Aum Sri Sai Ram

Sri Sathya Sai Accommodation Office, Prasanthi Nilayam

Form C
Please fill up ALL fields, in BLOCK LETTERS, CLEARLY & LEGIBLY.
One form per visitor, (Including Children) on arrival.
Personal Details:
Surname :
Given Name :
Gender :

Male

Female
(in dd/mm/yyyy format)

Date of Birth :
Category of Travel :

Tourist

PIO

OCI If others, mention: _______

Nationality :
Address in country where residing permanently:
Permanent Address :
City :
Country :
Home Address or Reference in India, if any :
Any home address or
Reference in India :

None

Prasanthi Nilayam

If any other, mention here : _______________________

Passport Details:
Passport No. :
City of Issue :
Country of Issue :
Date of Issue :

(in dd/mm/yyyy format)

Valid Till which date :

(in dd/mm/yyyy format)

.. PTO

Visa Details:
Visa No.
( or OCI No. / PIO No. )
City of Issue :
Country of Issue :
Date of Issue :

(in dd/mm/yyyy format)

Valid Till which date :

(in dd/mm/yyyy format)

Type of Visa :

Tourist

PIO

OCI If others, mention: ____

Arrival Information:
Arrived in India, from which country :
City (Place) in above country :
Date of Arrival in India :

(in dd/mm/yyyy format)

Date of Arrival in Ashram :

(in dd/mm/yyyy format)

Time of Arrival in Ashram :

Staying how many days in Ashram ? :

(planned duration)

Other Details:
Whether employed in India? :
Purpose of Visit :
Proposed Next Destination In India :
(after departure from Prasanthi
Nilayam)

No

Yes

Tourist If others, mention :

____________
Bangalore

Mumbai

Chennai
Delhi
If others, mention here : ______________

Your contact Mobile No./ In INDIA:

Telephone No.
In YOUR COUNTRY :
I certify that all information presented here is true and I agree to abide by the rules
and regulations of the Ashram during my stay.

Signature:________________________
(Based on Form C of the Ministry of Home Affairs, Government of India. http://mha.gov.in)