Pakistan Visa Application Form Chicago Page 4
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4iv.
Have you ever been refused entry on arrival to Pakistan?
Yes
No
(If yes please provide details of refusal)
v.
Have you ever been deported, removed or otherwise required to leave any country,
including Pakistan? Yes
No
(If yes please provide details)
Date
Country
Reason
Reference Number (
For Pakistan)
vi.
Do you have any criminal convictions or charged in any country?
Yes
No
(If yes please provide details)
Date
Country
Offence
Sentence
DECLARATION:
I declare that the information given in this form is correct to the best of my knowledge and belief
and if any of the particulars furnished above are found to be incorrect or withheld the visa is liable
to be rejected / cancelled at any time.
Date
___________________
Signature of the Applicant ____________________________
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