2. FATHER’s NAME: SPOUSE’s NAME:

1. NAME (IN BLOCK LETTERS):

2. FATHER’s NAME: SPOUSE’s NAME:

3. DATE OF BIRTH: PLACE OF BIRTH:

4. PRESENT NATIONALITY:

5. ANY OTHER NATIONALITY PREVIOUS OR PRESENT WITH DETAILS:

6. Details of PROFESSION / OCCUPATION ( with address):

7. ADDRESS (with telephone no.)

A) PRESENT:

B) PERMANENT

8. PASSPORT NO.: DATE OF ISSUE:

PLACE OF ISSUE: DATE OF EXPIRY:

9. DETAILS OF ALL PASSPORTS/TRAVEL DOCUMENTS HELD BY YOU DURING THE LAST THREE YEARS;

Passport No. Place of Issue Date of Issue Date of Expiry

10. DETAILS OF ALL PREVIOUS VISITS TO INDIA IN THE LAST THREE YEARS:

PERIOD OF STAY FROM TO	JOURNEY PERFORMED ON PASSPORT NO. / DATE OF ISSUE / PLACE OF ISSUE	VISA OBTAINED FROM PLACE NO.

11. Particulars of children, if any included in your passport(as per Indian regulations, a separate travel document is necessary for every child of the age of 15 years and above):

Name: Sex Date & Place of Birth:

12. Have you visited India previously, if so indicate places with dates:

13. Whether permission to visit India / extend stay in India / Visa has been refused previously, if so, when and by whom:

14. Period of which Visa is required: days Months

15. No. of entries requested: SINGLE / DOUBLE / TRIPLE / MULTIPLE

16. Purpose of journey to India:

Transit: (Place/country to be visited further)

Tourism: (Place/area to be visited)

Business: {Trade/Project/Scheme(Give brief description)}

Education: Name & particulars of educational institutions)

Any other: (Please specify)

17. Approx. date of arrival in India:

18. Port of ENTRY in India: Port of Departure from India:

19. Name & address of two references 1.

in Belarus and India who could

be contacted in case of need:

2.

I hereby undertake that I shall utilise my visit to India for the purpose for which the Visa has been applied for and shall not, on arrival in India, try to extend my stay for any other purpose. I also declare that the information given above by me, is true to the best of my knowledge and belief. If, however, it is found at any time that the information furnished by me is incorrect or incomplete, the Visa may be refused or cancelled at any time.

Place:

Date: Signature of Applicant

Note: Unless otherwise stated in the visa, the visa expires within 6 months from the date of issue.

Persons arriving in India for a stay of more than 6 months, are required to register themselves with the Foreigners Regional Registration Office or the District Police Authorities, within 14 days of their arrival in India.

Дата добавления: 2015-11-04