VISA APPLICATION FORM http://indianvisaonline.gov.in/visa & NON-RESIDENT FORM Click here to download[ ]  Note : Use Internet Explorer to download the PDF file

FAX NO: 00-603-2092 2752

ADDITIONAL FORM TO BE FILLED IN BY NON-RESIDENTS, (IN BOLD CAPITAL LETTERS) ALONG WITH VISA APPLICATION FORM

NAME OF THE APPLICANT	:	________________________________________
FATHER’S NAME	:	________________________________________
NATIONALITY	:	________________________________________
DATE AND PLACE OF BIRTH	:	________________________________________
PASSPORT NUMBER	:	________________________________________
DATE AND PLACE OF ISSUE	:	________________________________________
OCCUPATION	:	________________________________________
PERMANENT ADDRESS	:	________________________________________
(In Country of Origin)		________________________________________
TYPE OF VISA HOLDING FOR STAY IN MALAYSIA	:	________________________________________

_______________________________

SIGNATURE OF APPLICANT

FOR OFFICE USE ONLY

TO              : ________________________________

REPEAT TO : ________________________________

FROM : FIRST SECRETARY (CONSULAR)

OUR REF : KUA/CON/407/1/2003                                                                                                                                    DATE: ________________

THE ABOVE MENTIONED___________________________________NATIONALS_____________________ APPROACHED THIS MISSION FOR SINGLE/MULTIPLE ENTRY / TOURIST / BUSINESS / SOSIAL / EMPLOYMENT VISA (S) TO INDIA FOR A PERIOD OF ______________________ REQUEST TELEX CLEARANCE, COST RECOVERED.

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For FIRST SECRETARY (CONS)