High Commission of India-Islamabad

Visa Application Form for Pakistani Nationals

For Office Use Only

Visa Category Visa No. Date of Issue Date of Expiry
Entry Port Exit Port Duration Days No. of Entries
Valid for stay at places specified below for
First Visit Second Visit Third Visit

TO BE FILLED BY THE APPLICANT

Please use ARIAL Font Size 9 only for filling the form. Form is to be submitted in duplicate.

Section A. Personal Particulars

Enter Surname and Name/Date and Place of Birth/Religion as given in passport. In Sex column, write M for Male/F for
Female.
1. Surname SOCHI(HINDU)
2. Name JETHO MAL
Photo
20-04-
3. Sex M 4. Date of Birth
1962
5. Place of birth KAMBER
Paste (do not staple)
43202-1064082- recent passport size studio
6. Religion HINDU 7. NIC Card No.
3 photograph (35mm x 45mm)
8. Visible identification marks WOUND MARK OIN HEAD Marital Status MARRIED on proper photo paper. The
photo should be with straight
Enter complete present and permanent address. If this is not as given in NIC Card,
frontal face of the applicant
reasons for difference (if any) should be indicated clearly in a separate sheet of paper
and with light background.
when submitting the application.
All phone numbers should be given with area code.
9. Address (House/Village/Tehsil/Distt./Province):
(i) Present: HOUSE NO:D/2378 MOHALLA ANAJ MANDI KAMBER
Phone No. N/A Mobile No. 03463355894 Email Address Mks_hindu50@yahoo.com
(ii) Permanent: SAME Phone No. 03463355894

Enter present and past occupation/profession with details.

10. Present Occupation SHOPKEEPER 11. Past occupation SAME

In case of House wife/ student, give below details of occupation of spouse NIL or father X (Mark X in the
relevant box of the person whose details you are giving).
Name of employer/business NIL
Designation/Rank NIL Department NIL Monthly Income (Pak Rs.) NIL
Address NIL Tel. No. NIL

12. Father’s Name LEKHO MAL Occupation DEAD

13. Spouse’s Name PARTI BAI Occupation HOUSE WIFE

14. Are/were you in a Military/Semi-Military/Police/Govt. Organization? If yes, please give details.

15. Passport Details Passport No. AN0790821 Date of Issue 15-JAN-2010

Place of Issue LARKANA Date Of Expiry 15-JAN-2015 Previous Passport No. KE698623

If you are holding any other nationality, give details of passport.

16. Any other foreign passport/identity certificate held: (Yes/No) NO If yes, give details below:
Country of Issue NIL Passport/IC No. NIL
Date of Issue NIL Place of Issue NIL
Nationality/Status described therein NIL
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Section B. Visa Information

17. Visa Information

Enter type of visa required depending upon purpose of visit - Visitor/Business/Conference/Medical/ Student/
Journalist (Refer to instructions for explanation of various visa types)

Type of visa VISIT Purpose of visit TO MEET RELATIVES AND YATRA

‘ No. of Entries’ – Visas are normally issued for only one entry (Single entry). Applicants for business visas may apply
for up to 3 entries (Single/Double/Triple).

No. of Entries TRIPLE Period of Stay (days) 30 DAYS Date of journey AS SOON AS POSSIBLE

The entry/exit point and mode of travel (for onward/return journeys) should be the same.
Designated entry/exit points and available modes of travel are:

Delhi by Air/Mumbai by Air/Chennai by air; Attari by Train/Munabao by Train; Wagah by Bus (this option should be
given by those using Delhi-Lahore/Amritsar-Lahore/Amritsar-Nankana Sahib bus services)
(pls. mention one of these options)

Entry/Exit Point & Mode of Travel MUNA BAO BY TRAIN

If you have been issued an Indian visa before, please mention details of the last visa below:

Previous Indian Visa No. P384584 Date of Issue 18-04-2005 Type of visa VISIT

18. 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)
NIL

19. Details of previous pending application or unavailed visa, if any (with Visa No./Control No./date): In case of any
unavailed visa please attach the Immigration sheets (in original) while submitting the application.
NIL

20. Places of visit (More than one entry is allowed only in case of Business Visa)
First Entry Second Entry Third Entry
Place State Place State Place State
1. JODHPUR RAJISTAN
2, HARIDWAR
3. AGRA
4.
5.
6.
7.
8.
9.
10.
11.
12.

Instruction for Col. 21.

For each place of visit, enter name/address/telephone number of -

(i) relative/friend in the case of visitor visa
(ii) business associate in case of business visa
(iii) conference organizer in the case of conference visa
(iv) head of academic institution in case of student visa
(v) doctor and hospital in case of medical visa
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21. Address of relatives/business associates/contact persons at places of visit (in the same order as in Col. 20):
(Visa is Not Valid for Protected/Cantonment Areas)

Name and Father’s Name Relationship with H.No./Street/Mohallah/Post Office Village/Town/ District/State Telephone No.
(Enter as Name S/o Father’s Name) applicant City
MATERNAL H.NO:5-B-7 SHOPPING JODHPUR JODHPUR/R 0091-
1. UNCLE CENTRPARTAB NAGAR,PS AJISTAN 2912762404
HERO MAL/POKAR DAS
PARTAB NAGAR
2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

22. Address at place of stay (in the same order as in Col. 20)
Place Address District/State Telephone No.
H.NO:5-B-7 SHOPPING CENTRE PARTAB NAGAR, PS
1. JODHPUR
PARTAB NAGAR.
2. HARIDWAR
3. AGRA
4.
5.
6.
7.
8.
9.
10.
11.
12.

23. For Transit Visa Only Transit visa applicants must ensure that their passport is valid for the country of
destination and contains a valid visa.
Place of final destination NIL

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

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 I will be liable to such other penalties as may be prescribed.
Place:
Date: ISLAMABAD __________________________________
Signature of applicant