HIGH COMMISSION OF INDIA

31, GRANGE ROAD

SINGAPORE 239702.

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https://indianvisaonline.gov.in
006567376777

Visa Application Form

Signature

SGPS08825715

A. Personal Particulars (As in Passport)

Surname (As in Passport)
KAUR
Given Nam e (As in Passport) AMARJIT
Previous/other Name if any
Sex

Web Registration Date : 13-OCT-2015

Application Id :SGPS08825715

Date of birth
Place of Birth Town/City
Citizenship /National ID No
Visible identification marks
Current Nationality

Female
27-AUG-1943
PUNJAB
E2854503E
NONE
SINGAPORE

Any Other Previous/Past Nationality

Marital Status
Religion
Country of Birth
Educational Qualification

Married
SIKH
INDIA
OTHERS

Nationality by Birth/ Naturalization

NATURALIZATION

INDIA

B. Passport Details

E2854503E
SINGAPORE

Passport No.
Place of issue

Date of issue ( dd/mm/yyyy )

Date of expiry (dd/mm/yyyy)

15-NOV-2011
17-JUL-2017

Any other Passport/Identity Certificate held (if yes ,please fill in the following) NO
Country of issue

Place of issue

Passport/IC No

Date of issue(dd/mm/yyyy)

Nationality/status
C. Applicants Contact Details
Present
address

721 BEDOK RESERVOIR ROAD #12-4632

BEDOK
SINGAPORE, SINGAPORE 470721

Phone No

64486251

65 92292147
Email address amerjitkaur@gmail.com

Mobile /Cell No

Permanent 721 BEDOK RESERVOIR ROAD #12-4632

Address
BEDOK
SINGAPORE
D. Family Details
Relation

Name

Nationality

Prev. Nationality

Place/Country of Birth

Fathers

BUDH SINGH

INDIA

INDIA
INDIA

Mothers

BHAGWAN KAUR

INDIA

INDIA
INDIA

Spouse

SARJEET SINGH

SINGAPORE

SINGAPORE
SINGAPORE

Were your Grandfather/Grandmother(Paternal/Maternal) Pakistan Nationals Or belong to Pakistan held area : NO

E. Details of Visa Sought

TOURIST VISA
(Month) 6 Month
DELHI

Type Of Visa Required

Period of Visa
Port Of Arrival

(Visa shall be valid from the Date of Issue and not from the Date of Journey)

AMARJIT KAUR

No of Entries
Expected Date of Journey
Port of Exit

Multiple
31-OCT-2015
DELHI

Required Detail of

TOURIST VISA
PUNJAB

Purpose of Visit : TOURISM

F. Previous Visit Details
Have You Ever visited India ?
Address where You stayed in
India

YES

VILAGE DAUDHAR,DISTRICT MOGA

PUNJAB INDIA,

Application Id :SGPS08825715

Places to be Visited

Cities in India Visited DELHI ,MOGA AND LUDHIANA

Type of Visa TOURIST VISA
Visa Number
VI0852471
Visa Issued Place SINGAPORE
Date of Issue
17-OCT-2012
Countries visited in last 10 years
MALAYSIA AUSTRALIA INDIA NEW ZEALAND U.K
Have you been refused an Indian Visa or extension of the same previously or deported from India ?
If yes above mention when and by whom with control
No/Date
G. Profession/Occupation Details of Spouse
Present Occupation HOUSE WIFE
Designation/Rank
Employer name/business Employer Address Phone Number
-

Past occupation if any GOVERNMENT SERVICE

Are/have you worked with Armed forces/ Police/ Para Military forces ? YES
Organization
Designation
SINGAPORE PRISONS
Place of Posting
Rank
CHANGI
H. Address of Place of Stay / Hotel
Place/Hotel Name
Address of Place / Hotel

I. Details of Two Reference

In India
Nam e SANT KAPOOR SINGH
Address VILLAGE DAUDHAR DISTRICT MOGA
PUNJAB INDIA

Phone
919872651159
Number

In
MANJIT SINGH

CUSTODIAL OFFICER
CORPORAL

State

Phone No.

SINGAPORE

BLK 753 PASIR RIS ST 71 #09-112

65 91901493

J. DECLARATION:
a.
b.
c.
d.

I do not hold any other passport(s) other than those detailed above.
I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them.
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.
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.

13-OCT-2015
Date :.

..
Applicants signature (as in Passport)