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DJORDJA RADOJLOVICA 7A
11040 BELGRADE
https://eoibelgrade.gov.in/
381 11 2667 990
Signature
SRBBV005FE15
Application Id :SRBBV005FE15
Date of birth
Place of Birth Town/City
Citizenship /National ID No
Visible identification marks
Current Nationality
Female
10-JUL-1992
LOZNICA
1007992778626
NONE
SERBIA
Marital Status
Religion
Country of Birth
Educational Qualification
Single
CHRISTIAN
SERBIA
GRADUATE
BY BIRTH
20-JUL-2010
20-JUL-2020
009218874
PU U SAPCU
Passport No.
Place of issue
Any other Passport/Identity Certificate held (if yes ,please fill in the following) NO
Country of issue
Place of issue
Passport/IC No
Date of issue(dd/mm/yyyy)
Nationality/status
C. Applicants Contact Details
Present
address
NN / BRASINA
BRASINA/MALI ZVORNIK /MALI ZVORNIK
SERBIA, SERBIA 15318
Phone No
7796-365
064 45 88 631
Email address aleksandarat.madrid@gmail.com
Mobile /Cell No
Permanent NN / BRASINA
Address
BRASINA/MALI ZVORNIK /MALI ZVORNIK
SERBIA
D. Family Details
Relation
Name
Nationality
Prev. Nationality
Place/Country of Birth
Fathers
RADENKO
SERBIA
LOZNICI
SERBIA
Mothers
MIROSAVA
SERBIA
LOZNICA
SERBIA
Spouse
Were your Grandfather/Grandmother(Paternal/Maternal) Pakistan Nationals Or belong to Pakistan held area : NO
E. Details of Visa Sought
(Visa shall be valid from the Date of Issue and not from the Date of Journey)
EMPLOYMENT VISA
(Month) 12 Month
BANGALORE
ALEKSANDRA JOVANOVIC
No of Entries
Expected Date of Journey
Port of Exit
Single
05-DEC-2015
Required Detail of
EMPLOYMENT VISA
Qualifiaction/Emp.EPFO ID
Company Name
Address
Designation
Salary
NA
INDUSTRIAL PHARMACIST
VENKAT CHARAN ASSOCIATES
185,RAMKRISHNA NILAYAM BANGALORE
MODEL
2100
3585473
Visa Number
Date of Issue
28-JAN-2015
Have you been refused an Indian Visa or extension of the same previously or deported from India ?
If yes above mention when and by whom with control
No/Date
G. Profession/Occupation Details
Present Occupation WORKER
Designation/Rank
STEVAN SREMCA
Employer name/business DEMONS MODEL MENAGAMENT
Employer Address 37/11 BELGRADE
Phone Number
Past occupation if any
Are/have you worked with Armed forces/ Police/ Para Military forces ? NO
Organization
Designation
Place of Posting
Rank
H. Address of Place of Stay / Hotel
Place/Hotel Name
Address of Place / Hotel
In
MIROSAVA JOVANOVIC
State
Phone No.
SERBIA
J. DECLARATION:
a.
b.
c.
d.
I do not hold any other passport(s) other than those detailed above.
I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them.
I declare that the information given in the form is complete and correct and the visit to India will be undertaken for the
purpose indicated in the application.
I understand that in case the information provided in the form is found to be incorrect, I will be liable for denial of visit/ entry
or deportation and/ or other penalties during the visit as provided by Indian law.
02-DEC-2015
Date :.
..
Applicants signature (as in Passport)
Application Id :SRBBV005FE15