VisaFormindia.pdf

11.Passport particulars:

Passport No.

Date of Birth

Date of issue

Place of Birth

Place of issue

12. Previous nationality (ties) held, if any

EMBASSY OF INDIA TOKYO

APPLICATION FORM FOR VISA FOR INDIA

APPLICANTS SHOULD NOTE THAT IF ANY RELEVANT

INFORMATION IS WITHHELD OR IS GIVEN

INCORRECTLY, THE VISA IS LIABLE TO BE REFUSED

OR, IF ALREADY ISSUED, TO BE CANCELLED

13. Details of previous visit(s) to India, if any:

1. Type of visa required (please encircle): Business /

Diplomatic / Employment / Journalist / Medical / Official

/ Research / Student / Transit / Tourism / Yoga / Other

14. Whether visa or extension of stay in India has been

refused previously?

15: If so, give details

(Please specify):

2 . Period, in months, for which visa is required :

3. Number of entries required: Single / Double / Triple /

16. Detailed purpose of present visit:

Multiple

4. Present Nationality of the applicant :

5. Full Name Mr./Mrs/Miss

17. Expected date of departure from Japan:

6. Previous Name, if any: Mr/Mrs/Miss

18. Expected date of Entry in India:

7. Father's / Husband’s Name: Mr.

19. Port of entry in India:

20. Name of destination country (for transit visas):

8. Permanent Address:

21. Expected date of departure from India:

22. Name, phone and address of two references:

9.Present Address & phone number:

10. Profession / Occupation along with name of

Company/ address / phone number:

23. I undertake to utilise my visit to India for the purpose

for which the visa has been applied for and for that

purpose only.

Date: (Signature)

Place: