Form 'C'

Arrival Report of Foreigner in Individual House

Applicant ID : 070121S4F2S0

070121S4F2S0

Accomodation Details
Name Casmiro Residency

Address Flat No. G1, Kamat Gardens, Block 18 Dattawadi Mapusa Goa

City/District GOA

State GOA

Star Rating Others

Phone no.

Mobile no. 9822144337

Personal Details
Surname NAVEED
Given name SHOKRIA
Sex Female
Date of birth 11/12/1998 Special Category Others
Nationality AFGHANISTAN
Address in country where residing permanently
Address BAMYAN, KABUL, AFGANISTAN
City KABUL
Country AFGHANISTAN
Address/Reference in India
Address F1CASMIRO RESIDENCY BLOCK 18KAMAT GARDENS, MAPUSA, BARDEZ - GOA
City/District GOA
State GOA
Pincode 403507
Passport Details
Passport No. 02436779
Place of Issue KABUL, AFGHANISTAN
Date of Issue 30/05/2017
Expiry Date 30/05/2022

Visa Details
Visa Number VL4015488 Date of Issue 22/12/2020
Valid Till 21/03/2021 Visa Type STUDENT VISA
Place of Issue kabul, AFGHANISTAN Visa Subtype S-1

Arrival Details
Arrived From BAMYAN , KABUL , AFGHANISTAN
Date of arrival in India 26/12/2020
Date of Arrival in 29/12/2020
Individual House
Time of Arrival in 12:00 Intended Duration of Stay in 365
Individual House Individual House

Whether Employed in India N

Other Details
Purpose of Visit Studies
Next Place BAMYAN
Destination City KABUL
Country AFGHANISTAN
Contact No.(in India)
Mobile No.(in India) 919356059086
Contact No.(Permanently residing 93765744759
country)
Mobile No.(Permanently residing
country)
Remarks(If any)
Remark

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