High Commission of India: Visa Application Form

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HIGH COMMISSION OF INDIA

DHAKA(BANGLADESH) Paste your unsigned


recent color photograph.
Size: 2” X 2”

Visa Application Form

Signature
BGDDV382F620

A. Personal Particulars (As in Passport)


Surname (As in Passport) BISWAS
Given Nam e (As in Passport) RAJANISH
Previous/other Name if any
Sex MALE Marital Status SINGLE
Date of birth 14-FEB-1996 Religion HINDU
Application Id :BGDDV382F620

Place of Birth Town/City NARAIL Country of Birth BANGLADESH


Citizenship /National ID No 9151857365 Educational Qualification GRADUATE
Visible identification marks ONE BEAUTY SPOT BELOW RIGHT EAR
Current Nationality BANGLADESH Nationality by Birth/ Naturalization BY BIRTH
Any Other Previous/Past Nationality
B. Passport Details
Passport No. BN0945141 Date of issue ( dd/mm/yyyy ) 12-APR-2017
Place of issue DHAKA Date of expiry (dd/mm/yyyy) 11-APR-2022
Any other Passport/Identity Certificate held (if yes ,please fill in the following) NO
Country of issue Place of issue
Passport/IC No Date of issue(dd/mm/yyyy)
Web Registration Date : 04-MAR-2020

Nationality/status
C. Applicant’s Contact Details

200 Phone No
Present
address SADANANDAKATHI Mobile /Cell No1521458393
NARAIL, BANGLADESH 7500 Email address [email protected]

Permanent 200
Address SADANANDAKATHI
NARAIL

D. Family Details
Relation Name Nationality Prev. Nationality Place/Country of Birth
NARAIL
Father’s SANGKAR BISWAS BANGLADESH BANGLADESH BANGLADESH
GOPALGANJ
Mother’s SABITA RANI BISWAS BANGLADESH BANGLADESH BANGLADESH

Spouse

Were your Grandfather/Grandmother(Paternal/Maternal) Pakistan Nationals Or belong to Pakistan held area : NO


E. Details of Visa Sought (Visa shall be valid from the Date of Issue and not from the Date of Journey)

Type Of Visa Required BUSINESS VISA No of Entries MULTIPLE


Period of Visa ( Month) 36 Month Expected Date of Journey 02-APR-2020
Port Of Arrival BY AIR Port of Exit BY AIR

RAJANISH BISWAS
Required Detail of BUSINESS VISA
Company Name NTPC POWER MANAGEMENT INSTITUTE
Address PLOT NO 5-14 SECTOR-16A NOIDA-201301 DISTRICT:GAUT
Phone 00919650990788
Email [email protected]

Purpose of Visit : FOR THOSE COMING TO ESTABLISH AN INDUSTRIAL/BUSINESS VENTURE, THOSE REQUIRED TO TRAVEL FREQUENTL
F. Previous Visit Details
Have You Ever visited India ? YES
Address where You stayed in VIVEKANANDAPOLLI MAYNAGURI
India
JALPAIGURI PIN 735224,

Application Id :BGDDV382F620
Cities in India Visited JALPAIGURI
Type of Visa TOURIST VISA Visa Number VK5502613
Visa Issued Place DHAKA Date of Issue 15-MAY-2017
Countries visited in last 10 years
INDIA JALPAIGURI
Have you been refused an Indian Visa or extension of the same previously or deported from India ?
If yes above mention when and by whom with control
No/Date
G. Profession/Occupation Details
Present Occupation ENGINEER Designation/Rank ASSISTANT MANAGER
Employer name/business BANGLADESH INDIA FRIENDSHIP POWER COMPANY PVT LTD
Employer Address UH LEVEL 17 117 KAZI NAZRUL AVENUE ESKATON GARDEN
Phone Number
1521458393
Past occupation if any STUDENT
Are/have you worked with Armed forces/ Police/ Para Military forces ? NO
Organization Designation
Place of Posting Rank
H. Address of Place of Stay / Hotel
Place/Hotel Name Address of Place / Hotel State Phone No.
1 NTPC POWER MANAGEMENT INSTITUTE PLOT NO 5-14 SECTOR-16A NOIDA-201301 DISTRICT:GAUT DELHI UTTAR PRADESH. 00919650990788, [email protected]
2 .,
3 .,
4 .,
I. Details of Two Reference
In India In BANGLADESH
Nam e MOHAMMAD MUJTABA TABREZ NITISH DUTTA
Address C-5/56 YAMUNA VIHAR DELHI UH LEVEL 17 117 KAZI NAZRUL AVENUE
DHAKA 1000
Phone
00919650990788 1678582818
Number

J. DECLARATION:

a. I do not hold any other passport(s) other than those detailed above.
b. I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them.
c. I declare that the information given in the form is complete and correct and the visit to India will be undertaken for the
purpose indicated in the application.
d. I understand that in case the information provided in the form is found to be incorrect, I will be liable for denial of visit/ entry
or deportation and/ or other penalties during the visit as provided by Indian law.

..……………………………………
04-MAR-2020
Date :………………………. Applicant’s signature (as in Passport)

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