Seminar on Online Payments and Fraud Prevention (3G Direct Pay)


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Seminar on Online Payments and Fraud Prevention (3G Direct Pay)

  1. 1. High Commission Of India Nairobi Jeevan Bharti Building,Harambee Avenue Nairobi,Kenya,P.O. Box 30074-00100 Paste your unsigned recent color photograph. Size: 2” X 2” +254 20 2222566 Visa Application Form Signature KENNV0058C14 A. Personal Particulars (As in Passport) Surname (As in Passport) FEINSTEIN Given Nam e (As in Passport) AYELET Web File Number :KENNV0058C14 Previous/other Name if any Female 15-AUG-1973 RAMAT GAN 025671991 NONE ISRAEL Sex Date of birth Place of Birth Town/City Citizenship /National ID No Visible identification marks Current Nationality Marital Status Religion Country of Birth Educational Qualification Nationality by Birth/ Naturalization BY BIRTH Date of issue ( dd/mm/yyyy ) 27-OCT-2009 26-OCT-2019 Any Other Previous/Past Nationality B. Passport Details 13824053 ISRAEL Passport No. Place of issue Date of expiry (dd/mm/yyyy) Any other Passport/Identity Certificate held (if yes ,please fill in the following) NO Country of issue Web Registration Date : 22-JAN-2014 Married JEWISH ISRAEL PROFESSIONAL Place of issue Passport/IC No Date of issue(dd/mm/yyyy) Nationality/status C. Applicant’s Contact Details Present address 42 KAPUTEI RD NAIROBI NAIROBI, KENYA 01000 Phone No 254718988163 Email address Mobile /Cell No Permanent 42 KAPUTEI RD Address NAIROBI NAIROBI D. Family Details Relation Name Nationality Prev. Nationality Place/Country of Birth Father’s TZVIKA EDELSTEIN ISRAEL ISRAEL ISRAEL Mother’s SARA EDELSTEIN ISRAEL ISRAEL ISRAEL Spouse ERAN FEINSTEIN ISRAEL ISRAEL ISRAEL Were your Grandfather/Grandmother(Paternal/Maternal) Pakistan Nationals Or belong to Pakistan held area : NO E. Details of Visa Sought TOURIST VISA (Month) 3 Month DELHI Type Of Visa Required Period of Visa Port Of Arrival (Visa shall be valid from the Date of Issue and not from the Date of Journey) AYELET FEINSTEIN No of Entries Expected Date of Journey Port of Exit Single 16-MAR-2014 DELHI
  2. 2. TOURIST VISA Places to be Visited DELHI Purpose of Visit : TOURISM F. Previous Visit Details Have You Ever visited India ? Address where You stayed in India NO Web File Number :KENNV0058C14 Required Detail of , Cities in India Visited Type of Visa Visa Issued Place Countries visited in last 10 years Visa Number Date of Issue Have you been refused an Indian Visa or extension of the same previously or deported from India ? If yes above mention when and by whom with control No/Date G. Profession/Occupation Details of Spouse Present Occupation HOUSE WIFE Designation/Rank MD Employer name/business 3G DIRECT PAY LIMITED Employer Address LANDMARK PLAZA NAIROBI KENYA Phone Number 254700404699 Past occupation if any Are/have you worked with Armed forces/ Police/ Para Military forces ? NO Organization Designation Place of Posting Rank H. Address of Place of Stay / Hotel Place/Hotel Name Address of Place / Hotel I. Details of Two Reference In India Nam e NONE Address NONE Phone 00000000 Number In ERAN FEINSTEIN State Phone No. KENYA 42 KAPUTEI RD NAIROBI 0700404699 J. DECLARATION: a. b. c. d. I do not hold any other passport(s) other than those detailed above. I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them. I declare that the information given in the form is complete and correct and the visit to India will be undertaken for the purpose indicated in the application. I understand that in case the information provided in the form is found to be incorrect, I will be liable for denial of visit/ entry or deportation and/ or other penalties during the visit as provided by Indian law. 22-JAN-2014 Date :………………………. ..…………………………………… Applicant’s signature (as in Passport)