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    BGDDW1FEFA23MD890712

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    Md.Zakaria
    MD Zakaria, a 35-year-old married man from Bangladesh, has applied for a tourist visa to visit India. He works as an engineer for Incepta Pharmaceuticals Limited in Bangladesh. The visa application provides his personal details, passport information, contact information, purpose and details of the planned visit to India, references in both Bangladesh and India, and a signed declaration agreeing to abide by Indian visa rules. He plans to visit Kolkata and Delhi over 12 months for tourism, recreation and sightseeing purposes.

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    BGDDW1FEFA23MD890712

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    Md.Zakaria
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    MD Zakaria, a 35-year-old married man from Bangladesh, has applied for a tourist visa to visit India. He works as an engineer for Incepta Pharmaceuticals Limited in Bangladesh. The visa application provides his personal details, passport information, contact information, purpose and details of the planned visit to India, references in both Bangladesh and India, and a signed declaration agreeing to abide by Indian visa rules. He plans to visit Kolkata and Delhi over 12 months for tourism, recreation and sightseeing purposes.

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    MD Zakaria, a 35-year-old married man from Bangladesh, has applied for a tourist visa to visit India. He works as an engineer for Incepta Pharmaceuticals Limited in Bangladesh. The visa application provides his personal details, passport information, contact information, purpose and details of the planned visit to India, references in both Bangladesh and India, and a signed declaration agreeing to abide by Indian visa rules. He plans to visit Kolkata and Delhi over 12 months for tourism, recreation and sightseeing purposes.

    Copyright:

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

    BGDDW1FEFA23MD890712

    Uploaded by

    Md.Zakaria
    MD Zakaria, a 35-year-old married man from Bangladesh, has applied for a tourist visa to visit India. He works as an engineer for Incepta Pharmaceuticals Limited in Bangladesh. The visa application provides his personal details, passport information, contact information, purpose and details of the planned visit to India, references in both Bangladesh and India, and a signed declaration agreeing to abide by Indian visa rules. He plans to visit Kolkata and Delhi over 12 months for tourism, recreation and sightseeing purposes.

    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

    BGDDW1FEFA23

    A. Personal Particulars (As in Passport)


    Surname (As in Passport) ZAKARIA
    Application Id : BGDDW1FEFA23

    Given Name (As in Passport) MD


    Previous/other Name if any Not Applicable
    Gender MALE Marital Status MARRIED
    Date of Birth 12-JUL-1989 Religion ISLAM
    Place of Birth Town/City SIRAJGONJ Country of Birth BANGLADESH
    Citizenship /National ID No 3272118641 Educational Qualification GRADUATE
    Visible identification marks SPOT ON BESIDE LEFT EYE
    Current Nationality Nationality by Birth/
    BANGLADESH Naturalization BY BIRTH
    Any Other Previous/Past Nationality Not Applicable
    B. Passport Details
    Passport No. A12368991 Date of Issue ( dd/mm/yyyy ) 20-SEP-2023
    Place of Issue DHAKA Date of Expiry ( dd/mm/yyyy ) 19-SEP-2033
    Any other Passport/Identity Certificate held (if yes ,please fill in the following) NO
    Web Registration Date : 02-OCT-2023

    Country of Issue Place of Issue


    Passport/IC No. Date of issue (dd/mm/yyyy)
    Nationality/Status
    C. Applicant's Contact Details
    Present PORRA Phone No
    Address MANIKGONJ Mobile /Cell No 8801798772798
    MANIKGANJ, BANGLADESH
    1800 Email address [email protected]

    Permanent WARD NO-6


    Address CHANDIDASGANTI
    SIRAJGONJ
    D. Family Details
    Relation Name Nationality Prev. Nationality Place/Country of Birth
    SIRAJGONJ
    Father's MD SAMSUL HOQ BANGLADESH BANGLADESH BANGLADESH
    SIRAJGONJ
    Mother's MIST ZAHANARA BEGUM BANGLADESH BANGLADESH BANGLADESH
    SIRAJGONJ
    Spouse MST TASLIMA NASRIN BANGLADESH BANGLADESH BANGLADESH
    Were your Grandfather/Grandmother(Paternal/Maternal) Pakistan Nationals Or belong to Pakistan held area : NO

    MD ZAKARIA
    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 TOURIST VISA No of Entries MULTIPLE
    Period of Visa ( Month) 12 Month Expected Date of Journey 07-MAR-2024
    Port Of Arrival BY AIR/ HARIDASPUR Port of Exit BY AIR/ HARIDASPUR
    Required Detail of TOURIST VISA
    Places to be Visited KOLKATA,DELHI

    Purpose of Visit : TOURISM,RECREATION,SIGHT-SEEING


    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 NO
    Have you been refused an Indian Visa or extension of the same previously or deported from India ? NO
    G. Profession/Occupation Details :

    Application Id : BGDDW1FEFA23
    Present Occupation ENGINEER Designation/Rank OFFICER
    Employer name/business INCEPTA PHARMACEUTICALS LIMITED
    Employer Address
    Phone Number BAROBARIA,DHAMRAI,DHAKA
    Past occupation if any ENGINEER
    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 PARK SUITES 31 STEPHEN COURT, 18A, MOTHER TERESA SARANI, KOLKA KOLKATA WEST BENGAL. +91 98303
    01916, [email protected]
    2 .,
    3 .,
    4 .,
    I. Details of Two Reference
    In India In BANGLADESH
    Name BIDHAN BISWAS ARIFUZZMAN SARDAR
    Address SRI KRISNAPUR MANIKGONJ SADAR
    SHIVPURI MADHYA
    PRADESH
    Phone Number +919883637665 +8801916545921
    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.

    02-OCT-2023 ................................
    Date : ...................... Applicant's signature (as in Passport)

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