APPLICATION FORM

( Visa Extension )

130313U1TU83 Application ID No. 130313U1TU83 Appointment Date FOR OFFICE USE ONLY Reg. No. B 0 0 4 S D N 2 0 1 3 14/03/2013

Personal Details
Surname Given Name AHMED OMER Sex Male Date of Birth 03/02/1991 Age as on today Year(s) 22 Month(s) Place of Birth ELGASARIF,ELGASARIF,SUDAN Father's Name OMER Mother's Name Spouse's Name Any Identification mark(s) preferably visible BROWN Present nationality SUDAN Manner of acquiring present nationality Birth Date of acquiring present nationality Whether holding dual NO nationality? If yes, Name of the country of second nationality provide the following:- Passport No. of second country Date of Issue Date of Expiry Whether travelled on this passport earlier to India Paste your Recent passport size photograph here

Height (in cm) 1 Day(s)

0 10

Previous nationality

Whether person of Indian Origin

Address City ELGADARIF ELGADARIF

NO

Address of last residence (Outside India)

Country SUDAN

Address intended for longer stay in India (Registration)

Address ZEBABAGH HNO 12.2.894/3/1 City/District HYDERABAD Pin Code Phone Number State Mobile Number ANDHRA PRADESH

Any Other Address in India

Address City/District Pin Code Phone Number State 8801332460 Mobile Number

Email/Occupation/Profession Details
E-Mail Id Profession/Occupation STUDENT

Passport Details
Passport Number Date of Issue P00192953 03/08/2010 Place of Issue Expiry Date SUDAN, OMDURMAN 02/08/2015

Visa Details
Visa Number AP3911619 Date of Issue 25/03/2012 Valid For Multiple Entry Special endorsement, if any Place of Issue Expiry Date Visa Type SUDAN, KHRTOUM 24/03/2013 STUDENT VISA

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130313U1TU83 Application ID No. 130313U1TU83 Appointment Date 14/03/2013

Organization/Company/Institute/Hospital Details
Name ST MARYS COLLEGE Address YOUSUF GUAD State ANDHRA PRADESH Telephone Number

City Email ID

HYDERABAD

Arrival Details
Place of embarkation/boarding for India Date of arrival in India Place of disembarkation/arrival in India Mode of Journey Air Purpose of visit to India Studies KHARTOUM,KHARTOUM,SUDAN 12/09/2012 HYDRABAD Flight /Ship /Bus /Train No.

Previous Registration Details in India

Registration Number Name Name Address City Phone Number Place of Registration Nationality Relationship Country Visa Type Duration From Passport Number To

Details of family members/attendant/dependents, if any accompanying.

Relationship

Person to be contacted in Case of Emergency

Category

Missionaries-Student

Military service details

Organisation Rank Country of Last Posting Designation Place of Last Posting

Current Registration Details

Are you registered in current locality FRRO/FRO in the current visit? NO Current Registration No.

Current Extension Details

Have you got extended visa in current visit in current locality FRRO/FRO? NO Current Extension No.

Visa Extension Details

Wether Previously in India? Whether Permission to stay in India has been Previously refused? Whether Permission to extend stay in India has been Previously granted? Period of Extension requried Year(s) Month(s) Reason for extension FOR DEGREE In case of Missionary - Nature of work

12

Day(s)

Signature of the Applicant Date_ _ _ _ _ _ _ _ _ _ _ _ _

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130313U1TU83 Application ID No. 130313U1TU83 Appointment Date 14/03/2013

Instruction

Registration office address

Office Name Address City State Pin Code Phone Number : : : : : : FRRO - Hyderabad Office of the FRRO, Old Begumpet Airport, Begumpet HYDERABAD ANDHRA PRADESH 0 040-27900211

Office opening time: 10.00 Applications are accepted upto 13.00

closing time:

18.00

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