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    180523V3LRJJ

    Uploaded by

    subratdasbali
    This document is an application form for registration with immigration authorities in India. It contains personal details of the applicant such as name, date of birth, passport information, contact details, and family information. It also includes the applicant's arrival details in India, purpose of visit, and documents required for registration such as photo, residence proof, visa, and passport biodata page. The last section provides the address of the registration office where the applicant needs to submit the application.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    180523V3LRJJ

    Uploaded by

    subratdasbali
    24 views3 pages
    This document is an application form for registration with immigration authorities in India. It contains personal details of the applicant such as name, date of birth, passport information, contact details, and family information. It also includes the applicant's arrival details in India, purpose of visit, and documents required for registration such as photo, residence proof, visa, and passport biodata page. The last section provides the address of the registration office where the applicant needs to submit the application.

    Original Description:

    VISA EFO Letter

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    This document is an application form for registration with immigration authorities in India. It contains personal details of the applicant such as name, date of birth, passport information, contact details, and family information. It also includes the applicant's arrival details in India, purpose of visit, and documents required for registration such as photo, residence proof, visa, and passport biodata page. The last section provides the address of the registration office where the applicant needs to submit the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    24 views3 pages

    180523V3LRJJ

    Uploaded by

    subratdasbali
    This document is an application form for registration with immigration authorities in India. It contains personal details of the applicant such as name, date of birth, passport information, contact details, and family information. It also includes the applicant's arrival details in India, purpose of visit, and documents required for registration such as photo, residence proof, visa, and passport biodata page. The last section provides the address of the registration office where the applicant needs to submit the application.

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    © All Rights Reserved
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    You are on page 1of 3

    APPLICATION FORM

    ( Registration )

    180523V3LRJJ

    Application ID No. 180523V3LRJJ Final Submission Date Thu May 18 23:21:31 IST 2023

    FOR OFFICE USE ONLY

    Reg. No. B 0 0 1 R U S 2 0 2 3

    Personal Details
    Surname REPIN
    Given Name ILIA Paste your
    Sex Male Date of Birth 10/02/1988 Height (in cm) 178 Recent passport size
    Age as on today Year(s) 35 Month(s) 3 Day(s) 8 photograph here
    Place of Birth RUSSIA,KRASNODAR,RUSSIAN FEDERATION
    Father's Name ALEKSANDER
    Mother's Name INNA
    Spouse's Name
    Religion CHRISTIAN Any Identification mark(s) preferably NO
    visible

    Present nationality RUSSIAN FEDERATION Previous nationality RUSSIAN FEDERATION


    Manner of acquiring present nationality Birth
    Date of acquiring present nationality 10/02/1988
    Whether holding dual NO
    nationality? If yes, Name of the country of second nationality
    provide the following:- Passport No. of second country
    Date of Issue
    Date of Expiry
    Whether travelled on this passport earlier to
    India

    Whether person of Indian Origin NO

    Address of last residence (Outside India)


    Address JL. UMALAS KLECUNG NO 8X. KEROBOKAN KELOD KUTA UTARA KAB. BADUNG BALI
    City BADUNG Country INDONESIA

    Address intended for longer stay in India (Registration)


    Address G-13 GK2 NEW DELHI - 110048
    City/ District DELHI State DELHI
    Pin Code 110048
    Phone Number Mobile Number 9667789765
    Any Other Address in India
    Address 103 A SAHARA APARTMENT NEAR PANJABI VASANT KUNJ SOUTH WEST
    City/ District DELHI State DELHI
    Pin Code 110070
    Phone Number Mobile Number 9958427958
    Email/Occupation/Profession Details
    E-Mail Id repinilia88@gmail.com
    Profession/Occupation BUSINESS

    Passport Details
    Passport Number 754022133 Place of Issue RUSSIAN FEDERATION, RUSSIA
    Date of Issue 07/12/2016 Expiry Date 07/12/2026

    Visa Details
    Visa Number 900FBCF0N Place of Issue INDIA, DELHI
    Date of Issue 12/05/2023 Expiry Date 10/05/2024
    Valid For Multiple Entry Visa Type e-VISA
    Special endorsement, if any

    Organization/Company/Institute/Hospital Details
    Name
    Address

    Page 1 of 3
    180523V3LRJJ
    Application ID No. 180523V3LRJJ

    State City
    Telephone Number Email ID
    Employer EPFO ID Establishment ID
    Arrival Details
    Place of embarkation/boarding for India INDONESIA,BALI,INDONESIA
    Date of arrival in India 14/05/2023
    Place of disembarkation/arrival in India DELHI
    Mode of Journey Air Flight/ Ship/ Bus/ Train No. 174
    Purpose of visit to India Business

    Previous Registration Details in India


    Registration Number Place of Registration Visa Type Duration From To
    Details of family members/attendant/dependents, if any accompanying.
    Name Nationality Passport Number Relationship
    Person to be contacted in Case of Emergency
    Name SUBRAT DAS Relationship FRIEND
    Address 103, A SAHARA APT, VASANTKUNJ City DELHI
    Country INDIA Phone Number 9958427958
    Category Others

    Military service details


    Organisation Designation
    Rank Place of Last Posting
    Country of Last Posting

    Signature of the Applicant


    Date_ _ _ _ _ _ _ _ _ _ _ _ _

    Page 2 of 3
    180523V3LRJJ
    Application ID No. 180523V3LRJJ

    List of mandatory and non mandatory documents

    Mandatory Documents.
    1. Photo : Applicant's Photo
    2. Residence proof : Residence proof i.e. updated form 'C' generated by hotel/ lodge or Registered / Notarized Lease Deed or Utility Bill copy along with copy of photo-ID of landlord with
    declaration.

    3. Visa : Copy of latest Indian visa


    4. Passport : Bio-data page of passport

    Registration office address

    Office Name : FRRO NEW DELHI


    Address : EAST BLOCK 8, SECTOR 1 , R.K. PURAM, NEW DELHI
    City/District : DELHI
    State : DELHI
    Pin Code : 0
    Phone Number : 01126711443

    Office opening time: 9.30 closing time: 18.00

    There is no need to submit hard copy to concerned


    FRRO/FRO

    Page 3 of 3

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