Please affix one passport size photograph here - Indembniameyorg

By Herman Armstrong,2014-02-06 23:04
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Please affix one passport size photograph here - IndembniameyorgAffix,one,size,here



    PART -A

     This form should be submitted with

     1. Two passport size photographs one of which should be affixed in the space

    Please affix one provided. passport size 2. Valid Health Certificate for Yellow Fever. photograph here. 3. Return Air Ticket for India

    There may be additional requirements depending upon the type of visa applied for.

Mr./Mrs./Ms Last Name First Name Middle Name

    Previous Name Father’s Name Husband’s Name (for married woman only) (If any)

Whether the applicant or his parents or grand- parents (both paternal and maternal) were holding the

    nationality of Pakistan at any time? - Yes / No.

     If yes, please provide the following information:- Name(s) of parent / grand -parent Paternal or Maternal Relationship with


    Place of Birth (City) (State Province) (Country)

Date of Birth (Day) (Month) (Year)

    Address Phone No._____________ Mobile No : _____________


    (Details of present employment_______________________________________________________

    Passport No Date of issue : Date of expiry : Issued by: Place of issue :

    Present Nationality :____________________ Any other present Nationality_________________

    Nationality of any other country held previously : ____________________

    Whether the applicant has acquired nationality of the country by birth or by naturalization :Yes/No

Countries visited during the last 10 years

    Name of country Period of visit/stay

    (Please turn over page/Page 2)


Details of previous visits to India, if any {with dates}

    The addresses of friends/relatives/places of stay during the previous travel to India:-

From where the visa was acquired during previous visit

Whether Visa has been refused previously? If so give details:

    Visa applied for - Period for which visa is applied : _____________________


    No. of Entries : Single / Double / Triple

Countries from which entry into India will be made (1) (2) (3)

    Purpose of Journey : Transit Tourist Business Education Conference

     Medical, Medical Att. Employment Diplomatic Official Journalist

     Other (specify details)____________.

    Places to be visited :

    Approximate date of departure Approximate date of arrival in India

    Telephone number and mobile number of applicant as well as the sponsor in India.

    PART B

    Whether holding valid, no objection to return to India endorsement and if so, give particulars: Name and addresses of two references

    In the country of applicant: - 1.


     In India

    PART C

    I , __________________________ hereby undertake that I shall utilize my visit to India for the purpose for which visa has been applied and shall not, on arrival in India, try to obtain employment

    or set up business or extend my stay for any purpose, I fully understand that if any of the information is

    found to be withheld, the Visa is liable to be cancelled at any time.




     (Signature of applicant)

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