Surname (as shown in your Passport)
Surname/Family Name (As in Passport)
Given Name/s (Complete as in Passport)
Given Name/s (As in Passport)
Have you ever changed your name?
NO
Date of Birth
Date of Birth as in Passport in DD/MM/YYYY format
Town/City of birth
Province/Town/City of birth
Country of birth
Country of birth
Citizenship/National Id No.
If not applicable Please Type NA
Religion
If Others .Please specify
Visible identification marks
Visible identification marks
Educational Qualification
Educational Qualification
Did you acquire Nationality by birth or by naturalization?
Did you acquire Nationality by birth or by naturalization?
Have you lived for at least two years in the country where you are applying visa?
YES
Passport Number
Applicant's Passport Number
Place of Issue
Place of Issue
Date of Issue
In DD/MM/YYYY format
Date of Expiry
In DD/MM/YYYY format
Any other valid Passport/Identity Certificate(IC) held,
NO
Applicant's Address Details
House No./Street
Applicant's Present Address. Maximum 35 characters (Each Line)
Village/Town/City
Village/Town/City
State/Province/District
State/Province/District
Postal/Zip Code
Postal/Zip Code
Phone No.
One Contact No is Mandatory
Email Address
Email Address
House No./Street
Applicant's Permanent Address(with Postal/Zip Code)
Village/Town/City
Village/Town/City
State/Province/District
State/Province/District
Name
Applicant's Father Name
Nationality
Father's Nationality
Previous Nationality
Previous Nationality of Father
Place of birth
Place of birth
Country of birth
Country of birth
Name
Applicant's Mother Name
Nationality
Mother's Nationality
Previous Nationality
Previous Nationality of Mother
Place of birth
Place of birth
Country of birth
Country of birth
Applicant's Marital Status
Applicant´s Marital Status
Were your Grandfather/ Grandmother (paternal/maternal) Pakistan Nationals or Belong to Pakistan held area.
NO
Were your Grandfather / Grandmother (paternal/maternal) Pakistan Nationals or belong to Pakistan held area? Yes / No
Have you booked any room in Hotel/Resort etc. through any Tour Operator?
Previous Visa/Currently valid Visa Details
Have you ever visited India before?
YES
If Yes Please give Details
Has permission to visit or to extend stay in India previously been refused?
No
Countries Visited in Last 10 years
SAARC Country Visit Details
Have you visited SAARC countries (except your own country) during last 3 years?
No
Reference Name in India
Reference Name and Address in India
Reference Name in
Reference Name and Address in