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Applicant Information
Family Name *
  • question formulaire
    • Enter your family name as the family name appears on your passport under the Family Name or Surname field. The family name is required to complete the application.
First (Given) Name *
  • question formulaire
    • Enter your first (given) name as the first name appears on your passport under the First or Given Name field. Do not include the middle name in this field. First name is required to complete the application. If you have no first name, then enter the letters FNU which stands for First Name Unknown.
Sex *
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    • Choose your gender, either male or female. The sex (gender) is required to complete the application.
      Male       Female
Date of Birth
Day *
  • question formulaire
    • Choose the day on which you were born. The day of birth is required to complete the application or to check the status of your application.
Month *
  • question formulaire
    • Choose the month in which you were born. The month of birth is required to complete the application or to check the status of your application.
Year *
  • question formulaire
    • Choose the year in which you were born. The year of birth is required to complete the application or to check the status of your application.
City of Birth*
  • question formulaire
    • Enter the city, town, village, or hamlet in which you were born. The city, town, village, or hamlet where you were born is required to complete the application. If you do not know the city in which you were born, enter UNKNOWN.
Country of birth *
  • question formulaire
    • Choose the country in which you were born. The country where you were born is required to complete the application.
Additional citizenships
  • question formulaire
    • Indicate if you are a citizen of a country/territory other than the one on your passport.
National Id No.
  • question formulaire
    • If not applicable Please Type NA
Educational Qualification
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    • Educational Qualification
Religion
  • question formulaire
    • Specify the religion to which the applicant belongs
Visible identification marks
  • question formulaire
    • Visible identification marks
Have you lived for at least two years in the country where you are applying visa?
      Yes       No
Passport Details
Passport Number *
  • question formulaire
    • Enter your passport number as it appears on your passport. The passport number may contain numbers and/or characters. Please closely distinguish between the number zero and the letter O. The passport number is required to complete the application or to check the status of your application.
Place of Issue*
  • question formulaire
    • Place of Issue
Date of Issue
Day *
  • question formulaire
    • Choose the day on which your passport was issued, as it appears on your passport under the Date of Issue field. The day on which the passport was issued is required to complete the application.
Month *
  • question formulaire
    • Choose the month in which your passport was issued, as it appears on your passport under the Date of Issue field. The month in which the passport was issued is required to complete the application.
Year *
  • question formulaire
    • Choose the year in which your passport was issued, as it appears on your passport under the Date of Issue field. The year in which the passport was issued is required to complete the application.
Date of Expiry
Day *
  • question formulaire
    • Choose the day on which your passport expires, as it appears on your passport under the Expiration Date or Extension field. The day on which the passport expires is required to complete the application.
Month *
  • question formulaire
    • Choose the month in which your passport expires, as it appears on your passport under the Expiration Date or Extension field. The month in which the passport expires is required to complete the application.
Year *
  • question formulaire
    • Choose the year in which your passport expires, as it appears on your passport under the Expiration Date or Extension field. The year in which the passport expires is required to complete the application.
Any other valid Passport/Identity Certificate(IC) held
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    • If Yes Please give Details
      Yes       No
Country of Issue
  • question formulaire
    • Country of Issue
Place of Issue
  • question formulaire
    • Place of Issue
Passport/IC No.
  • question formulaire
    • Passport/IC No.
Nationality mentioned therein
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    • Nationality mentioned therein
Date of Issue
Day
  • question formulaire
    • Choose the day on which your passport was issued, as it appears on your passport under the Date of Issue field. The day on which the passport was issued is required to complete the application.
Month
  • question formulaire
    • Choose the month in which your passport was issued, as it appears on your passport under the Date of Issue field. The month in which the passport was issued is required to complete the application.
Year
  • question formulaire
    • Choose the year in which your passport was issued, as it appears on your passport under the Date of Issue field. The year in which the passport was issued is required to complete the application.
Applicant's Address Details
Present Address
House No./Street*
    • Applicant's Present Address
Village/Town/City*
    • Village/Town/City
Country*
    • Country
Département / région*
    • State/Province/District
Phone No.
    • One Contact No is Mandatory
Mobile No.
    • Mobile No.
E-Mail Address *
    • Enter the e-mail address at which you can be contacted. The e-mail address is optional to complete the application.
Is your permanent address different from your present address ?*
    • Is your permanent address different from your present address ?
      Yes       No
Permanent Address
House No./Street*
    • Applicant's Permanent Address(with Postal/Zip Code)
Village/Town/City*
    • Village/Town/City
Country*
    • Country
State/Province/District*
    • State/Province/District
Family Details
Father's Details
Name*
    • Applicant's Father Name
Nationality*
    • Nationality/Nationalities of Father
Place of Birth*
    • Place of Birth
Country of Birth*
    • Country of Birth
Mother's Details
Name*
    • Applicant's Mother Name
Nationality*
    • Nationality/Nationalities of Mother
Place of Birth*
    • Place of Birth
Country of Birth*
    • Country of Birth
Applicant's Marital Status*
    • Applicant's Marital Status
Spouse's Details
Name*
    • Applicant's Spouse Name
Nationality*
    • Nationality/Nationalities of Spouse
Place of Birth*
    • Place of Birth
Country of Birth*
    • Country of Birth
Were your Grandfather/ Grandmother (paternal/maternal) Pakistan Nationals or Belong to Pakistan held area.*
    • Were your Grandfather/ Grandmother (paternal/maternal) Pakistan Nationals or Belong to Pakistan held area.
      Yes       No
If Yes, give details*
    • If Yes, give details
Profession / Occupation Details of Applicant
Present Occupation*
    • Present Occupation
Employer Name/business*
    • Employer Name/business
Designation
Address*
    • Address
Phone No.
Past Occupation, if any
Are/were you in a Military/Semi-Military/Police/Security. Organization?*
    • Are/were you in a Military/Semi-Military/Police/Security. Organization?
      Yes       No
Organisation
Designation
Rank
Place of Posting
Details for Visa Applied
Type of visa
Places likely to be visited*
    • Places likely to be visited
Purpose of Visit*
    • Purpose of Visit
Duration of Visa (in Days)
No. of Entries
Expected Date journey
    • (Visa validity will start from the Visa Issue Date)
Day *
Month *
Year *
Port of Arrival in India*
    • Port of Arrival in India
Expected Port of Exit from India
    • Expected Port of Exit from India
Informations Complémentaires
Have you ever visited India before?*
    • If Yes, give details
      Yes       No
Enter the address of stay during your last visit
    • Enter the address of stay during your last visit
Line 1*
Line 2
Line 3
Cities previously visited in India (comma separated)*
    • Cities previously visited in India (comma separated)
Last Indian Visa No/Currently valid Indian Visa No.*
    • Last Indian Visa No/Currently valid Indian Visa No.
Place of Issue*
    • Place of Issue
Date de delivrance du dernier visa indien / visa actuelle valide*
Type of visa*
    • Type of visa
Has permission to visit or to extend stay in India previously been refused?*
    • Has permission to visit or to extend stay in India previously been refused?
      Yes       No
If so, when and by whom (Mention Control No. and date also)*
    • If so, when and by whom (Mention Control No. and date also)
Countries Visited in Last 10 years (comma separated)
Contacts
Reference in India
Reference Name in India
    • Reference Name in India
Phone No.
Address
    • Address
Line 1
Line 2
Reference in Home Country
Reference Name in Home Country
    • Reference Name in Home Country
Phone No.
Address
    • Address
Line 1
Line 2
Questions Additionnels
Have you ever been arrested / prosecuted / convicted by a court in any country?

Oui
Non


Have you ever been refused / expelled by a country, including India?

Oui
Non


Have you ever been involved in human trafficking / drug trafficking / abuse / crime against women / economic crime / financial fraud?

Oui
Non


Have you ever been involved in cybercrime / terrorist activities / sabotage / espionage / genocide / political assassination / other veiling?

Oui
Non


Have you ever, in any form, expressed opinions that justify or glorify terrorist violence or that could encourage others to commit terrorist acts or other serious criminal acts?

Oui
Non


Have you applied for asylum (political or otherwise) in any country?

Oui
Non


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