e-visa Questionnaire

1. 1 | Page
INDIA VISA
Passport Type
Nationality
Port Of Arrival
Date of Birth
Email ID
Expected Date of Arrival
Visa Service
e- Tourist Visa
e-Business Visa
e-Medical/Medical Attendant Visa
Applicant Details
Surname (exactly as in your Passport)
Given Name/s (exactly as in your
Passport)
Have you ever changed your name?
(YES or NO). If YES, fill below details.
Gender
Date of Birth (DD/MM/YYYY)
Town/City of birth
Country of birth
Citizenship/National Id No.
Religion
Visible identification marks
Educational Qualification
Nationality
Did you acquire Nationality by birth or
by naturalization?
Have you lived for at least two years in
the country where you are applying
visa? Yes / No
Passport Details
Passport Number
Place of Issue
Date of Issue
Date of Expiry (DD/MM/YYYY)
Any other valid Passport/Identity
Certificate(IC) held, Yes No
* Mandatory Fields

2. 2 | Page
Applicant's Address Details
House No./Street
Village/Town/City
Country
State/Province/District
Postal/Zip Code
Phone No.
Mobile No
Email Address
Click here for same address
Permanent Address
House No./Street
Village/Town/City
State/Province/District
Family Details
Father's Details
Name
Nationality
Previous Nationality
Place of birth
Country of birth
Mother's Details
Name
Nationality
Previous Nationality
Place of birth
Country of birth
Applicant's Marital Status
Spouse's Details
Name
Nationality
Previous Nationality
Place of birth
Country of birth
Were your Parents/Grandparents
(paternal/maternal) Pakistan
Nationals or Belong to Pakistan held
area.

3. 3 | Page
Profession / Occupation Details of
Applicant
Present Occupation
Employer Name/business
Designation
Address
Phone
Past Occupation, if any
Are/were you in a Military/
Semi-military/ Police/ Security.
Organization?
Organization
Designation
Rank
Place of Posting
Details of Applicants Company (Only for Business e-visa)
Company Name
Company Address
Company Phone Number
Company website
Details of Invitee Company (Only for Business e-visa)
Indian Company Name
Indian Company Address
Indian Company Phone number
Indian Company Website
Details of Visa Sought
Type of Visa
Visa Service
Places to be visited
Places to be visited line 2
Duration of Visa
No. of Entries
Port of Arrival in India
Expected Port of Exit from India
Previous Visa/Currently valid Visa
Details
Have you ever visited India before?
(YES or NO). If YES give details
Address
Cities previously visited in India
Last Indian Visa No/Currently valid

4. 4 | Page
Indian Visa No.
Type of Visa
Place of Issue
Date of Issue (DD/MM/YYYY)
Has permission to visit or to extend
stay in India previously been refused?
(YES or NO)
If YES, when and by whom (Mention
Control No. and date also)
Other Information
Countries Visited in Last 10 years
SAARC Country Visit Details
Have you visited SAARC countries
(except your own country) during last 3
years? YES OR NO
Name of SAARC country
Year
No. of visits
Reference
Reference Name in India
Address
Phone
Reference Name in HOME COUNTRY
(As per Nationality)
Address
Phone