Form V.

2013

Visa Application Form of the Peoples Republic of China
(For the Mainland of China only)

The applicant should fill in this form truthfully completely and clearly. Please type the answer in capital English
letters in the space provided or tick () the relevant box to select. If some of the items do not apply, please type N/A or None.

Part 1: Personal Information

Last name
1.1
Full English name
as in passport

ABBASI

Middle name
First name

N/A

/Photo

MOHAMMAD HAMAS RAHMAN

1.2
Name in Chinese N/A
1.4 Sex

Affix one recent color passport

photo (full face, front view,
bareheaded and against a plain
light colored background).

1.3
Other name(s)
N/A

1.6
Current nationality(ies) PAKISTANI

1.5
1998-02-14
DOB(yyyy-mm-dd)
1.7 Former nationality(ies) N/A

1.8 (/)
Place of birth(city, province/state,country) MUZAFFARABAD, AZAD KASHMIR, PAKISTAN
1.9 /
Local ID/ Citizenship number

82203-7046422-3

1.10 / Passport/Travel document

type

Diplomatic

Service or Official

Ordinary

() Other (Please specify):

1.11
Passport number HR1014221

1.12
Date of issue(yyyy-mm-dd) 2013-09-05

1.13 MUZAFFARABAD, AZAD KASHMIR, 1.14

2018-09-04
Place of issue PAKISTAN
Date of expiry(yyyy-mm-dd)
/ Former/incumbent member of parliament
Businessperson
Position________________________
Company employee
/ Former/incumbent government
Entertainer
official
/ Industrial/Agricultural worker
Position________________________
Student
1.15
Military personnel
Crew member

Position________________________
Current
Self-employed
NGO staff
occupation(s)
Unemployed
Religious personnel
Retired
Staff of media
() Other (Please specify):
1.16
Education

1.17 /

Postgraduate
College
() Other (Please specify): HIGH SCHOOL GRADUATE

Name

ROOTS SCHOOL SYSTEM-ISLAMABAD

Employer/School
Address

1st Avenue, Phase 1, Sector A, DHA,

Islamabad, Pakistan

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Phone number +92-51-5788380

Zip Code

44000

1.18 HOUSE NO 54A opp. Bilal Mosque, STREET 1,

Home address GULRAIZ 1, CHAKLALA, RAWALPINDI, PAKISTAN

1.19
Zip Code

1.20 /
+92-315-2224549
Home/mobile phone number

1.21
E-mail address

1.22 Marital status

Married
Name

1.23
(
,)
Major family
membersspouse,
children,parents,et
c.,may type on
separate paper

1.24

Emergency
Contact

Single

46000
hamasrahman@gmail.com

Other(Please specify):

Nationality

Occupation

Relationship

SARDAR MOHAMMAD ABDUL

RAHMAN ABBASI

PAKISTANI

MAGISTRATE FIRST CLASS

FATHER

ROZINA RAHMAN ABBASI

PAKISTANI

BEAUTICIAN

MOTHER

MOHAMMAD HUMAIL RAHMAN

ABBASI

PAKISTANI

STUDENT

BROTHER

Name KHAWAJA JAVED IQBAL

Relationship with the applicant

Mobile phone number +923315141314

UNCLE

1.25 Country or territory where the

applicant is located when applying for this visa

PAKISTAN

Part 2: Travel Information

Official Visit

Non-business visit

As resident diplomatconsul or staff of international
organization
As permanent resident

Business & Trade

Work

As introduced talent

As child in foster care

Tourism

As crew member
Transit
2.1
Major
purpose
of your visit

Short-term visit to Chinese citizen or
foreigner with Chinese permanent residence status

Short-term visit to foreigner residing in
China due to work, study or other reasons
Short-term study for less than 180
days
As journalist for temporary news
coverage

180 Family reunion for over
180 days with Chinese citizen or foreigner with
Chinese permanent residence status

As accompanying family member of foreigner
residing in China due to work, study or other reasons
Long-term study for over 180 days
As resident journalist

()Other (Please specify)

( 3 ) One entry valid for 3 months from the date of issue

2.2

Intended number
of entries

( 3-6 ) Two entries valid for 3 to 6 months from the date of issue
6 ) Multiple entries valid for 6 months from the date of issue
1 ) Multiple entries valid for 1 year from the date of issue
Other (Please specify): Will apply for residence permit within 30 days of entry

2.3 Are you applying for express service?

Note: Express service needs approval
consular officials, and extra fees may apply.

of

2.4
Expected date of your first entry into China on this trip (yyyy-mm-dd)
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Yes

2015-08-20

No

2.5
Longest intended stay in China among all entries

1430

Date

2.6
,

Itinerary in
China (in time
sequencemay
type on separate
paper)

Detailed address

20 AUGUST 2015

1555 Century Ave, Pudong, Shanghai, China 200122

2.7 Who will pay for your travel and

expenses during your stay in China?

Name
2.8

Information of
inviter in China

Address

Days

NEWYORK UNIVERSITY SHANGHAI

DAVID PE
Room 1433, NYU Shanghai No.1555 Century Ave, Pudong, Shanghai, China 200122

Phone number

(+86-21) 2059-5312

Relationship with the applicant

Inviter to New York University Shanghai

2.9
Have you ever been granted a Chinese visa? If applicable,
please specify the date and place of the last time you were granted the visa.
2.10 12 Other countries or territories
you visited in the last 12 months

NONE

UNITED STATES OF AMERICA

Part 3: Other Information

3.1 Have you ever overstayed your visa or
residence permit in China?

Yes

No

3.2 ,Have you ever been refused a visa for China, or

been refused entry into China?

Yes

No

Yes

No

Yes

No

3.5 30 Did you visit countries or territories affected

Yes
by infectious diseases in the last 30 days?

No

3.3 Do you have any criminal record in China or any other

country?
3.4 Are you experiencing any of the following conditions?
Serious mental disorder
Infectious pulmonary tuberculosis
Other infectious disease of public health hazards

3.6 3.1 3.5

If you select Yes to any questions from 3.1 to 3.5, please give details below.

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3.7
If you have more information about your visa application other than the above to declare,please give details below or type on a
separate paper.

3.8 If someone else travels and shares

the same passport with the applicant , please affix their photos and give their information below.

Information

1
Person 1

2
Person 2

3
Person 3

Affix Photo
here

Affix Photo
here

Affix Photo
here

Full name

Sex

DOB(yyyy-mm-dd)

Part 4: Declaration & Signature

4.1
I hereby declare that I have read and understood all the questions in this application and shall bear all the legal consequences for the
authenticity of the information and materials I provided.
4.2

I understand that whether to issue a visa, type of visa, number of entries, validity and duration of each stay will be determined by
consular official, and that any false, misleading or incomplete statement may result in the refusal of a visa for or denial of entry into
China.
4.3
I understand that, according to Chinese law, applicant may be refused entry into China even if a visa is granted.

Applicants signature:

Date (yyyy-mm-dd): 2015-06-15

18 Note: The parent or guardian shall sign on behalf of a minor under 18 years of a

Part 5 If the application form is completed by another person on the

applicant's behalf, please fill out the information of the one who completes the form
5.1 Name

5.2 Relationship
with the applicant

5.3 Address

5.4 Phone number

5.5 Declaration

I declare that I have assisted in the completion of this form at the request of the applicant and that the applicant understands and
agrees that the information provided is true and correct.
/Signature

/Date (yyyy-mm-dd):

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