Generated at: 2025-04-15 12:55:43
HAJ COMMITTEE OF INDIA
ONLINE HAJ APPLICATION FORM FOR HAJ – 2025 (C.E.) 1446 (Hijri)
240829203629975
1 .Category General Cover No. TGF-769-2-0
2. No. of Persons 2 No. of Infants 0
3. Name of Cover Head MOHAMMED ABDUL WAHEED Embarkation Preference 1 / 2 :
HYDERABAD / HYDERABAD
4. Applicant’s Details (As per International Passport)
Passport Number S1087635 Place of Issue HYDERABAD Date of Issue 28-05-2018
Date of Expiry 27-05-2028 Date of Birth 03-03-1965 Place of Birth NIZAMABAD
Surname Given Name MOHAMMED ABDUL WAHEED Father’s Name MOHAMMED ISMAIL
Gender Male Mother’s Name WAHEEDA BEGUM Spouse’s Name PARVEEN SUTANA
Marital Status MARRIED Blood Group O+ Qualification MATRICULATION / SSC
Occupation BUSINESS Aadhaar No. 4525-2980***** PAN No.
Companion Name Companion Relation NA
5. Health Details
Detail of Co-Morbidity Not Applicable Pregnancy Status NA
6. Present Residential Address
Address 8-2-162 LINEGALLY Pincode 503001
State Telangana District Nizamabad
Mobile Number 7569999714 WhatsApp No / Mobile No.2 7093748610 Email Id
[email protected]7. Details of Nominee of Applicant
Name MOHAMMED WASEEM Mobile Number : 7013050780
Father’s /Husband’s Name MOHAMMED ABDUL WAHEED
Relationship SON
Address 8-2-162 LINEGALLY Pincode 503001
Signature / Thumb impression of
State Telangana District Nizamabad
Nominee
8. Name of Mehram with Relation (applicable for female pilgrims only)
Name NA Relationship: NA
Signature / Thumb impression of
Passport No. NA
Mehram
9. Bank Account Details
Name of Account Holder MOHAMMED ABDUL WAHED Bank Name SBI
Account No. 52085239589 IFSC Code SBIN0020108
10. Are you a permissible Repeater Mehram? NO
11. Do you want to perform ADAHI (Qurbani)? NO
12. Opting JHOFA Meeqat (Only for Shia Pilgrims)? NO
13. Are you NRI? NO
14. Are you a person with benchmark disability/disabilities, who cannot travel alone as certified by medical authorities? NO
Indicate the nature of your disability
Companion Name
Companion Relation
• I hereby undertake to abide by all the guidelines, including health protocol, age and travel restrictions, etc. issued by the Kingdom of Saudi Arabia and the Government of India/Haj Committee of India in view
of CoVID-19 pandemic. I agree to travel to the Embarkation Point allotted to me and am ready to pay all the charges on all accounts. I am also willing to go through the RT-PCR test and quarantine period as
specified in the protocol and guidelines
• I am aware of the tentative cost of Haj 2025, which may vary due to operational or functional reasons.
• I certify that the information furnished above is true and correct.
Signature / Thumb impression of the Applicant
FOR OFFICE USE ONLY
Online HAF Checked by Verified by Executive Officer, State / UT Haj Committee
All entries in the above HAF have been checked and found to be in order. Certified that the applicant is eligible to register for Haj-2025 (CE). 1446 (Hijri)
SOLEMN DECLARATION AND UNDERTAKING
For General Category
I, Mr./Mrs./Miss MOHAMMED ABDUL WAHEED S/o./W/o./D/o. MOHAMMED ISMAIL , an Indian citizen, do hereby solemnly affirm and declare as
under:
1. I am aware that, as per Government of India policy, a person can perform Haj only "Once in a Lifetime" through Haj Committee of India (HCol).
2. I have never performed Haj through HCol in the past, and hence I am eligible to apply for Haj - 2025 (Hijri - 1446). I am aware that repeaters are not
eligible for Haj - 2025 (Hijri - 1446) and if it is detected at any stage that I have already performed Haj through HCoI, my seat shall be cancelled and the
entire amount deposited by me shall be forfeited.
3. I have read and understood thoroughly the Guidelines for Haj - 2025 (Hijri - 1446), particularly with reference to eligibility, cost, payments and
confirmation, cancellation, refunds, embarkation points, vaccination and health requirements before flight, baggage, flight, and accommodation in the
Kingdom of Saudi Arabia, and I undertake to abide by the same.
4. I hereby authorize HCol to send SMS to my mobile phone number, even if I am on the DND registry.
5. The particulars given by me in HAF, Solemn Declaration and Undertaking are true and correct to the best of my knowledge. I do hereby affirm and
declare that in the event I have suppressed material information or given a false / incorrect declaration / undertaking, HCoI shall forfeit the amount
deposited by me and I shall be liable for prosecution.
6. I am aware that HCol reserves the right to change the Embarkation Point opted by me. In such a case, I shall abide by the decision of HCol and shall
not show any resentment, whatsoever, against the decision of HCoI.
7. I am ready to pay Visa Fees, as levied by the KSA Haj Authorities for endorsement of my Haj Visa.
8. I/We understand that the HCoI works without any profit motive and does not attract the provisions of the Consumer Protection Act, 2019.
9. I/we understand that the Courts of Greater Mumbai only shall have jurisdiction in all matters of dispute. Further, the Supreme Court of India, in its
April 16, 2013 Judgement, barred all Courts and Authorities from interfering with the Haj Process.
10. I/We understand that my/our candidature shall be cancelled if I am/we are found carrying khas-khas, viagra-tablets, sexual oil and creams, synthetic
capore, cystone, khammera, gutkha, khaini, gul, peppermint, or narcotics in any form. Besides, I/we will be penalized for carrying banned items as per the
prevailing regulations of Saudi Arabia, and I/we will be liable for deportation to India from KSA at any stage of Haj.
11. I hereby agree that the Rubat and metro transport facilities will be subject to the terms and conditions of KSA, and that if this is not possible, I will be
obligated to pay charges for the services provided to me.
12. I do not have any criminal prosecutions pending against me and there is no Court Order prohibiting me/us to travel abroad exists.
13. I am medically fit to perform the Haj pilgrimage and do not have any contagious diseases.
14. I understand that accommodation in Madinah is subject to availability, I may be allotted accommodation in Markazia or Non Markazia as per the
availability. I will accept the accommodation provided to me, which is approved by the authorities in KSA.
Date:___________________________
Place:___________________________
______________________________________________________
Signature / Thumb impression of the applicant.
PASSPORT DECLARATION FORM
(Only for Provisionally Selected Pilgrims)
To,
The Chief Executive Officer
Haj Committee of India,
Haj House, HAJ - 2025
7-A, M.R.A. Marg (Palton Road),
Mumbai - 400 001.
Cover Number: TGF-769-2-0
Details of Pilgrims
Sr. No. Information to be filled by Pilgrim
(as per Valid Indian International Passport)
1 Name of the Pilgrim MOHAMMED ABDUL WAHEED
2 Date of Birth (DD/MM/YYYY) 03-03-1965
3 Gender (Male/Female/Other) Male
4 Passport Number S1087635
Date of Issue of Passport
5 28-05-2018
(On or before 09-09-2024)
Date of Expiry of Passport
6 27-05-2028
(On or after 15-01-2026)
7 Whether it is a valid machine- readable passport (Yes/No)
8 Whether Passport is damaged/torn/wet/loosened, in any form. (Yes/No)
Whether at least two continuous blank pages are available in your
9
passport (Yes/No)
(i) I, the undersigned, hereby certify that the above information is correct to the best of my knowledge. I declare that the passport mentioned above is in
my possession and custody. The passport is not physically damaged/torn/wet/loosened and all pagesin the Passport are intact.
(ii) Further, whenever I travel abroad on this passport, I will inform to the Haj Committee of India (HCoI)and/or concerned SHC till my submission of
original passportwith the concerned SHC.
(iii) I also assure that whenever the HCoI require the passport, I will promptly submit it to the respective SHC.
_________________________________
Place:
Signature/Thumb impression
Date:
MOHAMMED ABDUL WAHEED
Generated at: 2025-04-15 12:55:43
HAJ COMMITTEE OF INDIA
ONLINE HAJ APPLICATION FORM FOR HAJ – 2025 (C.E.) 1446 (Hijri)
Adult Pilgrim Detail : 2
240829203629975
1 .Category General Cover No. TGF-769-2-0
2. No. of Persons 2 No. of Infants 0
3. Name of Cover Head MOHAMMED ABDUL Embarkation Preference 1 /
WAHEED 2 : HYDERABAD /
HYDERABAD
4. Applicant’s Details (As per International Passport)
Passport Number R6886471 Place of Issue HYDERABADD Date of Issue 15-03-2018
Date of Expiry 14-03-2028 Date of Birth 22-06-1968 Place of Birth NIZAMABAD
Surname Given Name PARVEEN SULTANA Father’s Name SHAIK MOINUDDIN
Gender Female Mother’s Name HAMEEDA BEGUM Spouse’s Name
Marital Status MARRIED Blood Group O+ Qualification PRIMARY
Occupation HOUSE WIFE Aadhaar No. 9574-2930***** PAN No.
Companion Name Companion Relation NA
5. Health Details
Detail of Co-Morbidity Not Applicable Pregnancy Status No
6. Present Residential Address
Address 8-2-162 LINEGALLY Pincode 503001
State Telangana District Nizamabad
Mobile Number 7569999714 WhatsApp No / Mobile No.2 7013050780 Email Id
7. Details of Nominee of Applicant
Name MOHAMMED WASEEM Mobile Number : 7093748610
MOHAMMED ABDUL
Father’s /Husband’s Name
WAHEED
Relationship SON
Address 8-2-162 LINEGALLY Pincode 503001
Signature / Thumb impression
State Telangana District Nizamabad
of Nominee
8. Name of Mehram with Relation (applicable for female pilgrims only)
MOHAMMED ABDUL
Name Relationship: HUSBAND
WAHEED
Signature / Thumb impression
Passport No. S1087635
of Mehram
9. Bank Account Details
MOHAMMED ABDUL
Name of Account Holder Bank Name SBI
WAHEED
Account No. 52085239589 IFSC Code SBIN0020108
10. Are you a permissible Repeater Mehram? NO
11. Do you want to perform ADAHI (Qurbani)? NO
12. Opting JHOFA Meeqat (Only for Shia Pilgrims)? NO
13. Are you NRI? NO
14. Are you a person with benchmark disability/disabilities, who cannot travel alone as certified by medical authorities? NO
Indicate the nature of your disability
Companion Name
Companion Relation
• I hereby undertake to abide by all the guidelines, including health protocol, age and travel restrictions, etc. issued by the Kingdom of Saudi Arabia and the Government of India/Haj
Committee of India in view of CoVID-19 pandemic. I agree to travel to the Embarkation Point allotted to me and am ready to pay all the charges on all accounts. I am also willing to go
through the RT-PCR test and quarantine period as specified in the protocol and guidelines
• I am aware of the tentative cost of Haj 2025, which may vary due to operational or functional reasons.
• I certify that the information furnished above is true and correct.
Signature / Thumb impression of the Applicant
FOR OFFICE USE ONLY
Online HAF Checked by Verified by Executive Officer, State / UT Haj Committee
All entries in the above HAF have been checked and found to be in order. Certified that the applicant is eligible to register for Haj-2025 (CE). 1446 (Hijri)
SOLEMN DECLARATION AND UNDERTAKING
For General Category
I, Mr./Mrs./Miss PARVEEN SULTANA S/o./W/o./D/o. SHAIK MOINUDDIN, an Indian citizen, do hereby solemnly affirm and declare as under:
1. I am aware that, as per Government of India policy, a person can perform Haj only "Once in a Lifetime" through Haj Committee of India (HCol).
2. I have never performed Haj through HCol in the past, and hence I am eligible to apply for Haj - 2025 (Hijri - 1446). I am aware that repeaters are not
eligible for Haj - 2025 (Hijri - 1446) and if it is detected at any stage that I have already performed Haj through HCoI, my seat shall be cancelled and the
entire amount deposited by me shall be forfeited.
3. I have read and understood thoroughly the Guidelines for Haj - 2025 (Hijri - 1446), particularly with reference to eligibility, cost, payments and
confirmation, cancellation, refunds, embarkation points, vaccination and health requirements before flight, baggage, flight, and accommodation in the
Kingdom of Saudi Arabia, and I undertake to abide by the same.
4. I hereby authorize HCol to send SMS to my mobile phone number, even if I am on the DND registry.
5. The particulars given by me in HAF, Solemn Declaration and Undertaking are true and correct to the best of my knowledge. I do hereby affirm and
declare that in the event I have suppressed material information or given a false / incorrect declaration / undertaking, HCoI shall forfeit the amount
deposited by me and I shall be liable for prosecution.
6. I am aware that HCol reserves the right to change the Embarkation Point opted by me. In such a case, I shall abide by the decision of HCol and shall
not show any resentment, whatsoever, against the decision of HCoI.
7. I am ready to pay Visa Fees, as levied by the KSA Haj Authorities for endorsement of my Haj Visa.
8. I/We understand that the HCoI works without any profit motive and does not attract the provisions of the Consumer Protection Act, 2019.
9. I/we understand that the Courts of Greater Mumbai only shall have jurisdiction in all matters of dispute. Further, the Supreme Court of India, in its
April 16, 2013 Judgement, barred all Courts and Authorities from interfering with the Haj Process.
10. I/We understand that my/our candidature shall be cancelled if I am/we are found carrying khas-khas, viagra-tablets, sexual oil and creams, synthetic
capore, cystone, khammera, gutkha, khaini, gul, peppermint, or narcotics in any form. Besides, I/we will be penalized for carrying banned items as per the
prevailing regulations of Saudi Arabia, and I/we will be liable for deportation to India from KSA at any stage of Haj.
11. I hereby agree that the Rubat and metro transport facilities will be subject to the terms and conditions of KSA, and that if this is not possible, I will be
obligated to pay charges for the services provided to me.
12. I do not have any criminal prosecutions pending against me and there is no Court Order prohibiting me/us to travel abroad exists.
13. I am medically fit to perform the Haj pilgrimage and do not have any contagious diseases.
14. I understand that accommodation in Madinah is subject to availability, I may be allotted accommodation in Markazia or Non Markazia as per the
availability. I will accept the accommodation provided to me, which is approved by the authorities in KSA.
Date:___________________________
Place:___________________________
______________________________________________________
Signature / Thumb impression of the applicant.
PASSPORT DECLARATION FORM
(Only for Provisionally Selected Pilgrims)
To,
The Chief Executive Officer
Haj Committee of India,
Haj House, HAJ - 2025
7-A, M.R.A. Marg (Palton Road),
Mumbai - 400 001.
Cover Number: TGF-769-2-0
Details of Pilgrims
Sr. No. Information to be filled by Pilgrim
(as per Valid Indian International Passport)
1 Name of the Pilgrim PARVEEN SULTANA
2 Date of Birth (DD/MM/YYYY) 22-06-1968
3 Gender (Male/Female/Other) Female
4 Passport Number R6886471
Date of Issue of Passport
5 15-03-2018
(On or before 09-09-2024)
Date of Expiry of Passport
6 14-03-2028
(On or after 15-01-2026)
7 Whether it is a valid machine- readable passport (Yes/No)
8 Whether Passport is damaged/torn/wet/loosened, in any form. (Yes/No)
Whether at least two continuous blank pages are available in your
9
passport (Yes/No)
(i) I, the undersigned, hereby certify that the above information is correct to the best of my knowledge. I declare that the passport mentioned above is in
my possession and custody. The passport is not physically damaged/torn/wet/loosened and all pagesin the Passport are intact.
(ii) Further, whenever I travel abroad on this passport, I will inform to the Haj Committee of India (HCoI)and/or concerned SHC till my submission of
original passportwith the concerned SHC.
(iii) I also assure that whenever the HCoI require the passport, I will promptly submit it to the respective SHC.
_________________________________
Place:
Signature/Thumb impression
Date:
PARVEEN SULTANA
