EMBASSY OF INDIA

MUSCAT
VISA APPLICATION FORM
PART A
NOTE:
1. The Passport should be
(a). valid for minimum six months and
(b). have a minimum of two blank pages
2. Payment by cash in Omani Riyals. No refund of any fees/ charges.
3. For further information, please visit us at www.indemb-oman.org
4. All columns must be filled up completely failing which the
application may be rejected.
1.

NAME (AS PER PASSPORT IN BLOCK LETTERS)

FIRST NAME
MIDDLE NAME

LAST NAME (SURNAME)

2.

PREVIOUS NAME, IF ANY

5.

PLACE OF BIRTH
(CITY / PROVINCE / COUNTRY)

6.

7.

PRESENT NATIONALITY

8.

9.

ADDRESS & TELEPHONE NO.

10.
PRESENT OCCUPATION
( PLEASE PROVIDE DESIGNATION AND NAME OF
P.O. Box:
ORGANISATION, IF APPLICABLE )
P.C:
NAME OF CITY:
TELEPHONE No.:
11.
PASSPORT NO.
GSM NUMBER:
E-MAIL ID:
PLACE OF ISSUE 13.
DATE OF ISSUE 14.
DATE OF EXPIRY

12.

3.

Paste One
Photograph Here and
Staple the other.

FATHERS NAME

4.

HUSBANDS NAME

DATE OF BIRTH
(DAY / MONTH / YEAR)

FOR OFFICIAL
USE ONLY

ANY OTHER NATIONALITY

(PRESENT OR PREVIOUS)

15.

WHETHER VISA HAS BEEN REFUSED PREVIOUSLY :

(IF YES, PLEASE GIVE DETAILS)

YES / NO

16.

PURPOSE OF JOURNEY (PUT ON WHICHEVER IS APPLICABLE)

(TRANSIT / BUSINESS / TOURIST / MEDICAL / STUDENT / ANY OTHER)

17.

DETAILS OF PREVIOUS VISITS TO INDIA : (MONTH & YEAR)

A.

B.

C.

18.

NUMBER OF ENTRIES PUT ON ONE

(SINGLE / DOUBLE / MULTIPLE)

19.

PERIOD OF VISA REQUIRED

20.

COUNTRY FROM WHICH ENTRY INTO

INDIA WILL BE MADE

21.

DATE OF ARRIVAL IN INDIA

ID Card No

C.R.No

Company Name

22.

PLACES IN INDIA TO BE VISITED

A.

B.

C.

23.

PORT OF FIRST ENTRY

24.

PORT OF FINAL DEPARTURE

25.

DECLARATION TO BE MADE BY APPLICANT SEEKING TO STAY IN INDIA FOR MORE

THAN ONE YEAR :
I HEREBY UNDER TAKE THAT I SHALL SUBJECT MYSELF TO A MEDICAL TEST
INCLUDING FOR AIDS WITHIN ONE MONTH OF ARRIVAL IN INDIA,
IN CASE I AM FOUND POSITIVE FOR AIDS, I WILL LEAVE INDIA.

(SIGNATURE OF THE APPLICANT)

PART B
NOT TO BE FILLED BY APPLICANT FOR TOURIST VISA
(TO BE FILLED BY THOSE WHO WERE PREVIOUSLY REGISTERED WITH FRRO)
WHETHER HOLDING VALID NO OBJECTION TO RETURN TO INDIA
ENDORSEMENT AND IF SO, GIVE PARTICULARS.

1)

2)

NAME AND ADDRESS OF TWO REFERENCES :

IN OMAN
IN INDIA
1)

2)

PART C
I HEREBY UNDERTAKE THAT I SHALL UTILIZE MY
VISIT TO INDIA FOR THE PURPOSE FOR WHICH VISA HAS BEEN APPLIED AND SHALL NOT ON
ARRIVAL IN INDIA, TRY TO OBTAIN EMPLOYMENT OR SET UP BUSINESS OR EXTEND MY STAY
FOR ANY OTHER PURPOSE. I FULLY UNDERSTAND THAT IF ANY OF THE INFORMATION IS
FOUND TO BE INCORRECT OR WITHHELD, THE VISA IS LIABLE TO BE CANCELLED AT ANY
TIME.

Date:
(SIGNATURE OF THE APPLICANT)

Page 3

EMBASSY OF INDIA
MUSCAT
Additional Information to be Furnished by the Applicant

1.

Whether the applicant or his parents or

grandparents (both parental and
maternal) were holding the nationality of
Pakistan at any time

2.

Countries visited during the last 10 years

3.

Whether the applicant has acquired

citizenship of the country by birth or by
naturalization

4.

Citizenship of any other country held

previously

5.

The addresses of friends/relatives/places

of stay during the previous travel to India

6.

From where the visa was acquired during

previous visits to India

7.

Telephone number and mobile number of

the applicant as well as the sponsor in
India

DECLARATION
I hereby declare that the information given above is true to the best of my
knowledge and belief. If the information given above is found to be incorrect o r found to be
deliberately subdued by me, I will be liable to disqualification for visa to India in future.

(Signature of the applicant)