Visa Application Form for Pakistani Nationals


                              ( TO BE COMPLETED BY THE APPLICANT )


1. Name in full (in block letters) Mr. / Mrs. / Miss.

2. Address (House No / Village / City / Thana / Dist. / Province):
    (i) Present(House No / Village) :

    (City / Thana) :

    (Dist. / Province) :

    (ii) Permanent(House No / Village) :

    (City / Thana) :

    (Dist. / Province) :

3. Father's / Spouse’s Name (in full) :

    Nationality :
    Occupation :

    Address :

4. Date of Birth : Pick a date

5. Placeof Birth :

6. Religion :

7. Nationality :

8.(i) Distinguishing Marks :
(as described in the Passport)

8.(ii) Colour of (a) Eyes : (b) Hair :

8.(iii) Height : Meters Cms

9.(i) Present occupation in detail (with designation, rank, department, name of employer or if in Business, the        nature of business):
9.(ii) Past Occupation :

10. Duration : & Date of Commencement of visa applied for : Pick a date

11. Place of visit / stay (or break of journey in case of transit visa) desired :
SI.No Name of Place Father's
Name :
House No / Street Village / Town Police / Station Dist / State Whether Place is in Cantt. Area? Say (Yes/No)
Yes No
Yes No
Yes No
Note: In the vertical column No. 1 the applicant should mention only that place which he / she would visit first in India. No request for change of this place will be entertained at later stage.

12. Check post of :
(i) Entry into India : Attari / Bombay / Delhi
(ii) Exit from India : Attari / Bombay / Delhi

(Please see instruction no.4)

13. Children accompanying the applicant, if any:
SI.No Name Sex Date of Birth
1. Pick a date
2. Pick a date
3. Pick a date

14. Name, Parentage ,detailed address with contact numbers of at least two persons in India to whom the         applicant is known:
       i) Name :
          Referee's Parentage :
          Address :

       ii) Name :
          Referee's Parentage :
          Address :

15.(a) International / Special Pakistan passport held
              ( Applicable or Not Applicable ) :
               No : issued at on  
               with endorsement for journey to India valid unto

15.(b) Details of any other passport(s) previously held, and if so, whether passport(s) renewed/ lost, etc.
              ( Applicable or Not Applicable ) :
               No : Date of Issue :  

15.(c) Any other foreign passport / Identity Card held
              ( YES / NO ) :
       Country of Issue :
       Passport(s) No :
       Date :   
       Place of Issue :
       Nationality / Status described therein :

16 . Object of visit (Give detailed information including documentary evidence)

17 . Has permission to visit or to extend stay in India previously been refused ? ( YES / NO ) :
          If so, when and by whom ?
     (Mention control No. and date also)
18. Details of last visit: Category, number, date and office of issue of visas previously held, if any:
19. Details of previous pending application or unavailed of Visa, if any (with control no. and date):

20. For Transit Visas only ( Applicable or Not Applicable ) :
     (i) Place of final destination :
     (ii) Is passport valid for country of destination ?
     (iii) Has visa / immigration permit of that country been
          obtained ?
     (iv) If so, its No :
                    date :  
                    place of issue :
     (v) The address and contact number of stay in India:

21. If you have migrated from India to Pakistan on or after 1st March 1947, please state ( Yes or No )
     (i) Approximate date of migration:  
     (ii) Address in India before migration:

22. Do you belong / have you previously belonged to
      military / semi-military / police / semi-police organization ? ( Yes or No ) :
     (If the answer is Yes, please give details):

23. I hereby declare that all the statements and information given above by me in this application are true to
      the best of my knowledge and belief. I also declare that I have not submitted any application for visa for
      India under any other name, surname, maiden name, etc. and that the passport held by me at present as
      indicated in column 15 is the only passport held by me at present. I realize that should any of the above
      statements be found to be false, untrue or incorrect, my visa will be liable to cancellation by any
      competent authority and I will be liable to such other penalties as may be prescribed.
     Place :
     Date :   Pick a date
     Tel No :



1) Mode of acquiring the present Nationality by the Applicant :
a) By Birth  b) By naturalization  c) Any other  

2) Any other Nationality of Applicant's Father :
 ( other than the one mentioned in Part-A )

3) Name & Nationality of Applicant's Mother :
Name :  
Nationality :  

4) Any other Nationality of Applicant's Mother :
 ( present or previous )

5) Name & Nationality of Applicant's paternal Grandfather :
Name :  
Nationality :  

6) Name & Nationality of Applicant's paternal Grandmother :
Name :  
Nationality :  

7) Name & Nationality of Applicant's maternal Grandfather :
Name :  
Nationality :  

8) Name & Nationality of Applicant's maternal Grandmother :
Name :  
Nationality :  

9) Nationality of Applicant's Spouse :

10) Countries visited by the Applicant during the last 10 years :

11) The address of friends / relatives / places of stay during the previous travel to India :

12) Places from where visa was acquired during previous visits :

13) Telephone and Mobile number in India of :
Applicant :  
His / Her sponsor :