This document provides instructions and guidelines for applicants applying for Haj registration for the year 1431 Hijri (2010 AD). It outlines various requirements including submitting a completed application form in capital letters, attaching passport photos, and providing details of any previous applications. Applicants who were rejected in the last 3 years must furnish rejection details. No more than one application per individual or group of 5 is allowed. Only correct and complete information in the application will be accepted. The Haj Committee of India is responsible for final selection and will consider all eligible Indian Muslims based on rules set by the Saudi government. Those who have performed Haj in the last 5 years or have certain medical conditions are not eligible to apply.

1. HAJ COMMITTEE OF INDIA
(Constituted under the Act of Parliament No. 35 of 2002)
PROVISIONAL REGISTRATION FORM FOR HAJ - 1431 (H) – 2010
SUBMITTED THROUGH CONCERNED STATE HAJ COMMITTEE ONLY
Please read the instruction and guidelines carefully before filling the Form, in ENGLISH & CAPITAL LETTERS in the blue/
black ball pen only. Furnish correct name and other information same as per international passport & attached Xerox copy of
passport all co-applicants. It needs to be noted that the false information or suppression of facts shall lead to rejection of application.
FOR OFFICE USE ONLY
COVER NUMBER __________________ SIGNATURE OF EXECUTIVE OFFICER
STATE HAJ COMMITTEE
Details of non refundable provisional registration fee RS.200/- per pilgrim deposited in Haj Committee of India Account
No. 30683623887 in any State Bank of India branch.
Amount Name of Branch Branch Code No.
Receipt Date (The Copy Of Pay-In-Slip Is Attached) No. of Adult = Infant =
COVER HEAD (first applicant) should be MALE
I. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished)
Year Cover No. Year Cover No. Year Cover No.
2007 2008 2009
DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached)
Passport Number Place of Issue PASTE
Date of Issue Date of Expiry SELF
ATTESTED
Applicant:- Surname PHOTO
Given Name
Father’s Full Name
Mother’s Name Spouse Name
Present Residential Address, Including Street Number with PIN code
PIN CODE
District State
Telephone Number with Code Number :- Mobile No. :-
MARITAL STATUS
Occupation :- EDU. QUALI :-
MARRIED / UNMARRIED
Date of Birth Age :- Place of Birth
DETAILS OF THE OTHER APPLICANT/S
II. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished)
Year Cover No. Year Cover No. Year Cover No.
2007 2008 2009
DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached)
Passport Number Place of Issue PASTE
Date of Issue Date of Expiry SELF
ATTESTED
Applicant:- Surname PHOTO
Given Name
Father’s Full Name
Mother’s Name Spouse Name
SEX - Male / Female MARITAL STATUS
MARRIED / UNMARRIED
Occupation :- EDU. QUALI :-
Date of Birth Age :- Place of Birth
NAME OF MEHRAM WITH RELATION (for female pilgrims only)
Name Relationship
III. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished)
Year Cover No. Year Cover No. Year Cover No.
2007 2008 2009
DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached)
Passport Number Place of Issue PASTE
Date of Issue Date of Expiry SELF
ATTESTED
Applicant:- Surname PHOTO
Given Name
Father’s Full Name
Mother’s Name Spouse Name
SEX - Male / Female MARITAL STATUS
MARRIED / UNMARRIED
Occupation :- EDU. QUALI :-
Date of Birth Age :- Place of Birth
NAME OF MEHRAM WITH RELATION (for female pilgrims only)
Name Relationship

2. IV. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished)
Year Cover No. Year Cover No. Year Cover No.
2007 2008 2009
DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached)
Passport Number Place of Issue PASTE
Date of Issue Date of Expiry SELF
ATTESTED
Applicant:- Surname PHOTO
Given Name
Father’s Full Name
Mother’s Name Spouse Name
SEX - Male / Female MARITAL STATUS
MARRIED / UNMARRIED
Occupation :- EDU. QUALI :-
Date of Birth Age :- Place of Birth
NAME OF MEHRAM WITH RELATION (for female pilgrims only)
Name Relationship
V. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished)
Year Cover No. Year Cover No. Year Cover No.
2007 2008 2009
DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached)
Passport Number Place of Issue PASTE
Date of Issue Date of Expiry SELF
ATTESTED
Applicant:- Surname PHOTO
Given Name
Father’s Full Name
Mother’s Name Spouse Name
SEX - Male / Female MARITAL STATUS
MARRIED / UNMARRIED
Occupation :- EDU. QUALI :-
Date of Birth Age :- Place of Birth
NAME OF MEHRAM WITH RELATION (for female pilgrims only)
Name Relationship
DETAILS OF INFANT/S (IF ANY ACCOMPANIED)
1. DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached)
Passport Number Place of Issue PASTE
Date of Issue Date of Expiry SELF
ATTESTED
Applicant:- Surname PHOTO
Given Name
Father’s Name Mother’s Name
SEX - Male / Female Date of Birth Age :- Place of Birth :-
2. DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached)
Passport Number Place of Issue PASTE
SELF
Date of Issue Date of Expiry
ATTESTED
Applicant:- Surname PHOTO
Given Name
Father’s Name Mother’s Name
SEX - Male / Female Date of Birth Age :- Place of Birth :-
Attached: Photo copy of passport for all applicants. OR
(1) PROOF OF ADDRESS (ATTACH ONE OF THE FOLLOWING)
(a) Ration Card (b) Driving License (c) Electricity Bill (d) Telephone Bill (Land Line)
(2) PROOF OF CITIZENSHIP (ATTACH ANY ONE) (a) Voter’s Identity Card (b) Pan Card (c) Senior Citizen Card.
NOTE : Pilgrim having performed Haj within five years are not eligible. Pilgrims of same district should apply in one
cover. The intending Pilgrim shall submit one and only one application form individual or in Group of FIVE (5)
Persons cover. In case submits more than one application form he/she shall be disqualified.
SIGNATURE OF HEAD OF COVER
*Photo copy of Form may also be

3. BANK COPY
CA ACCOUNT PAY-IN-SLIP
State Bank of India
BRANCH ________________________ . CODE __________________ . DATE _______________________________
NOTE : Branches are requested to return two copy to the depositor duly stamped for the credit of the Account of (Name)
Haj Committee of India. Mumbai.
Account No. 30683623887
PARTICULARS OF PILGRIMS, Cover No. ___________________________________
Accommodation Category Opted: - _____________________________________________
Name (Head of Cover) :- _______________________________________________________________________________
Sr. No. NAME OF THE PILGRIMS ADDRESS OF HEAD OF COVER CASH NOTE AMOUNT IN RS.
X 1000 Rs.
X 500 Rs.
X 100 Rs.
X 50 Rs.
X 20 Rs.
X 10 Rs.
Total No. of Persons X5 Rs.
Amount (in words) Rupees _________________________________________ Total Rs. Rs.
CASH OFFICER JOTTING
CASHIER’S SCROLL NO. CASHIER PARTITION NO.
PASSING OFFICER BOOK
DEPOSITED BY Bank Stamp
(SIGNATURE) to be affixed
-----------------------------------------------------------------------------------------------------------------------------------------------
COPY – HAJ COMMITTEE OF INDIA, MUMBAI.
(Constituted under the Act of Parliament No.35 of 2002)
HAJ HOUSE, 7-A, M.R.A. MARG, (PALTON ROAD), MUMBAI-400 001.
CA ACCOUNT PAY-IN-SLIP
State Bank of India
BRANCH ________________________ . CODE __________________ . DATE _______________________________
NOTE : Branches are requested to return two copy to the depositor duly stamped for the credit of the Account of (Name)
Haj Committee of India. Mumbai.
Account No. 30683623887
PARTICULARS OF PILGRIMS, Cover No. ___________________________________
Accommodation Category Opted: - _____________________________________________
Name (Head of Cover) :- _______________________________________________________________________________
Sr. No. NAME OF THE PILGRIMS ADDRESS OF HEAD OF COVER CASH NOTE AMOUNT IN RS.
X 1000 Rs.
X 500 Rs.
X 100 Rs.
X 50 Rs.
X 20 Rs.
X 10 Rs.
Total No. of Persons X5 Rs.
Amount (in words) Rupees _________________________________________ Total Rs. Rs.
CASH OFFICER JOTTING
CASHIER’S SCROLL NO. CASHIER PARTITION NO.
PASSING OFFICER BOOK
DEPOSITED BY Bank Stamp
(SIGNATURE) to be affixed
-----------------------------------------------------------------------------------------------------------------------------------------------
PILGRIM COPY
CA ACCOUNT PAY-IN-SLIP
State Bank of India
BRANCH ________________________ . CODE __________________ . DATE _______________________________
NOTE : Branches are requested to return two copy to the depositor duly stamped for the credit of the Account of (Name)
Haj Committee of India. Mumbai.
Account No. 30683623887
PARTICULARS OF PILGRIMS, Cover No. ___________________________________
Accommodation Category Opted: - _____________________________________________
Name (Head of Cover) :- _______________________________________________________________________________
Sr. No. NAME OF THE PILGRIMS ADDRESS OF HEAD OF COVER CASH NOTE AMOUNT IN RS.
X 1000 Rs.
X 500 Rs.
X 100 Rs.
X 50 Rs.
X 20 Rs.
X 10 Rs.
Total No. of Persons X5 Rs.
Amount (in words) Rupees _________________________________________ Total Rs. Rs.
CASH OFFICER JOTTING
CASHIER’S SCROLL NO. CASHIER PARTITION NO.
PASSING OFFICER BOOK
Bank Stamp
to be affixed
DEPOSITED BY
(SIGNATURE)
NOTE :- Xerox copy of pay–in-slip may also be used for deposit of amount.

4. tIcf kwØm lÖv I½nän
lÖv lukv, ]n.H. Imen¡äv FbÀt]mÀ«v, ae¸pdw þ 673 647.
t^m¬: 0483 - 2710717
Ref. : H2-01/10 HAJ-2010 Xn¿Xn: 30þ03þ10
2010 lÖnv At]£n¡p¶Xnpff amÀKnÀt±i§Ä
1. At]£m t^mdw ]qÀ®ambpw hyàambn, Cw¥ojn henb A£c¯n ]mkvt]mÀ«nÂ
tcJs¸Sp¯nbXvt]mse ]qcn¸nt¡­XmWv. ]qÀ®aÃm¯ At]£ kzoIcn¡p¶XÃ.
IhÀ eoUÀ ]pcpjmbncn¡Ww. kv{XoIÄ Hä¡v At]£ kaÀ¸n¡phm³ ]mSnÃ.
2. At]£bn Gähpw ]pXnb 2.5cmx2.5cm hen¸apÅ Hcp t^mt«m ]Xnt¡­XmWv.
3. 2007, 2008, 2009 hÀj§fn lÖnv XpSÀ¨bmbn At]£n¡pIbpw sXcsªSp¡s¸SmXncn
¡pIbpw sNbvXhÀ 2010þse lÖnv At]£n¡pIbmsW¦n Ahsc dnkÀhvUv ImäKdnbnÂ
DÄs¸Sp¯n dps¡Sp¸v IqSmsX lÖnv Xmsg ]dbp¶ n_ÔIÄ¡v hnt[bambn ApaXn
ÂIphm³ lÖv I½nän Xocpamn¨n«p­v. aäpÅhÀ Pd ImäKdn (dps¡Sp¸v)
hn`mK¯nemWv DÄs¸SpI.
i) Hcp Ihdn At]£n¡p¶ apgph³ BfpIfpw 2007, 2008, 2009 hÀj§fnÂ
At]£n¨hcmbncn¡Ww.
ii) Hmtcm At]£Isâbpw nÝnX tImf¯n ap³ hÀj§fnse IhÀ ¼dpIÄ
nÀ_Ôambpw FgpXnbncn¡Ww.
iii) IhÀ¼À sXämbn FgpXpItbm, aq¶phÀjhpw At]£n¡m¯hsc Ihdn DÄs¸Sp¯pItbm
sNbvXm Hcdnbn¸pw IqSmsX Xs¶ Ahsc Pd ImäKdnbnte¡v amäp¶XmWv.
iv) ap³ hÀj§fn sXcsªSp¡s¸SpIbpw F¶m GsX¦nepw ImcW¯m bm{X
d±m¡pIbpw sNbvXhÀ¡v Cu BpIqeyw e`yaÃ.
4. lÖv 1431(H)2010 amÀ¤nÀt±i¯n ]dªn«pff amZWvU§Ä ]qÀ®ambpw ]men¨psIm­m
bncn¡Ww At]£ kaÀ¸nt¡­Xv.
5. At]£bn ImWn¨ncn¡p¶ Imcy§Ä kXykÔambncn¡Ww. At]£bn IhÀeoUÀ
H¸ntS­XmWv. AÃm¯]£w At]£ nckn¡p¶Xmbncp¡pw.
6. At]£ kwØm lÖv I½nän apJm´ncw am{Xta kzoIcn¡pIbpffq.
7. lÖnsâ ]qÀ® D¯chmZnXzw ]mÀesaâdn N«{]Imcw tI{µ lÖv I½nän¡pffXmWv.
Pn±bnse¯p¶ C´y³ lmPnamcpsS {]iv§Ä Pn±bnse C´y³ tIm¬kpteäv ]cntim[n¡p¶Xpw
amÀ¤nÀt±iw ÂIp¶XpamWv. lmPnamÀ¡v e`n¡p¶ kuIcy§fpsS taÂtm«w tI{µ lÖv
I½nän nÀÆln¡p¶XmWv.
8. Xmsg ]dbp¶ hyànIÄ lÖv 1431(H) 2010þv At]£ kaÀ¸n¡phm³ ]mSnÃ.
1. Ignª A©v hÀj¯npffn (2006 þ 2009) lÖv sNbvXhÀ.
2. Sn._n., FbnUvkv, aäp kmw{IanI tcmK§fpffhÀ AwKsshIeyw, _p²namµyw XpS§nb imcocnI
{]iv§fpffhÀ.
3. 31þ12þ2010þv 5 hbÊv XnIªXpw 16 hbÊv XnIbm¯Xpamb B¬Ip«nIÄ.
4. salvdw CÃm¯ kv{XoIÄ.
9. C³^âv: 31þ12þ2010þv c­v hbÊv ]qÀ¯nbmIm¯ Ip«nIÄ¡v AhcpsS amXm]nXm¡tfmsSm¸w
At]£n¡mhp¶XmWv.
10. ]WaS¡Â:-þ 1) Hmtcm At]£tbmsSm¸hpw tÌäv _m¦v Hm^v C´ybpsS GsX¦nepw imJbnÂ
30683623887--þF¶ A¡u­n HcmÄ¡v 200cq] hoXw nt£]n¨Xnsâ t]þC³þÉn]v DffS¡w
sNbvXncn¡Ww. Cu XpI Xncn¨pÂIp¶XÃ. Unamâv {Um^vtäm, ]Wtam Hcp ImcWhimepw
kznIcn¡p¶XÃ. Hcp Ihdn H¶nÂIqSpX At]£Icps­¦n apgph³t]cpsSbpw XpI
H¶n¨S¡mhp¶XmWv.
2.)1431(H) 2010 lÖnpff At]£ kzoIcn¡p¶Xnpff Ahkm Xn¿Xn 30-04-2010 sshIpt¶cw
5 aWn hscbmWv. Ahkm XnbXn¡ptijw e`n¡p¶ At]£IÄ bmsXmcp ImcWhimepw
kzoIcn¡p¶XÃ. At]£IÄ tIcf kwØm lÖv I½nän Hm^oknte¡mWv Abt¡­Xv.
11. bm{Xm kab¯v ]qÀ® KÀ`nWnIfmb kv{XoIÄ lÖv bm{Xm Hgnhmt¡­XmWv. IpSpw_
_ÔapÅ ]camh[n A©pt]À¡v Hcp Ihdn At]£n¡mhp¶XmWv. IhdnepÄs¸«
At]£IcpsS ]WanS]mSnsâ NpaXe apJy At]£IpffXmWv. HcmÄ H¶ne[nIw At]£
kaÀ¸n¡m³ ]mSpffXÃ. A§s kaÀ¸n¨Xmbn sXfnªm AbmfpÄs¸Sp¶ apgph³
At]£Ifpw nckn¡p¶Xpw nbaS]SnIÄ kzoIcn¡p¶XpamWv.
12. At]£bn At]£IcpsS t^m¬ ¼À STD tImUv klnXw hyàambn ]qcn¸nt¡­XmWv.
At]£bpsS Hcp t^mt«mÌmäv tIm¸n nÀ_Ôambpw At]£I³ kq£nt¡­XmWv.
13. lÖv I½nän¡v GP³knItfm Ap_Ô Øm]§tfm CÃ. Bhiy¯ne[nIw XpI
hyànItftbm GP³knIsftbm Gev]n¨v h©nXcmImXncn¡pI.
14. lÖpambn _Ôs¸« FÃmImcy§fnepw tI{µ lÖv I½nänbpsS Xocpamw A´naambncn¡pw.
15. 1431(H) 2010 lÖnpff At]£ FIvknIyq«ohv Hm^oÊÀ, tIcf tÌäv lÖv I½nän Hm^okv,
lÖv lukv, ]n.H. Imen¡äv FbÀt]mÀ«v, ae¸pdw þ 673 647 F¶ hnemk¯nÂ
30þ04þ2010þv sshIp. 5 aWn¡pap¼mbn e`nt¡­XmWv. At]£tbmsSm¸w, 5 cq]
Ìms¼m«n¨
IhÀeoUdpsS taÂhnemksagpXnb c­p IhdpIÄ, FÃm At]£IcpsSbpw ]mkvt]m«nsâ
tIm¸n F¶nh D­mbncn¡Ww. At]£ Ab¡p¶ Ihdnv ]pd¯v ""lÖv At]£þ 2010''F¶pw,
sam¯w At]£IcpsS F®hpw FgptX­XmWv. At]£ Ab¨v ]Xn©v Znhk¯nIw IhÀ
¼À e`n¨n«nsæn At]£bpsS t^mt«m tIm¸n klnXw lÖv I½nän Hm^oÊpambn
_Ôs¸tS­XmWv.
16. 2010þse lÖnmbn XncsªSp¡s¸Sp¶hÀ¡pÅ S]SnIsf¡pdn¨pÅ hnhc§Ä ]n¶oSv
Adnbn¡p¶XmWv. hntZi hnnab kwJybpsSbpw hnam¡qenbpsSbpw 30 iXamhpw
C³ÀmjW ]mkvt]mÀ«pw 2010 sabv amk¯n kaÀ¸nt¡­XmWv. _m¡n 70 iXamw 2010
BKÌv 31þIw ASbvt¡­XmWv.
(H¸v) PnÃm- I-fIvSÀ, ae¸pdw & FIvkn-Iyp-«ohv Hm^o-kÀ