Fillable VISA APPLICATION FORM EMBASSY OF INDIA

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VISA APPLICATION FORM EMBASSY OF INDIA

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EMBASSY OF INDIA
Consular Wing
2536 Massachusetts Avenue, NW
Washington, DC 20008
VISA APPLICATION FORM
(This application can be used at the Embassy of India, Washington, D.C. or at any other
Consulate Generals of India provided the applicant resides in states of Consulate’s jurisdiction)
Please read the instructions carefully before filling the application
(PLEASE PRINT IN BLOCK LETTERS ONLY)
1. Full Name: ___________________________________________________
(First) (Middle) (Last)
2. Last name at birth (if different): _____________________________________
3. Marital Status: Married/Unmarried __________________________________
4. If married give maiden name: ______________________________________
5. Date of Birth: ____/ ____/ _____ 6. Sex: Male/Female
mm dd yy
7. Place of birth (City, State & Country):________________________________
8. Current Nationality: ______________________________________________
9. Are you a permanent /long-term resident in USA? Yes __ No __
If yes, please furnish photocopy of your GREEN-CARD/Long-Term Visa status:
_________ (For Non-US passport holders only)
10. Nationality at birth: _____________________________________________
11. Any other nationality held at present/past: ___________________________
12. Present Address: _____________________________________________________________________________
______________________________________________________________________________________________
13. Phone:____________________________________(Home) _____________________________________(Work)
14.Permanent Address:___________________________________________________________________________
______________________________________________________________________________________________
15. Profession:__________________________________________________________________________________
16. Employer’s Name and Address:__________________________________________________________________
______________________________________________________________________________________________
Staple two
PHOTOS here
Consulate General of India
3 East 64
th
Street
New York, NY 10021
Tel: (212) 774-0600
Fax: (212) 861-3788
http://www.indiacgny.org
Jurisdiction: Connecticut,
Maine, Massachusetts, New
Hampshire, New Jersey, New
York, Ohio, Pennsylvania,
Puerto Rico, Rhode Island,
Vermont, Virgin Islands
Consulate General of India
455, N. Cityfront Plaza Dr.
NBC Tower, Suite 850
Chicago, IL 60611
Tel: (312) 595-0405
Fax: (312) 595-0418
http://chicago.indianconsulate.com
Jurisdiction: Illinois, Indiana,
Iowa, Michigan, Minnesota,
Missouri, North Dakota, South
Dakota, Wisconsin
Consulate General of India
540 Aguello Blvd.
San Francisco, CA 94118
Tel: (415) 668-0662
Fax: (415) 668-9764
http://www.indianconsulate-sf.org
Jurisdiction: Alaska, Arizona,
California, Colorado, Hawaii,
Idaho, Montana, Nebraska,
New Mexico, Nevada, Oregon,
Utah, Washington, Wyoming
Consulate General of India
1990 Post Oak Blvd. Suite
600 Houston, TX 77056
Tel: (713) 626-2355
Fax: (713) 626-2450
Jurisdiction: Alabama,
Arkansas, Florida, Georgia,
Kansas, Louisiana,
Mississippi, Oklahoma,
Texas
Embassy of India
2536 Massachusetts Ave., NW
Washington, DC 20008
Tel: (202) 939-9839/9806
Fax: (202) 265-7532
http://www.indianembassy.org
Jurisdiction: Delaware,
Kentucky, Maryland, North
Carolina, South Carolina,
Tennessee, Virginia, West
Virginia, Washington, DC
For Office use only
Religion :
Religion:___________
17. Passport Number:_________________________________18.ValidTill:__________________________________
19. Issued At:_______________________________________ 20. Issue Date:_______________________________
21. Father’s/Husband’s Name:______________________________________________________________________
22.Nationality of Father/Husband:___________________________________________________________________
23. Name and Nationality of Mother:_________________________________________________________________
24. Type of Visa required: __Tourist, __Business, __Student, __Entry, __Transit, __ Journalist, __ Conference, __
Employment, __Others,
25. Period of Visa: __15 Days* __ Six Months ___One Year __Five Year __ Ten Years__ (*For Transit only)
26. Have you ever visited India before? If yes, give address where you stayed with dates or years:
______________________________________________________________________________________________
______________________________________________________________________________________________
27. Has Indian visa or extension of the same ever been refused to you previously? YES:__/ NO:__
If yes, give details: _______________________________________________________________________________
28. Are you holding a valid "NO OBJECTION TO RETURN TO INDIA" endorsement?
YES / NO:____ If yes, give details: __________________________________________________________________
______________________________________________________________________________________________
29. Object of Journey: ____________________________________________________________________________
30. Are you travelling on behalf of a company? YES____ / NO ______
31. If yes, give name and address of company:_________________________________________________________
32. Expected date of departure from USA:_____________________________________________________________
33. Expected date of arrival in India:_________________________________________________________________
34. Port of arrival in India:__________________________________________________________________________
35. Are any children included in your passport accompanying you? YES / NO. If yes, give details:
Full Name Date of Birth Sex
(a)____________________________________________________________________________________________
(b)____________________________________________________________________________________________
36. Name and address of two references:
(a) In India:_____________________________________________________________________________________
______________________________________________________________________________________________
(b) In applicant’s country:__________________________________________________________________________
______________________________________________________________________________________________
I, ___________________________________, hereby undertake that I shall utilize my visit to India for the purpose for
which the visa has been applied for and shall not, on arrival in India, try to obtain employment or set up business or
extend my stay for any other purpose.
Signature of applicant:__________________________ Date:_______________ Place:________________________
Name & Place of birth HUSBAND/WIFE
Place of Birth:
Place of birth:
Place of birth:
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VISA APPLICATION FORM EMBASSY OF INDIA

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Completed 15 March 2022

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