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BUREAU OF CIVIL AVIATION SECURITY

AERODROME ENTRY PERMIT (AEP) APPLICATION FORM (AEPAF)

Fill up the form in CAPITAL LETTERS. Copy of recent colored passport size
photographs needs to be uploaded in the space provided. All the columns must be filled
up otherwise application is liable to be rejected. All dates are to be given in DD/MM/YY
format. Any overwriting / correction must be countersigned with official seal.

Photograph
(Auto-Generated)
1. AEP Application Reference Id:
2. Type of AEP requested (Check Appropriate Box)
a. Single Airport Pass
Multi Airport-Single Region Airport Pass
Multi Airport-Multi Region Airport Pass
b. Temporary AEP
Permanent AEP
Commercial AEP
Government Security
Agencies Protocol Pass
Foreign National Pass
3. ISSUE CATEGORY
FRESH: -
(If selected, Appointment Order to be uploaded for private OR
Posting Order to be uploaded for govt. employees)
RE-ISSUE:-
(If selected, please select following reasons)
Designation Change:-
(If selected, Promotion order to be uploaded)
Transfer:-
(If selected, Transfer order to be uploaded)
Mutilation:-
Expiry: -
(If selected, copy of previous AEP to be uploaded)
Loss: -
(If selected, copy of FIR/police complaint along with penalty
challan and internal enquiry conducted to be uploaded)
Any other reason: -
(If selected, mention reason and upload relevant document)
_______________________________________________________
4. Previous AEP Colour / Zones: - Purple / A, D, T, S, P, B, F, Ft, C I & X

5. Date as of (3) 31/12/2016

6. Applicant Name SANTANU GHOSH


(Pls. mention type of ID-proof AADHAAR CARD
document)
7. Aadhaar Number if Available 3111-7297-7469

8. Father’s Name: - MANOJ KUMAR GHOSH

9. Mother’s Name: - REKHA GHOSH

10. a. Permanent Address: -

KALYANPUR, BESIDE RAM THAKUR MANDIR, AGARPARA, NORTH 24 PARGANAS

KOLKATA, PIN 700109, WEST BENGAL

b. Present Address: -

E-1204, Shriram Suhaana, Opposite BMSIT College, Nagenahalli Gate,


DDSuryavamshiLaLayoutLayoutDoddaballapur
YELAHANKA, BANGALORE, PIN-560064, KARNATAKA

Type of Address Proof Attached AADHAAR CARD

11. Email Id: - santanu@bialairport.com

12. Mobile No: - 9538882914

13. Emergency Mobile No: - 9830407112

14. Blood Group:- A+

15. Date of Birth:- 16th MAY 1969

16. Date of Superannuation:-

17. a. Organization Name: BANGALORE INTERNATIONAL AIRPORT LIMITED

b. Designation: ASSISTANT VICE PRESIDENT

c. Employee No.: 101550

d. Place of duty: PROJECTS, TERMINAL & AIRSIDE

e. Nature of duty: CONSTRUCTION

KEMPEGOWDA INTERNATIONAL AIRPORT LIMITED, PROJECT OFFICE,


f. Office Address: DEVANAHALLI, BIAL, BANGALORE – 560 300

18. Did you apply for AEP earlier?

YES

NO

Whether issued or not?

YES

NO

19. Details of existing AEP in possession: -


AEP No.: - HYD00028172; Valid Upto:- 31/12/2016; Place of Issue:- HYDRABAD

20. Information relating to applicants other than Indian nationals.

a. Nationality:- __________________________________

b. Passport No:- __________________________________

c. Place of Issue:- __________________________________

d. Date of Issue:- __________________________________

e. Expiry of Passport:- __________________________________

f. Type of Visa:- __________________________________

g. Expiry of Visa:- __________________________________

21. AVSEC Awareness Training: -

Date of Training: - 25/11/2016; Location: BIAL, E&M – SISIL CONFERENCE ROOM

Name: - ; Organization of the AVSEC Instructor: