Form 'C'

Arrival Report of Foreigner in Individual House

Applicant ID : 0607190V2336

0607190V2336

Accomodation Details
Name Rosa Maria Cardoso

Address L7, Ekta Nagar, Housing Board colony, Mapusa Bardez Goa. 403507

City/District GOA

State GOA

Star Rating Others

Phone no.

Mobile no. 9850772103

Personal Details
Surname SHARIFI
Given name AZIZULLAH
Sex Male
Date of birth 14/05/1997 Special Category Others
Nationality AFGHANISTAN
Address in country where residing permanently
Address YAWAN DISTRICT BASAKHSHAN
City BASAKHSHAN
Country AFGHANISTAN
Address/Reference in India
Address L7, EKTA NAGAR, HOUSING BOARD COLONY, MAPUSA BARDEZ GOA
City/District GOA
State GOA
Pincode 403507
Passport Details
Passport No. 02428929
Place of Issue KABUL,, AFGHANISTAN
Date of Issue 28/03/2017
Expiry Date 28/03/2022

Visa Details
Visa Number VL2761731 Date of Issue 19/06/2019
Valid Till 18/06/2020 Visa Type STUDENT VISA
Place of Issue KABUL,, AFGHANISTAN

Arrival Details
Arrived From BASAKHSHAN , KABUL , AFGHANISTAN
Date of arrival in India 30/06/2019
Date of Arrival in 30/06/2019
Individual House
Time of Arrival in 18:00 Intended Duration of Stay in 365
Individual House Individual House

Whether Employed in India N

Other Details
Purpose of Visit Studies
Next Place BASAKHSHAN
Destination City KABUL
Country AFGHANISTAN
Contact No.(in India)
Mobile No.(in India) 8788447904
Contact No.(Permanently residing
country)
Mobile No.(Permanently residing 0093708875810
country)
Remarks(If any)
Remark

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