Control No.

___________

High Commission of India-Islamabad

Visa Application Form for Pakistani Nationals
For Office Use Only
Visa Category
Visa No.
Entry Port
Exit Port
Valid for stay at places specified below for
First Visit
(i)
(ii)
(iii)
(iv)
(v)
(vi)
(vii)
(viii)

Date of Issue
Duration

Days

Date of Expiry
No. of Entries

Second Visit

Third Visit

TO BE FILLED BY THE APPLICANT

Personal Particulars
1.

Surname

2.

Name

3.

Sex

6.

Religion

8.

Visible identification marks

4.

Date of Birth
7.

5.

Place of Birth

NIC Card No.

9. Address (House/Village/Tehsil/Distt./Province)
(i) Present:

Photo
Phone No.

Email Address

Mobile No.

(ii) Permanent:
Phone No.
10.

Present Occupation

Past Occupation

11.

Details (with designation, rank, department, name of employer

or if in business, the nature and address of business

12.

Fathers Name

Occupation

13.

Spouses Name

Occupation

14.

15.

Do you belong/previously belonged to Military/Semi-Military/Police/Govt. organization ? If yes, please state details:

Passport Details

Place of Issue
16.

Passport No.

Dt. of Issue

Dt. of Expiry

Previous Passport No.

Any other foreign passport/identity certificate held: (Yes/No)

Country of Issue

If yes, give details below:

Passport/IC No.

Date of Issue

Place of Issue

Nationality/Status described therein

17. Visa Information
Category

Purpose of visit

No. of Entries

Period of Stay (days)

Entry Point & Mode of Travel

Previous Indian Visa No.
18.

Starting From
Exit Point & Mode of Travel

Date of Issue

Category

Has permission to visit or to extend stay in India previously been refused? If so, when and by whom (Mention
Control No. and date also)

19.

20.

Details of previous pending application or un-availed visa, if any (with Visa No. / Control No. /date):

Places of visit (More than one entry/visit is allowed only in case of Business Visa)
Second Visit
First Visit
Place

State

Place

State

Third Visit

Place

State

(i)
(ii)
(iii)
(iv)
(v)
(vi)
(vii)
(viii)
21.

Address of relatives/business associates/contact persons at places of visit: (Visa is Not Valid for Protected / Cantt.
Areas) (in the same order as in Col. 20)

Name/Fathers Name

Relationship
with applicant

H.No./Street/Mohallah/Post Office

Village/Town/
City

District/State

Telephone
No.

1.
2.
3.
4.
5.
6.
7.
8.
22.
Place

Address at Place of Stay (in the same order as in Col. 20) (Only for Business/Conference/Medical visa applicants)
Name and Address of Hotel

District/State

Telephone No.

1.
2.
3.
4.
5.
6.
7.
8.
23.

For Transit Visa Only

Place of final destination

st

24.
If you have migrated from India to Pakistan on or after 1 March, 1947, please state:
(i) Approximate date of migration:
(ii) Address in India before migration:

25.

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 also declare that I have not submitted any application for visa to visit India under any other name,
surname, maiden name etc and that the passport held by me as indicated in column 15 is the only valid Pakistani passport
that I hold. I realize that should any of the above statements be found to be false, untrue or incorrect, my visa will be liable
to cancellation by any competent authority and will be liable to such other penalties as may be prescribed.

Place: ________________________
Date: ________________________

__________________________________
Signature of applicant