Confirm Details

The applicant is requested to verify the particulars filled in

the application Form.The applicant may face legal
action(including refusal to enter India or deportation) in case
of provision of wrong information.
Please verify your Registration Details. If all details are correct please Press "Verified and Continue".
For any corrections press "Modify/Edit"

Please note down the Temporary Application ID: 39A8A242T8H5B5F

Applicant Details
Surname (as shown in your RZAYEV Surname/Family Name (As in
Passport) Passport)
Given Name/s (Complete as SARKHAN Given Name/s (As in Passport)
in Passport)*
Have you ever changed your NO
name? *
Gender* MALE Gender
Date of Birth* 06/01/1994 Date of Birth as in Passport in
DD/MM/YYYY format
Town/City of birth* GANJA Province/Town/City of birth
Country/Region of birth* AZERBAIJAN Country/Region of birth
Citizenship/National Id No.* AZERBAIJAN Citizenship/National Id No.
Religion* ISLAM
Visible identification marks* NA Visible identification marks
Educational Qualification * GRADUATE Educational Qualification
Nationality/Region * AZERBAIJAN Nationality
Did you acquire Nationality BY BIRTH
by birth or by naturalization?
*
Have you lived for at least YES
two years in the country
where you are applying
visa?
Passport Details
Passport Number * C03744222 Applicant's Passport Number
Place of Issue * AZERBAIJAN Place of Issue
Date of Issue * 07/10/2022 In DD/MM/YYYY format
Date of Expiry * 06/10/2032 In DD/MM/YYYY format
Any other valid NO
Passport/Identity
 Certificate(IC) held
Applicant's Address Details
House No./Street* UZEYIR HACIBEYOV 13/17
Village/Town/City* GANJA
State/Province/District* AZERBAIJAN
Postal/Zip Code AZ2001
Country* AZERBAIJAN
Phone No. +994502951018
Mobile No. 502951018
Email Address S.RZAYEV@ICENTER.AZ
Permanent Address
House No./Street* UZEYIR HACIBEYOV 13/17
Village/Town/City GANJA
State/Province/District AZERBAIJAN
Family Details
Father's Details
Name * VAGIF RZAYEV
Nationality/Region* AZERBAIJAN
Previous Nationality/Region AZERBAIJAN
Place of birth * GANJA
Country/Region of birth * AZERBAIJAN
Mother's Details
Name * ANJELA RZAYEVA
Nationality/Region* AZERBAIJAN
Previous Nationality/Region AZERBAIJAN
Place of birth * GANJA
Country/Region of birth * AZERBAIJAN
Applicant's Marital Status * MARRIED
Spouse's Details
Name * RENA RZAYEVA
Nationality/Region* AZERBAIJAN
Previous Nationality/Region AZERBAIJAN
Place of birth * GANJA
Country/Region of birth * AZERBAIJAN
Were your Grandfather/ NO
Grandmother
(paternal/maternal) Pakistan
Nationals or Belong to
Pakistan held area.
Profession / Occupation Details of Applicant
Present Occupation* GOVERNMENT SERVICE
Employer Name/business * INNOVATION CENTER LLC
Designation
Address * HASAN ALIYEV STREET 36
Phone +994 12 4447433
Past Occupation, if any NA
Applicant's Present Address.
Village/Town/City
State/Province/District
Postal/Zip Code
Country
Phone Number
Mobile Number
Email Address
Applicant's Permanent
Address(with Postal/Zip Code)
Village/Town/City
State/Province/District
Applicant's Father Name
Father's Nationality/Region
Previous Nationality/Region of
Father
Place of birth
Country/Region of birth
Applicant's Mother Name
Mother's Nationality/Region
Previous Nationality/Region of
Mother
Place of birth
Country/Region of birth
Applicant´s Marital Status
Applicant's Spouse Name
Spouse's Nationality/Region
Previous Nationality/Region of
Spouse
Place of birth
Country/Region of birth
If Others,please specify
Employer Name / Business
Designation
Address
Phone
Past Occupation, if any
 Are/were you in a NO
Military/Semi-
Military/Police/Security.
Organization?
Details of Visa Sought
Visa Type* STUDENT VISA
Details of person on whom you are attending/dependent
Name* SARKHAN RZAYEV
Date of Birth* 06/01/1994 (DD/MM/YYYY) format
Nationality/Region* AZERBAIJAN
Passport No.* C03744222
Duration of Visa (in Month)* 3 Duration of visit (in Month)
No. of Entries * SINGLE
Purpose of Visit* DEPENDENT OF STUDENT
FOR RESEARCH SCHOLAR,
VISITING RESEARCH
FACULTY, RESEARCH
SCHOLAR ON BILATERAL
EXCHANGE PROGRAMME,
MEMBERS OF BOTANICAL
SCIENTIFIC,
ANTHROPOLOGICAL ETC.
EXPEDITIONS
Expected Date journey * 30/12/2023
Port of Arrival in India * GANDHI NAGAR AIRPORT
AREA
Expected Port of Exit from
India
Previous Visa/Currently valid Visa Details
Have you ever visited India NO
before?*
Has permission to visit or to extend stay in India previously
been refused? No
Other Information
Countries Visited in Last 10 GEORGIA
years
SAARC Country Visit Details
Have you visited SAARC countries (except your own
country) during last 3 years? No
Reference
Reference Name in India* MS. HARMEET KAUR DAWAR Reference Name and Address in
India
Address* VILLAGE BHAT, P.O. BHAT
382428 DIST. GANDHINAGAR

State* GUJARAT
District* GANDHINAGAR
Phone* 9824023204 Phone no
Reference Name in DINESH KUMAR Reference Name and Address in
AZERBAIJAN* AZERBAIJAN
Address* BAKU, OLIMPIA STREET 6A

Phone* +994125646344 Phone no

Verified and Continue Modify