India Visa Application
Personal Information
Have you changed your name?
*
Yes
No
If yes, give details?
Name on Passport
*
First Name
Middle Name
Last Name
Gender
*
Male
Female
Date of Birth
*
/
Month
/
Day
Year
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Town/City of Birth
*
Country of Birth (as written on passport)
*
Did you acquire Nationality by birth?
*
Yes
No
Visible Identification Marks
*
*A visible identification mark can be a mole, scar, tattoo, birthmark or any other permanent mark on your body which can be seen without removing the clothes. It is also acceptable to mention the unusual body parts like an extra sixth finger. Visible parts of the body example: Head; Face; Neck; Wrist; Palm; Hand; Foot. Please explain where it is and what it is.
Father's Name
*
First Name
Middle Name
Last Name
Father's Town/City and Country of Birth
*
Father's previous Nationality (If any)
*
Mother's Town/City and Country of Birth
*
Mother's Name
*
Prefix
First Name
Last Name
Mother's City of birth and previous Nationality (If any)
*
Spouse's Name (type NA, if not applicable)
*
Mr.
Mrs.
Prefix
First Name
Last Name
Spouse's Town/City and Country of Birth
*
Spouse's previous Nationality (If any)
*
Were your parents/ grandparents Pakistan Nationals or belong to Pakistan held area?
*
Yes
No
Highest Level of Education
*
Current Occupation
*
Employers Name/ Business
*
Employers Name/ Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are/were you in aMilitary/Semi-Military/Police/Security, organization?
*
Yes
No
If yes, please fill out the information below
Organization
Designation
Rank
Place of Posting
Postal / Zip Code
Current Nationality
*
Country of Residence
*
Current Physical Address (No P.O. Boxes)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone
*
-
Area Code
Phone Number
Email
*
example@example.com
Passport Information
Passport Number
*
Issuing Country
*
Date of Issue
*
/
Month
/
Day
Year
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Date of Expiration
*
/
Month
/
Day
Year
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Issued by
*
Country Entry Questions
Have you visited India before?
*
Yes
No
Have you been previously denied entry into India before?
*
Yes
No
If you answered "yes", state when and give reasons for denial?
Have you been previously denied entry into another Country?
*
Yes
No
If you answered "yes", state when and give reasons for denial?
Have you ever been convicted of any offense under any system of law?
*
Yes
No
If you answered "yes", state the offense and penalty?
Upload a photo of yourself here*.
*
Browse Files
*Please be sure that this photo is different from your passport photo, and is one with a white background. No sunglasses, scarves or hats.
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Accuracy Statement
*
I certify that all statements given on this application are correct with no omissions.
Applicant Digital Signature (Printed Name):
*
Current Date:
/
Month
/
Day
Year
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Digital Signature of Parent or Guardian (if under 18):
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