Designation/Rank

Place of Issue

Passport/IC No.
Department
Date Of Expiry
HighDate
Commission of India-Islamabad
of Issue
Visa Application Form for (Pak
Monthly Income Pakistani
Rs.) Nationals
Previous Passport No.
Place of Issue
For Office Use Only
Address
Visa Category Visa No. Nationality/Status
Date described
of Issue therein Date of Expiry
Entry Port Exit Port Duration Days No. of Entries
Valid for stay at places specified below for Tel. No.
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
2. Name
3. Sex 4. Date of Birth 5. Place of birth
6. Religion 7. NIC Card No.
8. Visible identification marks Marital Status
Enter complete present and permanent address. If this is not as given in NIC
Card, reasons for difference (if any) should be indicated clearly in a separate sheet
of paper when submitting the application.
All phone numbers should be given with area
code.
9. Address (House/Village/Tehsil/Distt./Province):
(i) Present:
Phone No. Mobile No. Email Address
(ii) Permanent: Phone No.

Enter present and past occupation/profession with details.

10. Present Occupation 11. Past occupation

In case of House wife/ student, give below details of occupation of spouse or father (Mark X in the
relevant box of the person whose details you are giving).

12. Father’s Name Occupation

13. Spouse’s Name Occupation

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

15. Passport Details

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

16. Any other foreign passport/identity certificate held: (Yes/No) If yes, give details below:
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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 Purpose of visit

‘ 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 Period of Stay (days) Date of journey

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

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

Previous Indian Visa No. Date of Issue Type of visa

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)

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.

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.
2,
3.
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
1.

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.

1.
2.
3.
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
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 I will be liable to such other penalties as may be prescribed.
Place:
Date:
Signature of applicant