EMBASSY OF INDIA / CONSULATE GENERAL OF INDIA

UAE

VISA APPLICATION FORM

PART. A

FOR OFFICIAL USE ONLY

No. Date & Type of Visa issued. Three
Two recent
Amount of visa fee received. studio passport
Date of which passport returned to applicant. photographs (with
front view)
to be attached to
the visa form.
One to be affixed
in this space.

First Name Middle Name Last Name

Mr. / Mrs./ Miss _______________________________________________________________________

Previous Name ________________________________________________________________________
Father’s /Husband’s Name _______________________________________________________________
Place and Date of Birth _________________________________________________________________
Local Address / Tel. No. _________________________________________________________________
Profession (Details of present employment)___________________________________________________
Passport No. ______________________________ Date of issue _________________________________
Issued by _________________________________ Expiring on _________________________________
Present Nationality _____________________________________________________________________
Any other Nationality ___________________________________________________________________
present or previous _____________________________________________________________________

Whether Visa has been refused previously?

If so, give details _______________________________________________________________________
Details of previous visits to India, if any _____________________________________________________

CHILDREN INCLUDED IN THE APPLICANT’S PASSPORT

Name Place & Date of Sex Relationship Identification mark

birth if any
No. of entries Single Double Triple / Multiple

Countries from which entry Period for which visa

into India will be made. is required.

Purpose of journey Transit / Tourist / Business / Education / Others

Places in India proposed to be visited

Approximate date of departure

and arrival

Port of first entry into India

Port of Final Departure from India

PART. B

NOT TO BE FILLED BY APPLICANTS FOR TOURIST VISAS

Whether holding valid “No objection” to return to India and if so, give particulars.

NAME AND ADDRESS OF TWO REFERENCE

In the country of Applicant (1)

(2)

In India (1)

(2)

PART. C

I, ______________________________________hereby undertake that I shall utilize my visit to India for

the purpose for which visa has been applied and shall not, on arrival in India, try to obtain an employment
or set up business or extend my stay for any purpose. I fully understand that if any of the particulars
furnished above are found to be incorrect or if any information is found to have been with held, the visa is
liable to be canceled at any time.

(Signature of the Applicant)

Date :
Place : DUBAI
Note : The request for business Visas should be accomplished by a
letter from the employer giving the position of applicant in
the company, the reason for the visit with particulars of
companies to be visited.
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