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    BGDDW4530F23MD990718

    Uploaded by

    mdfoysal12041996
    The document appears to be a visa application form for an Indian visa submitted by Md Mazharul Islam Rasel, a 24-year-old male citizen of Bangladesh who is applying for a 12-month double entry visa to India for business purposes. The form contains details about the applicant's personal information, passport, contact details, family, occupation, address in India, references, and declaration agreeing to abide by Indian visa rules.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    BGDDW4530F23MD990718

    Uploaded by

    mdfoysal12041996
    73 views2 pages
    The document appears to be a visa application form for an Indian visa submitted by Md Mazharul Islam Rasel, a 24-year-old male citizen of Bangladesh who is applying for a 12-month double entry visa to India for business purposes. The form contains details about the applicant's personal information, passport, contact details, family, occupation, address in India, references, and declaration agreeing to abide by Indian visa rules.

    Original Description:

    INDIA VISA FORM

    Original Title

    BGDDW4530F23MD990718 (1)

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    © © All Rights Reserved

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    The document appears to be a visa application form for an Indian visa submitted by Md Mazharul Islam Rasel, a 24-year-old male citizen of Bangladesh who is applying for a 12-month double entry visa to India for business purposes. The form contains details about the applicant's personal information, passport, contact details, family, occupation, address in India, references, and declaration agreeing to abide by Indian visa rules.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    73 views2 pages

    BGDDW4530F23MD990718

    Uploaded by

    mdfoysal12041996
    The document appears to be a visa application form for an Indian visa submitted by Md Mazharul Islam Rasel, a 24-year-old male citizen of Bangladesh who is applying for a 12-month double entry visa to India for business purposes. The form contains details about the applicant's personal information, passport, contact details, family, occupation, address in India, references, and declaration agreeing to abide by Indian visa rules.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    HIGH COMMISSION OF INDIA

    Paste your unsigned


    DHAKA(BANGLADESH) recent color photograph.
    Size: 2" X 2"

    Visa Application Form

    Signature

    BGDDW4530F23

    A. Personal Particulars (As in Passport)


    Surname (As in Passport) RASEL
    Application Id : BGDDW4530F23

    Given Name (As in Passport) MD MAZHARUL ISLAM


    Previous/other Name if any Not Applicable
    Gender MALE Marital Status SINGLE
    Date of Birth 18-JUL-1999 Religion ISLAM
    Place of Birth Town/City GAZIPUR Country of Birth BANGLADESH
    Citizenship /National ID No 3754402174 Educational Qualification HIGHER SECONDARY
    Visible identification marks NA
    Current Nationality Nationality by Birth/
    BANGLADESH Naturalization BY BIRTH
    Any Other Previous/Past Nationality Not Applicable
    B. Passport Details
    Passport No. A05523218 Date of Issue ( dd/mm/yyyy ) 22-NOV-2022
    Place of Issue DHAKA Date of Expiry ( dd/mm/yyyy ) 21-NOV-2032
    Any other Passport/Identity Certificate held (if yes ,please fill in the following) NO
    Web Registration Date : 05-NOV-2023

    Country of Issue Place of Issue


    Passport/IC No. Date of issue (dd/mm/yyyy)
    Nationality/Status
    C. Applicant's Contact Details
    FLAT# SA#937, RS# 1647,
    Present PLOT# 937 Phone No 01768224546
    Address HAFIZ UDDIN SARKER TONGI Mobile /Cell No 8801768224546
    [email protected]
    GAZIPUR, BANGLADESH 1712 Email address OM

    FLAT# SA#937, RS# 1647,


    Permanent PLOT# 937
    Address HAFIZ UDDIN SARKER TONGI
    GAZIPUR
    D. Family Details
    Relation Name Nationality Prev. Nationality Place/Country of Birth
    GAZIPUR
    Father's MD AMINUL ISLAM BANGLADESH BANGLADESH BANGLADESH
    GAZIPUR
    Mother's MST MORIUM BEGUM BANGLADESH BANGLADESH BANGLADESH
    Marital Status Single
    Were your Grandfather/Grandmother(Paternal/Maternal) Pakistan Nationals Or belong to Pakistan held area : NO

    MD MAZHARUL ISLAM RASEL


    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 DOUBLE ENTRY No of Entries SINGLE
    Period of Visa ( Month) 12 Month Expected Date of Journey 15-DEC-2023
    Port Of Arrival BY AIR/ HARIDASPUR Port of Exit BY AIR/ HARIDASPUR
    Required Detail of DOUBLE ENTRY
    Purpose of Visit : DOUBLE ENTRY VISA
    F. Previous Visit Details
    Have You Ever visited India ? NO
    Address where You stayed in
    India ,
    Cities in India Visited
    Type of Visa Visa Number
    Visa Issued Place Date of Issue
    Countries visited in last 10 years NA
    Have you been refused an Indian Visa or extension of the same previously or deported from India ? NO
    G. Profession/Occupation Details :
    Present Occupation PRIVATE SERVICE Designation/Rank DRIVER

    Application Id : BGDDW4530F23
    Employer name/business NAPTUNE LAB
    Employer Address 55/B, NOAKHALI TOWER
    Phone Number 01772773739
    Past occupation if any
    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 GULSHAN LODGE 115/2, COLLIN ST, JANBAZAR, TALTALA, KOLKATA, WEST KOLKATA WEST BENGAL. +91 90518
    56290,
    2 .,
    3 .,
    4 .,
    I. Details of Two Reference
    In India In BANGLADESH
    Name MONTOSH SARKER MM BORHAN UDDIN
    9B, MARQUIS STREET, 1ST
    FLOOR, FLAT NO: 103,
    Address KOLKATA - 700016 56,57 MOTIJHEEL, ROAD
    KOLKATA WEST BENGAL DHAKA 1000
    Phone Number +91 9836478335 01985289528
    K. 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.
    e. I will also submit hard-copy all the uploaded documents along with the print of application to submit to the concerning Indian
    Mission or Agency for processing of visa application.

    05-NOV-2023 ................................
    Date : ...................... Applicant's signature (as in Passport)
    Biometric Enrollment is not required till 17/01/2028.

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