PHOTO
VISA APPLICATION FOR INDIAN NATIONALS
PART “I”
1. Full Name: _______________________________________________________________
2. Date of Birth: ____________________ 3. Place of Birth: ________________________
4. Religion: _________________________ 5. Nationality by Birth: _____INDIAN _________
6. (a) Distinguishing marks:_____NIL_________________________________________
(b) Colour of Hair:__BLACK______ Colour of Eyes __BLACK__________________
7. (a) Occupation (Give details designation, department, Name of employer and nature of
business) ________________________________________________________________
(b) Educational Qualification _______________________ ______________________
8. Give detail if previously employed in Military, Police, Govt ______________________
_____________________________NIL____________________________________
9. Address: (Village, Police Station, District & Province) including Phone No, Mobile No
(a) Permanent (in India) _______________________________________________
_________________________________________________________________________
(b) Working / Residential Address ___________________________________________
___________________________________________________________________________
(c) Visiting address in Pakistan, ____________________________________________
________________________________________________________________________
10. International Passport No: __________________ Dated: ___________________________
Issued by the_GOVT.OF INDIA at___________ valid upto _____________________
11. (a) Father's Name________________________________________________________
(b) Spouse’s Name____NIL_______________________________________________
(c) Occupation of Father/Spouse (with designation, Department, Name of employer or if
in business, the nature of business and full address)
___________________________________________________________________
12. Has permission of visit to or extend in stay in Pakistan previously been refused? If so state
when and why? ____NIL___________________________________________________
13. Whether previously visited Pakistan and if so, state:-
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(a) Place of Previous Visit________NIL__________________________________
(b) Place of Residence (for previous visit) _________NIL_______________________
(c) Period of stay with dates (previous visit) _________NIL_____________________
14. Type, Number, Date and Office of issue of Visa previously or now held, if any
________________________NIL_____________________________________________
15. Object of Visit______________________________________________ _______________
(Give detailed information including documentary evidence, if any)
16. Visa applied for: (a) Type: VISIT / Business, Single/Double/Multiple
(b) Duration (days) ______________ _________ ___________
(c) Commencing from _____ABU DHABI _____________ _____
17. Whether the applicant would travel by Road/Air/Sea and if by Air/Sea, name the Airline/Ship
________________BY AIR__________________________________________________
18. Port of entry in Pakistan_____________________Exit______________________________
19. Expected date of departure__________________ Stay in UAE_________ _____________
20. Name, complete address and Tel No of two persons to whom applicant is well known.
(a) In the country of the applicant (U.A.E)
1. _________________________________________ _________________________
2. __________________________________________________________________
(b) In Pakistan
1. ___________________________________________________________________
2. ___________________________________ ________________________________
21. If you have migrated from Pakistan to India, state: -
(a) Reason of Migration__NIL_________________________________________
(b) Approximate date of Migration ___NIL _____________________________
(c) Address in Pakistan before Migration___NIL___________________________
____________________________________________________________________________________________________________________________
PART II
ADDITIONAL PARTICULARS
S. Place for which Name and Relation with Visiting / Staying address
NO Visa Required the person to be Visited In Pakistan
1
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Page "3"
FOR SEAMAN'S VISIT
(a) Name of the last ship : _____________________________________________
(b) Port Hold : _____________________________________________
(c) Port and date of recruitment : _____________________________________________
(d) Port and date of discharge : _____________________________________________
(e) Whether you desire a transit visa : _____________________________________________
(f) If so, probable date of commencement of journey: _________________________________
(g) Whether you desire a re-entry visa/if so, probable date of journey for return to India
________________________________________________________________________
(i) Country of final destination. ________________________________________
(ii) Is Passport valid for the country? ________________________________________
(iii) Has Visa/ migration permit of that country been obtained? _____________________
(iv) Place of visit/break of journey in transit required. ________________________
(v) Purpose of Visit ___________________________________________________
(vi) Full Address ___________________________________________________
(vii) Probable duration of break of country in transit. _____________________________
I hereby declare that all the statements and information given by me in this application are
true to the best of my knowledge and belief. I realize that if any of the above statements are found
to be false, untrue or incorrect; my visa will be liable to cancellation by any competent authority.
I belong/do not belong/have previously belonged/have not previously belonged to a
Military/Police/Semi Police Organization (Give details of answer if affirmative).
I hereby enclose four copies of the application, four photographs and the prescribed visa
fee in cash.
Place __ABU DHABI__ ____________________
Date _________________ (Signature of Applicant)
UNDERTAKING
I, ___ ________________ ________ holding Indian Passport No_________________ date
issue ______________ date Expire _________________________ issued at ______________
solemnly declare that I will not apply for Pakistan Citizenship / Emergency Certificate during my
stay in Pakistan.
___________________
(Signature of Applicant)
FOR USE BY PAKISTAN EMBASSY/CONSULATE ONLY
1. Granted Visa No: _Con_________/2022___________ Dated:_______/______/2022
_________
For _Single Entry / Multiple Entry ___VISIT ____ journey/journeys, valid for ______ days/months,
for stay at places specified below:-
(a) ______________________ (ii)_________________________________
(iii) _______XX_________________________________(iv) ______XX_______________________
2. No and date of letter issued by the Interior Division, Islamabad. ______________________
Authority for grant of visa: Head of Mission_________________________________
3. Special endorsement, if any: ______________________________________________
4. Duplicate copy given to applicant who should carefully note the condition of the visa stated
above and hand it over to the check post of entry in Pakistan.
5. Visa should be utilized within ___Three months ____________from date of issue.
COMPUTER PERFORMA
Ocation Serial No
1. Ministry of Interior__________________________________
2. Department________________________________________
3. Subject of the Case__________________________________
4. Full Name ________________________________________________
5Date of Birth__________________________ 6.Sex (male/female) __________
7. Fathers’ /Husband Name.____________________________________
8. Profession/Designation______________________________
9. Passport No._________________________ 10.Nationality___INDIAN___
11. Address/Address in __________________________________
Pakistan where to stay _____________________________________
______________________________
___________________________________________________
12. Permanent Address__________________________________________
____________________________________________________________
_____________________________________________________
13. Visit Sponsored by________________________________________
14. Purpose of visit/ Extension in stay____________________
FOR THE USE OF CLEARING AGENCY
Cleared/Not cleared C/N Clearing Criteria (R/G)
Reference No.__________ Dated
___________________________________________________________________________
NOTE
INSTRUCTIONSN FOR FILLING THE PROFORMA
a. The form should be filled in CAPITAL letters.
b. All the boxes ( ) should be left blanks.
c. Maximum information should be provided in the items 1 to 14.
d. In case of foreigner his contact address in Pakistan abroad be mentioned in Item No.(11)his
address abroad be mentioned in item No.(12) above.
