High Commission of India
Wellington, New Zealand

 

VISA APPLICATION FORM
 (Visa will be valid from the date of issue of visa and not from the date of arrival in India)

 
 

   

 

 


 
 

 Please paste your photo here. One additional photo to be sent with the application

 
     
1. Personal Details
1.1 Full Name (firstname, middlename, lastname)		 _________________________________________________
1.2 Last name at birth (if different) _________________________________________________
  1.3 Marital Status Married/Unmarried ________________________________
1.4 If married give your maiden name _________________________________________________
  1.5 Date of birth ________________________________
1.6 Place of birth (City, State & Country) _________________________________________________
1.7 Sex Male/Female ___________________________
2. Current Nationality ______________________________________
3. Are you a permanent / long-term resident in this country ? Yes/No  __________________________________________
 
4. Nationality at birth  
5. Any other nationalities previous or present:
(Dual nationality holders please submit both passports along with applications.)		  
6. Present Address  
7. Contact Phone Home Phone: ______________ Work Phone: _____________
8. Permanent Address:  
9. Profession  
10. Employer’s Name and Address:  
11. Passport Details Number: _________________    Valid Till:  ______________
    Issued at: ________________  Issue Date: ______________
12. Father’s/Husband’s Name  
13. Nationality of Father/Husband  
14. Name and Nationality of Mother  
15. Type of Visa Required: Tourist / Business / Student / Entry / Transit / Others (Write one of these) _________________________________________
16. Period of Visa: One Month/ 3 Months/ 6 Months / 1 Year / 5 Year _________________________________________
17 Entry Single / Double / Multiple
18. Have you ever visited India before ? If yes give address with dates: _________________________________________
19. Have you ever been refused while applying for your Indian visa or extension in the past ? YES/NO, If yes, give details: _________________________________________
20. Are you holding a valid “NO OBJECTION TO RETURN TO INDIA” endorsement ? YES/NO If yes, give details ( Applicable to holders of Indian Identity Certificates only ) _________________________________________
21. Object of journey _________________________________________
22. Are you travelling on behalf of a company ? YES/NO  _________________________________
23. If yes, give name and address of the company _________________________________________
24. Expected date of departure _________________________________________
25. Expected date of arrival in India _________________________________________
26. Port of arrival in India _________________________________________
27. Are any children included in your passport accompanying you ? Yes/No If yes, give details: Full Name, Date of Birth, Sex
_________________________________________
 _________________________________________
 _________________________________________
28. Name and address of two references,(if any)       : (i)  In India  

________________________________________________
  (ii) In applicants country  

_____________________________________

 

  Space for additional Information if any you would like to give:

________________________________________________________________________________

 

  
  I affirm & declare that I do not hold any valid Indian passport (for persons of Indian origin)

I, ____________________________________________, hereby undertake that I shall utilize my visit to India for the purpose for which the visa has been applied for and shall not, on arrival in India, try to obtain employment or set up business or extend my stay for any other purpose.

  
Place: ________
Date: _________

 

______________________________________
( Signature of applicant )

  
     

Note

 1:  Forms in Hindi can be obtained from High Commission’s office in Wellington.  
   2. Visa Fee should be paid by Bank Draft in favour of "High Commission of India Wellington"  
  3. Cash is accepted only if the application is submitted at the counter.  
  4. Completed application (Application Form duly filled in with two passport sized photos ; one  
      pasted on the form and another extra;, bank draft of visa fee; return courier pack and  
      original passport) should be sent to High Commission of India, 180 Molesworth Street  
      Thorndon, Wellington.  
     

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