Form 'C'

Arrival Report of Foreigner in Individual House

Applicant ID : 110716SHML1U

110716SHML1U

Accomodation Details
Name house of Dilwar shah

Address No.443AKamakoti Nagarsecond Main Road, pallikarania, chennai 600100

City/District CHENNAI

State TAMIL NADU

Star Rating Others

Phone no.

Mobile no. 9841205859

Personal Details
Surname MOHAMED
Given name MOHAMEDAMIN AHMED
Sex Male
Date of birth 30/01/1998 Special Category Others
Nationality KENYA
Address in country where residing permanently
Address ISLII 1ST AVENUE NAIROBI KENYA
City NAIROBI
Country KENYA
Address/Reference in India
Address NO.443AKAMAKOTI NAGARSECOND MAIN ROAD, PALLIKARANIA, CHENNAI 600100
City/District CHENNAI
State TAMIL NADU
Pincode 600100
Passport Details
Passport No. A2408799
Place of Issue NAIROBI, KENYA
Date of Issue 16/09/2015
Expiry Date 14/09/2025

Visa Details
Visa Number VJ8158838 Date of Issue 04/11/2015
Valid Till 03/06/2016 Visa Type STUDENT VISA
Place of Issue nairobi, KENYA

Arrival Details
Arrived From NAIROBI , NAIROBI , KENYA
Date of arrival in India 09/11/2015
Date of Arrival in 06/07/2016
Individual House
Time of Arrival in 10:45 Intended Duration of Stay in 365
Individual House Individual House

Whether Employed in India N

Other Details
Purpose of Visit Studies
Next Place NAIROBI
Destination City NAIROBI
Country KENYA
Contact No.(in India)
Mobile No.(in India) 7349666160
Contact No.(Permanently residing
country)
Mobile No.(Permanently residing 00254710995579
country)
Remarks(If any)
Remark

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