sample indian visa application form

7/26/2019 Sample Indian VISA Application Form

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Visa Application Form

A. Personal Parti cul ars (As in Passport)

Surname (As in Passport)

Given Name (As in Passport)

Previous/other Name if any

Sex Marital Status

Date of birth Religion

Place of Birth Town/City Country of Birth

Citizenship /National ID No Educational Qualification

Visible identification marks

Current Nationality Nationality by Birth/ Naturalization

Any Other Previous/Past Nationality

B. Passport Details

Passport No. Date of issue ( dd/mm/yyyy )

Place of issue Date of expiry (dd/mm/yyyy)

Any other Passport/Ident it y Cert if icate held (if yes ,p lease fi ll in the fo llowing)

Country of issue Place of issue

Passport/IC No Date of issue(dd/mm/yyyy)

Nationality/status

C. Applicants Contact Details

Phone No

Mobile /Cell NoPresentaddress

Email address

Permanent

Address

D. Family Details

Relation Name Nationalit y Prev. Nationalit y Place/Country of Bir th

Fathers

Mothers

Spouse

Were your Grandfather/Grandmother(Paternal/Maternal) Pakistan Nationals Or belong to Pakistan held area:

E. Details of Visa Sought (Visa shall be valid from the Date of Issue and not from the Date of Journey)

Type Of Visa Required No of Entries

Period of Visa Expected Date of Journey

Port Of Arrival Port of Exit

Paste your unsignedrecent color photograph.

Size: 2 X 2

SignatureBGDDV8643216

SK SHAHIDUL ISLAM

DHAKA

BANGLADESH

BANGLADESH

BANGLADESH

ApplicationId:BGDDV8643216

KHULNA

SK SHAHIDUL

BANGLADESH

BANGLADESH

01711584716

WebR

egistrationDate:05-M

AR-2

016

BY AIR/ HARIDASPUR

MOUSUMI ISLAM

17-MAY-2015

16-MAY-2020

12 Month

ISLAM

DHAKA(BANGLADESH)

BY BIRTH

NIL

KHULNA

KHULNA

BANGLADESH

BY AIR/ HARIDASPUR

KHULNABANGLADESH

PABLA BANIK PARA,DAULATPUR

DAULATPURKHULNA

Appointmen

tDate:14-MAR-2016

At:

11.30

06-JAN-1970

BANGLADESH

Multiple

SHAKH SAMIR UDDIN

Male

19704793305012650

BANGLADESH

BANGLADESH

BF0687952

Married

NO

NO

(Month)

MRS NOOR JAHAN BEGUM

HIGH COMMISSION OF INDIA

30-APR-2016

TOURIST VISA

BANGLADESH

HIGHER SECONDARY

DAULATPUR

ISLAM

PABLA BANIK PARA,DAULATPUR

KHULNA, BANGLADESH 9202


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Required Detail of

Purpose of Visit :

F. Previous Visit Details

Have You Ever visited India ?

Address where You stayed inIndia

Cities in India Visited

Type of Visa Visa Number

Visa Issued Place Date of Issue

Countries visited in last 10 years

Have you been refused an Indian Visa or extension of the same previously or deported from India ?

If yes above mention when and by whom with controlNo/Date

G. Profession/Occupation DetailsPresent Occupation Designation/Rank

Employer name/businessEmployer AddressPhone Number

Past occupation if any

Are/have you worked with Armed forces/ Police/ Para Military forces ?

Organization Designation

Place of Posting Rank

H. Address of Place of Stay / Hotel

Place/Hotel Name Address of Place / Hotel State Phone No.

I. Details of Two Reference

In India In

Name

Address

PhoneNumber

J. DECLARATION:

a. I do not hold any other passport(s) other than those detailed above.b. I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them.c. I declare that the information given in the form is complete and correct and the visit to India will be undertaken for the

purpose indicated in the application.d. I understand that in case the information provided in the form is found to be incorrect, I will be liable for denial of visit/ entry

or deportation and/ or other penalties during the visit as provided by Indian law.

..Date :. Applicants signature (as in Passport)

4 . ,

SK RUHUL AMIN

NO

3 . ,

Ap

plicationId:BGDDV8643216

SK SHAHIDUL ISLAM

PRIVATE SERVICE

DEANA,EAST PARA,DAULATPUR,

2 . ,

05-MAR-2016

01715401161

BARASAT,N 24 PGS.

1 KAMAL SIKDER KAZIPARA,BARASAT NORTH 24 PARGANAS WEST BENGAL . 00919088666818,

DAULATPUR,KHULNA

KAZIPARA,BARASAT

KHULNA

,

KAMAL SIKDER

00919088666818

Places to be Visited

NO

TOURISM

KAZIPARA,BARASAT

BARASAT,N 24 PGS.

TOURIST VISA


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