India Visa Application Form
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4CONSULATE GENERAL OF INDIA
3 EAST 64T H ST REET
P AST E
(Bet. Madison and Fifth Avenue)
ONE P ASSP ORT SIZE
NEW YORK, NY 10021
P HOT OGRAP H HERE
T EL (212) 774-0600. Fax (212) 570-9581
E-mail:
For more information visit our w ebsite:
P lease sign in the box
below
.
VISA APPLICATION FORM
•
PLEASE READ INSTRUCTIONS before filling up this form. Instructions can be obtained from the
Consulate General of India, New York or from our web site.
•
Applications are accepted from 9.15 A.M. to 12:15 P.M. on working days and serviced passports are
delivered between 4:30 to 5:15 P.M.
•
VALIDITY OF VISA STARTS FROM THE DATE OF ISSUE. This form is also for transfer of visa
.
•
Enclose passport in Original valid for a minimum of six months
•
Send exact amount of FEE in the form of MONEY ORDER/CERTIFIED CHECK payable to
CONSULATE GENERAL OF INDIA or in CASH in bills no larger than $50/-. WE DO NOT ACCEPT
PERSONAL CHECKS. Use only one mode of payment for the entire fee.
•
Please DO NOT SEND CASH IF APPLYING by mail. Also enclose payments (US $ 5 for certified mail
or US $ 15 for Express mail) for return of serviced documents by mail.
•
Effective 1 February, 2003.This f orm is t o be used by all applicant s residing in t he f ollowing states: CT,
ME, MA, NH, NJ, NY, OH, PA, PR, RI, VT, USVI
1. Full Name:________________________________________________________________________________
(First)
(Middle )
(Last)
2. Last Name at Birth (if different):___________________________________________________________
3. Marital Status:
Married
Unmarried
4. If married, give maiden name:_____________________________________________________________
6. Sex: Male
Female
5. Date of Birth:___________________
mm/dd/yyyy
7. Place of birth:___________________
8. Current Nationality:_______________________________
9. Are you a permanent/long-term resident in USA?
Yes
No
If yes, please attach copy of Green Card/Long-Term Visa (Non-US passport holders only)
10. Nationality at birth:_____________________________________________________________________
11. Any other nationality held at present or in the past:______________________________________
(Are you in possession of any other passport?)
12. Present Address:________________________________________________________________________
_________________________________________________________________________________________
13. Phone:________________________________(Home) ____________________________________(Work)
14. Permanent Address:____________________________________________________________________
_________________________________________________________________________________________
15. Profession:______________________________________________________________________________
16. Employer’s Name and Address:__________________________________________________________
_________________________________________________________________________________________
17. Passport Number:__________________________ 18. Valid Till:_______________________________
19. Issued At:________________________________
20. Issue Date: _____________________________
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