APPLICATION FORM

( Visa Extension , Registration Extension and Change of

Passport )

080217X71R48

Application ID No. 080217X71R48 Appointment Date and Time 14/02/2017 10.00

FOR OFFICE USE ONLY

Reg. No. B 0 1 4 M D V 2 0 1 7

Personal Details
Surname IBRAHIM
Given Name NIYAZ Paste your
Sex Male Date of Birth 09/11/1978 Height (in cm) 0 Recent passport size
Age as on today Year(s) 38 Month(s) 2 Day(s) 29 photograph here
Place of Birth HITHADHOO,ADDU CITY,MALDIVES
Father's Name IBRAHIM MANIK
Mother's Name
Spouse's Name
Religion ISLAM Any Identification mark(s) preferably MOLE ON NECK
visible

Present nationality MALDIVES Previous nationality

Manner of acquiring present nationality Birth
Date of acquiring present nationality
Whether holding dual NO
nationality? If yes, Name of the country of second nationality
provide the following:- Passport No. of second country
Date of Issue
Date of Expiry
Whether travelled on this passport earlier to
India

Whether person of Indian Origin NO Aadhar Number

Address of last residence (Outside India)
Address SELEENA
City MALE CITY Country MALDIVES

Address intended for longer stay in India (Registration)

Address 1-9-297/3,VIDYANAGAR, HYDERABAD
City/ District HYDERABAD State TELANGANA
Pin Code
Phone Number Mobile Number
Any Other Address in India
Address
City/ District State
Pin Code
Phone Number Mobile Number
Email/Occupation/Profession Details
E-Mail Id niazibrahimk@gmail.com
Profession/Occupation STUDENT

Passport Details
Passport Number NC30G9587 Place of Issue MALDIVES, MALE CITY
Date of Issue 28/11/2016 Expiry Date 28/11/2021

Visa Details
Visa Number VJ1282593 Place of Issue INDIA, INDIAN HIGH COMMISION MALDIVES
Date of Issue 07/12/2015 Expiry Date 06/12/2016
Valid For Triple Entry Visa Type STUDENT VISA
Special endorsement, if any

Organization/Company/Institute/Hospital Details
Name UNIVERSITY COLLEGE OF ENGINEERING OU
Address OSMANIA UNIVERSITY

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 080217X71R48
Application ID No. 080217X71R48 Appointment Date 14/02/2017

State TELANGANA City HYDERABAD

Telephone Number Email ID
Employer EPFO ID Establishment ID
Arrival Details
Place of embarkation/boarding for India MALE INTERNATIONAL AIRPORT,MALE CITY,MALDIVES
Date of arrival in India 19/12/2015
Place of disembarkation/arrival in India BANGALORE
Mode of Journey Air Flight/ Ship/ Bus/ Train No.
Purpose of visit to India Studies

Previous Registration Details in India

Registration Number Place of Registration Visa Type Duration From To
Details of family members/attendant/dependents, if any accompanying.
Name Nationality Passport Number Relationship
Person to be contacted in Case of Emergency
Name Relationship
Address City
Country Phone Number
Category Others

Military service details

Organisation Designation
Rank Place of Last Posting
Country of Last Posting

Current Registration Details

Are you registered in current locality FRRO/FRO in the current visit? YES Current TS02/RCF/MDV/2/2016
Registration No.

Current Extension Details

Have you got extended visa in current visit in current locality Current TS02/RCF/MDV/2/2016
FRRO/FRO? Extension No.

Visa Extension Details

Whether previously in India?
Whether permission to stay in India has been previously refused?
Whether permission to extend stay in India has been previously granted?
Period of Extension requried Year(s) Month(s) 7 Day(s)
Reason for extension CONTINUE STUDIES
In case of Missionary - Nature of work

Registration Extension Details

Current Registration Valid Upto 06/12/2016 Required for period of Year(s) 0 Month(s) 7 Day(s) 0
Reason Of Extension continue studies

Change of Passport Details

Reason of Change of Passport RENEWAL OF PASSPORT

Signature of the Applicant

Date_ _ _ _ _ _ _ _ _ _ _ _ _

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 080217X71R48
Application ID No. 080217X71R48 Appointment Date 14/02/2017

List of mandatory and non mandatory documents

Mandatory Documents.
1. Photo : Applicants Photo
2. Residence proof : Form C copy from Hotel or Lodge/ Electricity bill/ Landline/ Telephone /Municipal Bill of the landlord in case of staying in
a house of relative or friend along with a letter and photo-id card of the landlord.In case of rented accommodation copy of
Lease and Licence agreement (1st and last page and page containing its validity). and Form C copy from Hotel or Lodge/ Electricity bill/ Landline/ Telephone /Municipal Bill of the landlord in case of
staying in a house of relative or friend along with a letter and photo-id card of the landlord.In case of rented accommodation copy of Lease and Licence agreement (1st and last page and page
containing its validity). and Form C copy from Hotel or Lodge/ Electricity bill/ Landline/ Telephone /Municipal Bill of the landlord in case of staying in a house of relative or friend along with a letter
and photo-id card of the landlord.In case of rented accommodation copy of Lease and Licence agreement (1st and last page and page containing its validity).

3. Form S/ Bonafide certificate : Form S/ Bonafide certificate.

4. Passport and Visa : Photo page, page indicating validity, page bearing arrival stamp of Indian immigration,visa with endorsement.
5. Financial resource proof : Bank statement copy or Proof of payment to institution.
6. RC/RP : Registration Certificate/ Residential Permit.

Non mandatory Documents.

1. Passport : Old and New passport (Photo Page, Page Indicating Validity, Page Bearing arrival Stamp of Indian Immigration(for old passport) ).
2. Others : if document type is not in the list.

Registration office address

Office Name : FRRO HYDERABAD

Address : Bureau of Immigration,(MHA), Govt. of India, Room No. 301, 3rd Floor, CGO Towers, Kavadiguda
City/District : HYDERABAD
State : TELANGANA
Pin Code : 500080
Phone Number : 27541022

Office opening time: 10.00 closing time: 18.00

Applications are accepted upto: 15.00

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