TO BE FILLED BY THE APPLICANT |
|
Personal Particulars |
1.
|
Surname
|
|
2.
|
Name
|
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3.
|
Sex
|
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4.
|
Date of Birth |
0000-00-00 |
5.
|
Place of Birth |
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6.
|
Religion
|
|
7.
|
NIC Card No.
|
|
Photo
|
8.
|
Visible identification marks |
|
9. Address
(House/Village/Tehsil/Distt./Province) |
(i) Present:
|
|
Phone No.
|
|
Email Address
|
|
Mobile
No.
|
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(ii) Permanent
|
|
Phone No.
|
|
10.
|
Present Occupation |
0
|
Past Occupation
|
0
|
11.
|
Details (with designation,
rank, department, name of employer or if in business, the nature and address
of business
|
|
12.
|
Father’s Name
|
|
Occupation
|
0
|
13.
|
Spouse’s Name
|
|
Occupation
|
0 |
|
|
|
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|
|
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| |
| 14. Do you belong/previously belonged to
Military/Semi-Military/Police/Govt. Organization ? If yes, please state
details.
|
|
|
| 15.Passport Detail |
Passport No. |
|
Dt of Issue |
0000-00-00 |
|
|
Place of Issue |
|
Dt. Of Expiry |
0000-00-00 |
Previous Passport No. |
|
|
| |
16.
|
Any other
foreign passport/identity certificate held: (Yes/No)
|
|
If yes,
give details below:
|
Country of Issue
|
|
Passport/IC No.
|
|
Date of Issue
|
0000-00-00
|
Place of Issue
|
|
Nationality/Status described therein
|
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|
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| |
17. Visa Information
Category
|
0
|
Purpose of
visit
|
|
No. of
Entries
|
0 |
Period of
Stay (days)
|
0
|
Starting
From
|
0000-00-00
|
Entry
Point
|
|
Exit Point
|
|
Mode of
Travel
|
|
Previous
Indian Visa No.
|
|
Date of
Issue
|
0000-00-00
|
Category
|
0
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
18.
|
Has permission to
visit or to extend stay in
India
previously been refused? If so, when and by whom (Mention Control No. and
date also)
|
|
|
| |
19.
|
Details of previous pending
application or unavailed visa, if any
(with Visa No./Control No./date):
|
|
|
20. Places of visit (More than one
entry/visit is allowed only in case of Business Visa)
|
|
First
Visit
|
Second
Visit
|
Third
Visit
|
|
|
Place
|
State
|
Place
|
State
|
Place
|
State
|
(i)
|
|
0 |
|
0 |
|
0 |
(ii)
|
|
0 |
|
0
|
|
0
|
(iii)
|
|
0
|
|
0 |
|
0
|
(iv)
|
|
0 |
|
0 |
|
0
|
(v)
|
|
0
|
|
0 |
|
0 |
(vi)
|
|
0 |
|
0
|
|
0 |
(vii)
|
|
0 |
|
0
|
|
0 |
(viii)
|
|
0
|
|
0 |
|
0 |
|
| |
21.
|
Address of relatives/business
associates/contact persons at places of visit: (Visa is Not Valid for Protected/Cantt.
Areas) (in the same order as in
Col.
20)
|
|
| |
Name/Father’s
Name
|
Relationship
with applicant
|
H.No./Street/Mohallah/Post
Office
|
Village
/Town/
City
|
District/State
|
Telephone No.
|
1.
|
|
|
|
|
0 |
|
2.
|
|
|
|
|
0
|
|
3.
|
|
|
|
|
|
|
4.
|
|
|
|
|
0
|
|
5.
|
|
|
|
|
0
|
|
6.
|
|
|
|
|
0 |
|
7.
|
|
|
|
|
0
|
|
8.
|
|
|
|
|
0 |
|
|
| |
21.
|
Address at Place of Stay (in the same order as in Col. 20) (Only for Business/Conference/Medical visa applicants) |
|
| |
Place |
Name and Address of Hotel
|
District/State
|
Telephone No.
|
1.
|
|
|
0
|
|
2.
|
|
|
0 |
|
3.
|
|
|
0 |
|
4.
|
|
|
0 |
|
5.
|
|
|
0 |
|
6.
|
|
|
0 |
|
7.
|
|
|
0 |
|
8.
|
|
|
0 |
|
|
| |
23.
|
For
Transit Visa Only
|
|
|
|
Place of
final destination
|
|
|
|
|
|
|
|
|
| |
| |
24.
|
If you have migrated
from
India
to
Pakistan
on or after
1st March, 1947
, please state:
|
(i)
Approximate date of migration:
|
0000-00-00 |
(ii)
Address in
India
before migration:
|
|
|
|
|
|
|
|
| |
| |
