Form 'C'

Arrival Report of Foreigner in Individual House

Applicant ID : 040221946GI6

040221946GI6

Accomodation Details
Name Farzana Shaikh

Address Radiant IVY Building Flat no 102 , Kausarbaugh Society, Kondhwa Pune

City/District PUNE

State MAHARASHTRA

Star Rating

Phone no. 9890009323

Mobile no. 9890009323

Personal Details
Surname MOHAMMED TARIG
Given name ABDELGADIR
Sex Male
Date of birth 13/11/2000 Special Category Others
Nationality SUDAN
Address in country where residing permanently
Address KHARTOUM
City KHARTOUM
Country SUDAN
Address/Reference in India
Address HEAVEN HILLS BUILDING FLAT NO 101 GAWHANI CHAWL NIBM ROAD KONDHWA PUNE
City/District PUNE
State MAHARASHTRA
Pincode 411048
Passport Details
Passport No. P03794192
Place of Issue KHARTOUM, SUDAN
Date of Issue 15/03/2017
Expiry Date 14/03/2022

Visa Details
Visa Number VL4323735 Date of Issue 06/01/2021
Valid Till 05/07/2021 Visa Type STUDENT VISA
Place of Issue KHARTOUM, SUDAN Visa Subtype S-1

Arrival Details
Arrived From KHARTOUM , KHARTOUM , SUDAN
Date of arrival in India 27/01/2021
Date of Arrival in 03/02/2021
Individual House
Time of Arrival in 10:30 Intended Duration of Stay in 365
Individual House Individual House

Whether Employed in India N

Other Details
Purpose of Visit Studies
Next Place KONDHWA
Destination City/District PUNE
State MAHARASHTRA
Contact No.(in India) 9545013220
Mobile No.(in India) 9545013220
Contact No.(Permanently residing 9545013220
country)
Mobile No.(Permanently residing 9545013220
country)
Remarks(If any)
Remark no

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