Travel Information Sheet Location Telephone No & Extn No. IGSI/IBM India Amex Card no.

with expiry date Employee No., Dep Code Lotus Notes ID/ E Mail ID Date of Joining IBM Designation Educational Qualification University Name as per Passport Surname Given Name (In case of Dependents traveling, fill additional Travel info sheet) Residence Address in Hyderabad Contact No., Mobile No., Passport No., Date of issue Place of issue Expiry Date Date of Birth Managers Name Extn no. Country (Traveling to) Destination(Place of travel) Purpose of travel Approx. yearly Gross Salary(in India) (To be filled only in case of US Visa) Did you have any previous visa rejections. (If yes attach the necessary communications from the consulate). Project Name & Hyderabad 040 6737 8391 376945629662000,07/13 06702f J8A saybasha@in.ibm.com/jani7860@gmail.com 03/11/2010 Senior System Engineer B.Tech Jawaharlal Nehru Technological University Syed Jhony Basha Syed JhonyBasha Flat No : A3,Sri Priya Enclave, Top to ICICI bank, Near More super market, Lingampally 500019 7799301093 7799301093 F4459558 10/08/2005 Hyderabad 09/08/2015 01/01/1985 Rajith Rajendran 080 40257796 (direct) United States of America Dublin,ohio trainging 7,25,000/annum No Nw pnc testing

Project ID Proposed Date of Travel Proposed return date Duration of stay Abroad Type of Visa Required (In case already holding visa, attach a copy of visa to the Travel Request)

In0903375 26th feb 7th april 60 days B1 visa