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APPLICATION FORM ( Registration ) 2804147T5Q2R Application ID No. 2804147T5Q2R Appointment Date and Time 29/04/2014

APPLICATION FORM

( Registration )

APPLICATION FORM ( Registration ) 2804147T5Q2R Application ID No. 2804147T5Q2R Appointment Date and Time 29/04/2014 11.00

2804147T5Q2R

Application ID No.

2804147T5Q2R

Appointment Date and Time

29/04/2014 11.00

FOR OFFICE USE ONLY Reg. No. B 0 0 1 M M R 2 0
FOR OFFICE USE ONLY
Reg. No.
B
0
0
1
M
M
R
2 0
1 4
Personal Details
Surname
Paste your
Given Name
BIAK LAL
Recent passport size
Sex
Male
Date of Birth
03/03/1983
Height (in cm)
0
photograph here
Age as on today
Year(s)
31
Month(s)
1
Day(s)
25
Place of Birth
SINGGIAL,CIKHA,MYANMAR (BURMA)
Father's Name
KAM SUAN
Mother's Name
Spouse's Name
Any Identification mark(s) preferably visible
NIL
Present nationality
MYANMAR (BURMA)
Previous nationality
Manner of acquiring present nationality
Birth
Date of acquiring present nationality
Whether holding dual
nationality? If yes,
provide the following:-
NO
Name of the country of second nationality
Passport No. of second country
Date of Issue
Date of Expiry
Whether travelled on this passport earlier
to India
Whether person of Indian Origin
NO
Address of last residence (Outside India)
Address
SINGGIAL, CIKHA TOWNSHIP, CHIN STATE
City
CIKHA
Country
MYANMAR (BURMA)
Address intended for longer stay in India (Registration)
Address
POLE NO-61, HASTSAL, UTTAM NAGAR
City/ District
DELHI
State
DELHI
Pin Code
110059
Phone Number
Mobile Number
7503275227
Any Other Address in India
Address
City/ District
State
Pin Code
Phone Number
Mobile Number
Email/Occupation/Profession Details
E-Mail Id
Profession/Occupation
OTHERS

Passport Details

 

Passport Number

30500079362

Place of Issue

INDIA, NEW DELHI

Date of Issue

04/08/2011

Expiry Date

09/05/2015

Visa Details

Visa Number

 

Place of Issue

,

Date of Issue

 

Expiry Date

 

Valid For

 

Visa Type

 

Special endorsement, if any

 

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Application ID No.

Application ID No. 2804147T5Q2R 2804147T5Q2R Appointment Date 29/04/2014 Organization/Company/Institute/Hospital Details

2804147T5Q2R

2804147T5Q2R

Appointment Date

29/04/2014

Organization/Company/Institute/Hospital Details

Name Address State City Telephone Number Email ID Arrival Details Place of embarkation/boarding for India
Name
Address
State
City
Telephone Number
Email ID
Arrival Details
Place of embarkation/boarding for India
KHENMAN,CIKHA,MYANMAR (BURMA)
Date of arrival in India
18/12/2010
Place of disembarkation/arrival in India
HILLI
Mode of Journey
Others
Flight/ Ship/ Bus/ Train No.
Purpose of visit to India
Others
Previous Registration Details in India
Registration Number
Place of Registration
Visa Type
Duration From
To
Details of family members/attendant/dependents, if any accompanying.
Name
Nationality
Passport Number
Relationship
Person to be contacted in Case of Emergency
Name
Relationship
Address
City
Country
Phone Number
Category
Refugee
Military service details
Organisation
Designation
Rank
Place of Last Posting
Country of Last Posting
Signature of the Applicant

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Application ID No.

Application ID No. 2804147T5Q2R 2804147T5Q2R Appointment Date 29/04/2014 Instruction Document required for Registration

2804147T5Q2R

2804147T5Q2R

Appointment Date

29/04/2014

Instruction Document required for Registration Registration office address Office Name : Address : City/District :
Instruction
Document required for Registration
Registration office address
Office Name
:
Address
:
City/District
:
State
:
FRRO NEW DELHI
EAST BLOCK 8, SECTOR 1 , R.K. PURAM, NEW DELHI
DELHI
DELHI
Pin Code
:
0
Phone Number
:
01126711443
Office opening time:
9.30
closing time:
18.00
Applications are accepted upto 15.00

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