VISA APPLICATION FORM TO ENTER JAPAN (Paste photo here) “offal use ony 45mm 245mm or 2inxzin Surname (as shown in passport)_ SINGH Given and middle names (as shown in passport)_RAJVIR Other names (including any other names you are or have been known by) NA Date of birth 14-08-2000 Place of birth __DAKHA PUNJAB. INDIA Sex: Male [XJ Female [_] Marital status: Single [z] Married [| Widowed (_] Divorced [] Nationality or citizenship INDIA og Former and/or other nationalities or citizenships NA a ID No. issued to you by your government NA Passport type: Diplomatic [1] Official [] Ordinary Passport No.S4541806 Place of issue CHANDIGARH Date of issue 27-06-2018 DayiAonchirveary Issuing authority INDIA Date of expiry 26-06-2028 ayitanchveary Purpose of visit to Japan TO ATTEND A TRADE SHOW Intended length of stay in Japan_8 DAYS Date of arrival in Japan 29-07-2023, Port of entry into Japan_NARITA TOKYO Name of ship or airline AIR INDIA Names and addresses of hotels or persons with whom applicant intends to stay Name SOTETSU GRAND FRESA HOTEL Tel, +81-3 6899 203 KOTO-KU ARIAKE 3-6-6 KOTO WARD, TOKYO 135-0063 , JAPAN Address Dates and duration of previous stays in Japan. NA Your current residential address (if you have more than one address, please list them all) Address V?© ROOM! DISTT, JAGRAON ( LUDHIANA) PIN: 142030, PUNJAB INDIA ress Tel.491 748782247 Mobile No, +91 9316642227 Current profession or occupation and position__PARTNER Name and address of employer Name_ROYAL JEWELRY COMPANY. Tel.+91 748782247 Address CASEMENT SHOP 23,FIRST MALL, THE MALL RAKH BAGH KOH-E-FIZA LUDHIANA PUNJAB ress*Partner's profession/occupation (or that of parents, if applicant isa minor): NA Guarantor or reference in JapaniPiesse provide details ofthe guarantor or the person tobe wstedin Japan) Name NA Tel._NA ‘Address w“ Date of birth_NA Sex: Male ["] Female [1] Relationship to applicant. NA Profession or occupation and position __NA Nationality and immigration status__NA Inviter in Japanirease wite same above'ifthe inviting person andthe guarantor are the same! Name INFORMA MARKETS JAPAN CO. Tel KANDA 91 BLDG. 1-8-3 KAJICHO, CHIYODA - KU, TOKYO 101-0044, JAPAN Address Date of birth_NA Sex: Male [] Female [] ~[payiinfonin Tear Relationship to applicant Profession or occupation and position Nationality and immigration status *Remarks/Special circumstances, if any Have you ever: © been convicted ofa crime or offence in any country? ‘@ been sentenced to imprisonment for 1 year or more in any country?** ‘© been deported or removed from Japan or any country for overstaying your visa or violating any law or regulation? vel] @ been convicted and sentenced for a drug offence in any country in violation of law concerning narcotics, marijuana, opium, stimulants or psychotropic substances?** ve] ‘® engaged in prostitution, orin the intermediation or solicitation of @ prostitute for other persons, orin the provision of a place for prostitution, or any other activity directly connected to prostitution? veQ] ‘© committed trafficking in persons or incited or aided another to commit such an offence? ve] ‘Please tick “Yes” if you have received any sentence, even ifthe sentence was suspended. if you answered "Yes" to any of the above questions, please provide relevant details. “Thereby declare thatthe statement given above i tue and correct. | understand that immigration status and period of stay to bbe granted ate decided by the Japanese immigration authorities upon my arrival. | understand that possession of avisa does not entitle the bearerto enter Japan upon arival at port of entry if he or she is found inadmissible.” “hereby consent to the provision of my personal information (by an accredited travel agent, within its capacity of representing ‘my visa application) to the Japanese embassy/consulate-general and entrust the agent with) the payment of my visa fee to the Japanese embassy/consulate-general, when such payment is necessary.” egy yr Date of application 06-07-2023 Signature of applicant ‘DmwenieR *teismot mandatory to complete theseitems. ‘Any personal information gathered inthis application as well as additional information submited for the visa application (hereinafter referred to as "Retained Personal information’) will be handled appropriately in accordance with the Acton the Protection of Personal Information Held by Administrative Organs (Act No. 8 of 2003, hereinafter, “the Act’) Retained Personal Information will only be used for the purpose of processing the visa application and to the extent necessary for the purposes statedin Article 8 oF the Act.