HIGH COMMISSION FOR PAKISTAN

2/50-G SHANTIPATH CHANAKYAPURI

NEW DELHI
http://www.pakhcndelhi.org.pk Passport size
(91-11) 26110601/2/5, Fax: (91-11) 26872339
Photograph

Assignment Visa Application Form

(For Indian Diplomats/ Officials)

(Please read these instructions carefully before filling in the application form)

1. No column should be left blank. Incomplete forms with vague entries shall not be accepted.
2. Note verbal / Letter of request should be submitted alongwith the application form.
3. Passport must be valid for the duration of visa applied (for long visit) or at least six months on the date
of application (for short visits).
4. Dependant family members of diplomats and officials would also fill in this form.

Diplomat Official / Staff Dependant Family Members

A. Personal Particulars (As in Passport)

1. Surname:

2. Given Name:

3. Sex: 4. Date of Birth: 5. Place of Birth:

6. Religion: 7. Aadhar Card No:

8. Nationality: Nationality by: I Previous Nationality:

9. Visible Identification Mark:

B. Applicant’s Contact Details:

10. Present Address: Permanent Address:

11. Email Address:

12. Phone No: Mobile No:

C. Professional/ Occupation Details:

13. Present Occupation: Name / Department:

Designation: Salary:

Address:

Date of Employment:

14. Past Occupation: Name / Department:

Designation:

Address:

From: To:

15. Do you belong/ previously belonged to Military/ Semi-Military/ Police/ Govt Organization? Yes No
if yes, give details:
D. Passport Details:
16. Passport No: Date of Issue: Date of Expiry:

Place of Issue:

E. Family Details:
17. Relation Name Date of Birth Nationality Place of Birth

Father

Mother

Spouse Mrs. Suvidha Jain 31.08.1972 Indian Rajasthan

Ser Name Relation with

the Applicant
(1)

Children (2)

(3)

(4)

18. Did your Grandfather/ Grandmother (paternal/ maternal) migrate from Pakistan? Yes No
if yes, give details:

F. Details of Visa Sought:

19. Type of Visa Required: Assignment Purpose of Visit:

20. No of Entries: Period of Visa

(days)
21. Previous Pakistani Visa: No Date of Issue: Type of Visa:

If assignment is against Name & Designation:

22. already existing post,

Passport No: Official Visa No
please include details of
Joining Date:
predecessor
23. If assignment is against a new post, mention letter of concurrence

G. Details of Previous Pending Application or unavailed Visa (if any):

24. Visa No: Date of Issue:

Reason for unavailed/ pending:

H. Has permission to visit or to extend stay in Pakistan previously been refused? If so, when and by whom:
25.

I. Places to be visited:
26. Place State

Islamabad

J. Address of relatives/ business associates/ contact persons at places of visit:

27. Name/ Father’s Name Address Province District Telephone No
K. Address at Place of Stay:

28. Place Address Telephone No

L. For Transit Visa Only:

29. Place of final destination:

30. 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
other application for visa to visit Pakistan under any other name, surname, maiden name etc and that the passport held by me
as indicated in column ‘D’ is the only valid Passport that I hold. I realize that should any of the above statements be found to
be false, incomplete or incorrect, my visa will be liable to cancellation.

Place: ______________
(Signature of applicant)
Date: ______________