select
Yes
No
Residency Certificate from 1974-1975 Available?
*
Please Select
Yes
No
Is applicants Passport Available
*
Please Select
Yes
No
Is applicants Aadhar Card Available
*
Please Select
Yes
No
Brief description of Case
Submit
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