DELHI AIRPORT

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e-Visa Application Form

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I004W2827419

A. Personal Particulars (As in Passport)

Surname MEENEN
Given Name MORITZ MICHAEL FABIAN
Previous Name
Gender MALE Marital Status SINGLE
Date of Birth 28/06/1983 Religion CHRISTIAN
Place of Birth HAMBURG Country of Birth GERMANY
File Ref No : I004W2827419

Nationality GERMANY
Identification
marks NONE
B. Passport Details
Passport No. C4YLWVRV1 Date of Issue 07/04/2014
Place of Issue GERMANY Date of Expiry 06/04/2024
Any other Passport/Identity Certificate held (if yes ,please fill in the following) NO
Country of Issue Place of Issue
Passport/IC No. Place of Issue
C. Applicant's Contact Details
Present Address BURGSTRASSE 20 ZURICH ZURICH
Mobile Email MORITZ@ELECTRICFEEL.COM
D. Family Details
Relation Name Nationality Prev. Nationality Place of birth
Father's NORBERT GERMANY PFORZHEIM
Mother's ILLE GERMANY HAMBURG
Spouse's
Were your Parents/Grandparents (paternal/maternal) Pakistan Nationals or Belong
to Pakistan held area. NO
E. Visa Details
Visa Service eBUSINESS VISA
Period of visa 365 days No. of entries Multiple
Journey Date 11/12/2019 Port of Exit DELHI AIRPORT
 F. Purpose Details
Purpose of Visit SALE/PURCHASE/TRADE
1) Places to be visited1 DELHI
2) Places to be visited2 GURUGRAM
3) Have you booked any room in Hotel/Resort etc. through any
Tour Operator? NO
4) Name of the tour operator
5) Address of the tour operator
6) Name of Hotel/Resort etc
7) Place/City of Hotel/Resort etc
Details of the Applicants Company
8) Name ELECTRICFEEL AG
9) Address,Phone no HARDTURMSTRASSE 253, 0041443502200
10) Website WWW.ELECTRICFEEL.COM
File Ref No : I004W2827419 :: Registration Date :07/DEC/2019

11) Nature of Business/Product SOFTWARE FOR MOBILITY SYSTEMS

12) Have you ever been arrested/ prosecuted/ convicted by
Court of Law of any country? NO
13) Have you ever been refused entry / deported by any
country including India? NO
14) Have you ever been engaged in Human trafficking/ Drug
trafficking/ Child abuse/ Crime against women/ Economic
offense / Financial fraud? NO
15) Have you ever been engaged in Cyber crime/ Terrorist
activities/ Sabotage/ Espionage/ Genocide/ Political killing/
other act of violence? NO
16) Have you ever by any means or medium, expressed views
that justify or glorify terrorist violence or that may encourage
others to terrorist acts or other serious criminal acts? NO
17) Have you sought asylum (political or otherwise)in any
country? NO
18) evisa_fee 80
G. Profession/Occupation Details
Present
Occupation BUSINESS PERSON Designation/Rank
Employer name/business ELECTRICFEEL AG
Employer Address HARDTURMSTRASSE 253 Employer Phone
H. Details of Two Reference
In India In GERMANY
Name RAYS POWER INFRA (P) LTD. PROF DR NORBERT MEENEN
LANDMARK HOUSE, SECTOR
44, PIKARTENKAMP 40A
Address GURUGRAM, HARYANA 122003 22587 HAMBURG, GERMANY
Phone +91-9717754352 00491724106546
I. DECLARATION
a. I do not hold any other passport(s) other than those detailed above.
b. I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them.
c. I declare that the information given in the form is complete and correct and the visit to India will be undertaken for the purpose
indicated in the application.
d. I understand that in case the information provided in the form is found to be incorrect, I will be liable for denial of visit/ entry or
deportation and/ or other penalties during the visit as provided by Indian law.

Date :07/DEC/2019