1. Name in full
2. Profession (designation and rank)
3. Full postal address (should include House No., Street,
District/Town, County, Province)
A. Office/Work Unit
B. Residence
4. (A) Father name （in full）
Present Occupation and Address
(B) Name of Spouse (in full)
Nationality Occupation
Office Address
5. Date & Place of birth
6. Visa applied for
Purpose
Duration
Full name of host organization
(Please attach letter of invitation. Give full name of concemed company if going on business etc.)
Commencing from/period of visit
7. Places intended to be visited
8. Places of intended entry into/exit from India
9. Children, of any, accompanying the applicant name
I)
II)
III)
10. Details of Passport (s) held:
Number of Passports
Category
Issued by
Place of Issue
Date of Issue
11. Has permission to visit of to extend stay in India previously been refused, if so when and by whom
12. Details of last visit
Date and Place from where visa issued
13. For TRANSIT VISA only
Place of final destination
Is passport valid for that country?
Has visa/immigration permit of that country been obtained?
Full address of place of place of stay in India
14.I, hereby declare that all the statements and information given by me in this application are true to the best of my knowledge and belief. I also declare that I have not submitted any application for visa to visit India under any other name, surname, maiden name, etc., and that the passport held by me at present as indicated in column 10 is the only passport that I hold. I realize that should any of the above statement be found to be false, untrue or incorrect, my visa will be liable to cancellation by the competent authority and I will be liable to such other penalties as may be prescribed.
Date
Place Signature of applicant
NOTE
1. Application form is to be filled in triplicate by each applicant.
2. Three recent passport size photographs to be attached with application in addition to one photograph pasted on the form.
3. All columns should be filled giving complete and detailed information. Incorrectly filled or incomplete forms would result in delay in processing.
4. If information furnished is found to be incorrect, visa is likely to be refused or cancelled.