EMBAIXADA DA NDIA

EMBASSY OF INDIA
SHIS QL 08 Conj. 08 Casa 01 Lago Sul Braslia DF, Brasil
CEP 71.620-285 Telefones/Telephones: (061) 3248-4006
Fax: (061) 3248-7849 E-mail: indemb@indianembassy.org.br

PARTE / PART A
(A SER PREENCHIDO EM LETRA DE FRMA POR TODOS OS CANDIDATOS AO VISTO)
(TO BE FILLED IN CAPITAL LETTERS BY ALL APPLICANTS FOR VISA)

1.

(a) Nome completo / Full name: ____________________________________________

(b) Sobrenome de famlia / Family name at birth (se diferente / if different):
___________________________________________________________________
(c) Sexo / Sex: M/ F

2.

Se alguma criana estiver acompanhando o candidato ao Visto e esta estiver includa em

seu passaporte, preencha os dados abaixo / Whether any children accompanying the
applicant are included in his/her passport. If so, give the following details:
Nome / Name:

_______________________________________________________

Local e Data de
Nascimento / Place
and date of birth

Sexo / Sex

Parentesco /
Relationship

Sinal de Nascena, se
houver/ Identification
marks if any

3.

Nome do pai ou do marido do requerente ao visto / Fathers or husbands name of the

person requiring visa: ____________________________________________________

4.

Endereo / Address:
(a) Residencial / Residence: _______________________________________________
______________________________________________________________________
E-mail: _______________________________ Fax: ____________________________
Telefone / Telephone: ___________________
(b) Comercial / Office: ___________________________________________________
______________________________________________________________________
E-mail: _______________________________ Fax: ____________________________
Telefone / Telephone: ___________________

5.

Data de Nascimento /Date of birth:

______________________________________

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6.

Local de Nascimento / Place of birth:

______________________________________

7.

Nacionalidade atual / Present Nationality: ____________________________________

8.

Alguma outra nacionalidade anterior ou presente, com detalhes / Any other previous or
present Nationality, with details: ______________________________________

Profisso ou ocupao / Profession or occupation:

__________________________
10. Informar:
(a) Se o aplicante ou seus pais ou avs (todos paternos e maternos) tiveram a
nacionalidade paquistanesa a qualquer tempo. / Whether the applicant or his parents
or grand parents (both paternal and maternal) were holding the nationality of
Pakistan at any time. __________________________________________________
9.

(b) Pases visitados durante os ltimos 10 anos. / Countries visited during the last 10
years. ______________________________________________________________
(c) Se foi adquirido a cidadania do pas por nascimento ou naturalizao. / Whether one
has acquired citizneship of the county by birth or by naturalization._____________
(d) Cidadania de qualquer outro pas que foi obtida anteriormente. / Citizenship of any
other country held previously.___________________________________________
(e) O endereo de amigos/parentes/lugares de estadia durante a viagem anterior ndia. /
The addresses of friends/relatives/ places of stay during the previous travel to India.
______________________________________________________________
____________________________________________________________________
__________________________________________________________________
(f) Local onde foi adquirido o visto durante as visitas anteriores. / From where the visa
was acquired duirng previous visits. ______________________________________
(g) Nmero telefnico e celular do aplicante assim como do patrocinador na ndia. /
Telephone number and mobile number of the applicant as well as the sponsor in
ndia. ______________________________________________________________
11.

Particularidades do(s) passaporte(s) ou outros documentos de viagem / Particular of

passport or passports or other travel documents:
(a) Nmero / Number:
__________________________________________________
(b) Local de emisso / Place of Issue:
______________________________________
(c) Data de emisso /Date of Issue:
______________________________________
(d) Data de validade / Date of Expire:
______________________________________

12.

Voc j visitou a ndia anteriormente? Se sim, indique os locais e datas Have you visited
India previously, if so indicate places with dates: _________________________

13.

Se a permisso para a visita ou o pedido para prorrogar a estadia na ndia foi recusado
anteriormente, indique quando / Whether permission to visit India or to extend stay in
India has been refused previously, and if so, when: _____________________________

14.

(a) Perodo que o Visto solicitado / Period for which visa is required: _____________
______________________________________________________________________

(Nota: A prorrogao do Visto de Trnsito vlido por uma quinzena no ser concedido
Note: Extension of Transit Visa which is valid for fortnight will not generally be granted).
(b) Qual dos Vistos de entrada requerido: Simples, Duplo, Triplo ou Mltiplo? Whether
a single, double, triple or multiple entry is required?____________________
15.

Objetivo da viagem / Object of journey:

(a)

Trnsito / Transit
(Especificar o destino final / Specify the final destination) _______________________

(b)

Turismo Tourism
(Especificar os locais a serem visitados / Specify places to be visited) ______________
______________________________________________________________________

(c)

Negcio / Business
(Nome da Empresa e natureza do negcio / Name of business partners and nature of
business) ______________________________________________________________

(d)

Educao / Education
(Nome e particularidades da Instituio de Ensino / Name and particulars of education
institutions) ___________________________________________________________

(e)

Outros / Any other

(Especificar propsito / Specify purpose) ____________________________________

PARTE / PART B

(NO PARA SER PREENCHIDO PELOS CANDIDATOS AO VISTO DE TURISMO)

(NOT TO BE FILLED BY APPLICANTS FOR TOURIST VISA)

1.

Estado, Cidade, etc. de destino na ndia / State, town etc of destination in India.
___________________________________________________________________

2.

Porto de desembarque na ndia / Port of landing in India.

___________________________________________________________________

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3.

Nome e endereo de pessoas que iro fornecer informaes sobre o candidato e

tambm fornecer garantias financeiras para estadia e retorno / Name and address of
persons who will furnish information as to applicant and also furnish guarantees for
maintenance and repatriation if referred to:

NO PAS DO CANDIDATO
IN COUNTRY OF THE APPLICANT

I.

___________________________________________________________
_________________________________________________________

II.

___________________________________________________________
_________________________________________________________
NA NDIA
IN INDIA

III.

___________________________________________________________
_________________________________________________________

IV.

___________________________________________________________
_________________________________________________________

PARTE / PART C

Eu, _____________________________________________, pela presente comprometo-me

utilizar minha visita ndia com o propsito do qual o Visto foi requerido e no irei ndia
para conseguir emprego ou estabelecer negcio ou estender minha estadia por qualquer outra
razo.
I, ___________________________________________ hereby undertake that I shall utilize
my visit to India for the purpose for which visa has been applied for and shall not, on arrival
in India, try to obtain employment or set business or to extend my stay for any other purpose.

Data / Date ___/___/___

________________________________________
Assinatura / Signature