Online Indian Visa Form https://indianvisa-bangladesh.nic.

in/visa/Verification

Confirm Details
The applicant is requested to verify the particulars filled in the application Form.The
applicant may face legal action(including refusal to enter India or deportation) in case of
provision of wrong information.
Please verify your Registration Details. If all details are correct please Press "Verified and Continue".
For any corrections press "Modify/Edit"

Please note down the Temporary Application ID: 2XXAXAA7Y332EYJ

Applicant Details
Surname (as shown in your HOSSAIN Surname/Family Name (As in Passport)
Passport)
Given Name/s (Complete as in MD ARMAN Given Name/s (As in Passport)
Passport)*
Have you ever changed your name? NO
*
Gender* MALE Gender
Date of Birth* 29/03/2001 Date of Birth as in Passport in
DD/MM/YYYY format
Town/City of birth* CHANDPUR Province/Town/City of birth

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Country/Region of birth* BANGLADESH Country/Region of birth

Citizenship/National Id No.* 8260612638 Citizenship/National Id No.
Religion* ISLAM
Visible identification marks* NONE Visible identification marks
Educational Qualification * HIGHER SECONDARY Educational Qualification
Nationality/Region * BANGLADESH Nationality
Did you acquire Nationality by birth BY BIRTH
or by naturalization? *
Have you lived for at least two years YES
in the country where you are
applying visa?
Passport Details
Passport Number * A06344812 Applicant's Passport Number
Place of Issue * DHAKA Place of Issue
Date of Issue * 27/12/2022 In DD/MM/YYYY format
Date of Expiry * 26/12/2032 In DD/MM/YYYY format
Any other valid Passport/Identity NO
Certificate(IC) held
Applicant's Address Details
House No./Street* DOALIA,WARD NO 04 Applicant's Present Address.
Village/Town/City* HAZIGANJ Village/Town/City
State/Province/District* CHANDPUR State/Province/District
Postal/Zip Code 3610 Postal/Zip Code
Country* BANGLADESH Country
Phone No. Phone Number
Mobile No. 1815484676 Mobile Number
Email Address ARMAN.OPI21@GMAIL.COM Email Address
Permanent Address
House No./Street* DOALIA,WARD NO 04 Applicant's Permanent Address(with
Postal/Zip Code)

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Village/Town/City HAZIGANJ Village/Town/City

State/Province/District CHANDPUR State/Province/District

Family Details
Father's Details
Name * MD ANWAR HOSSAIN MIAJI Applicant's Father Name
Nationality/Region* BANGLADESH Father's Nationality/Region
Previous Nationality/Region Previous Nationality/Region of Father
Place of birth * CHANDPUR Place of birth
Country/Region of birth * BANGLADESH Country/Region of birth
Mother's Details
Name * MORIUM BEGUM Applicant's Mother Name
Nationality/Region* BANGLADESH Mother's Nationality/Region
Previous Nationality/Region Previous Nationality/Region of Mother
Place of birth * CHANDPUR Place of birth
Country/Region of birth * BANGLADESH Country/Region of birth

Applicant's Marital Status * SINGLE Applicant´s Marital Status

Were your Grandfather/ NO
Grandmother (paternal/maternal)
Pakistan Nationals or Belong to
Pakistan held area.
Profession / Occupation Details of Applicant
Present Occupation* STUDENT If Others,please specify
Occupation details of Father
Employer Name/business * AL NAMAL Employer Name / Business
Designation Designation
Address * MANAMA, BAHRAIN Address
Phone Phone
Past Occupation, if any NA Past Occupation, if any

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Are/were you in a Military/Semi- NO

Military/Police/Security.
Organization?
Details of Visa Sought
Visa Type* DOUBLE ENTRY
Duration of Visa (in Month)* 3 Duration of visit (in Month)
No. of Entries * DOUBLE
Purpose of Visit* DOUBLE ENTRY VISA
Expected Date journey * 19/07/2023
Port of Arrival in India * BY AIR/ HARIDASPUR
Port of Exit from India * BY AIR/ HARIDASPUR

Previous Visa/Currently valid Visa Details

Have you ever visited India before?* NO
Has permission to visit or to extend stay in India previously been refused?
No
Other Information
Countries Visited in Last 10 years
SAARC Country Visit Details
Have you visited SAARC countries (except your own country) during last 3
years? No
Reference
Reference Name in India* VFS Reference Name and Address in India
Address* MEZZANINE LEVEL SHIVAJI STADIUM
METRO STATION, BABA KHARAK
SINGH RD, NEW DELHI

State* DELHI
District* NEW DELHI
Phone* +91 22 6786 60 Phone no
Reference Name in BANGLADESH* MORIUM BEGUM Reference Name and Address in
BANGLADESH

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Address* DOALIA, HAZIGANJ, CHANDPUR

Phone* 01815484676 Phone no

Stay Details
Place/ Name of Address of State* District* Email Telephone
Hotel* Place/Hotel * No.*
RAJ MAHAL CHANDI DELHI NEW DELHI +91 98710
INN WALI GALI, 26915
MAIN
BAZAAR,PAHARGANJ,
NEW DELHI

Verified and Continue Modify

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