singh, jugmohan

India Visa Summary - ID: 697379305

Applying: In Person *** Reservation *** Friday May 20, 2011 09:20am - It is very important to arrive within 10 minutes of your scheduled time. Departure Date: July 18, 2011 Citizenship: United States Passport Number: 219620274 Visa Type: Tourist Visa Visa Length: 10 Years Multiple Entry
Consular Fee: $153.00 Outsourcing Fee: $13.00 Shipping from Travisa Outsourcing back to You: $0.00 Total Fee: $166.00 Shipping From Travisa Outsourcing back to You: Pickup in person at window Home Phone: 3018796880 Cell Phone: 2405356707 Email: [email protected]
Please include this summary sheet along with the application. The checklist on Page 4 is for your records, and does not need to be included. All Consular Fees and Processing Fees are NONREFUNDABLE, even if a visa is denied or if a visa is issued for a shorter period of time or otherwise issued or returned at a time or on terms and conditions that vary from those sought by the applicant. Travisa Outsourcing is a service company only. Travisa Outsourcing does not issue visas or in any way determine or control the issuance of, or terms and conditions of, visas all of which is determined and controlled solely by the Consulates of the Embassy of India. Travisa Outsourcing is not and cannot be responsible for any determinations, acts or omissions by the Consulates. Any application that is not submitted to Travisa Outsourcing within 90 days from when it is completed online will be automatically deleted from our system. *** Important *** Office Security Regulations in all Travisa Outsourcing offices do not permit you to carry the following: You will be asked to power off your cell phone and put it away. All battery operated or electronic gadgets such as digital diaries, pagers, audio/video cassettes, compact discs, palmtops or portable music players. Only a small ladies pouch in hand will be permitted. All bags such as travel bags, back packs, briefcases, suitcases, leather, jute or cloth bags and zip folders. Only a plastic bag containing your application related papers is permitted. Strollers are also not permitted. Any food item. Sealed envelopes or packages. Any sharp objects such as scissors, pen knives or nail filers. Weapons or explosive material of any kind. This list is not finite. Other items may be prohibited based on security staff discretion. For security reasons there is no facility at Travisa Outsourcing to store prohibited items. You will have to make other arrangements to keep the same before entry. Only people applying for a visa will be allowed on our premises.
Office Use Only Name Passport Number Passport Date of Issue Passport Date of Expiration. Date of Birth $2.00 Copy Initials:

Application ID: 697379305 - Generated on: 05/18/2011 2:43pm EST

Tourist Visa - 10 Years Multiple Entry - $153.00 - United States

Embassy of India
Washington
Visa Application Form Handled by Indian Visa Center 1010 Wisconsin Ave, NW Suite #100 Washington, DC 20007
Application ID: 697379305 1. FULL NAME: jugmohan
(First)

Photo Instructions: Staple 2 photos together in this box as indicated

none
(Middle)

singh
(Last)

FOR OFFICE USE ONLY USAW03354211

2. LAST NAME AT BIRTH (IF DIFFERENT): 3. MARITAL STATUS: X Married Unmarried

4. IF MARRIED GIVE MAIDEN NAME: 5. DATE OF BIRTH: 04/01/1960

dd/mm/yyyy

6. SEX:

Male

Female

7. PLACE OF BIRTH: n delhi, MD, India 8. CURRENT NATIONALITY: United States By Birth X By Naturalization Yes X No

9. ARE YOU A PERMANENT/LONG TERM RESIDENT IN USA? 10. NATIONALITY AT BIRTH:

India United States; India

11. ANY NATIONALITY HELD PRESENT/PAST: 12. PRESENT ADDRESS: 14104 fairdale rd silver spring
(City)

MD
(State)

20905
(Zip)

United States
(Country)

13. PHONE

Home:

3018796880 14104 fairdale rd 20905

(Zip)

Work:

Mobile:

2405356707

14. PERMANENT ADDRESS: silver spring

(City)

MD,
(State)

United States
(Country)

15. PROFESSION:

preist

16a. EMPLOYER'S NAME: 12917 old columbia pike 20904

(Zip)

gnfa

16b. EMPLOYER'S ADDRESS: silver spring

(City)

MD
(State)

United States
(Country)

17. PASSPORT NUMBER: 19a. PASSPORT ISSUED AT:

219620274 Department of State

18. VALID UNTIL: 19b. ISSUE DATE:

19/10/2016 (dd/mm/yyyy) 20/10/2006 (dd/mm/yyyy)

20. HAVE YOU OR YOUR PARENTS OR YOUR GRANDPARENTS EVER HELD THE NATIONALITY OF PAKISTAN? Yes No X If yes above, give details: 21a. FATHER NAME: 22a. SPOUSE NAME: 23a. MOTHER NAME: nanak singh gurdeep kaur gurdeeep kaur Business 21b. FATHER NATIONALITY: 22b. SPOUSE NATIONALITY: 23b. MOTHER NATIONALITY: Student Entry Transit India United States India Journalist

24. TYPE OF VISA REQUIRED: Tourist X Conference Employment Other

Application ID: 697379305 - Generated on: 05/18/2011 2:43pm EST

Embassy of India - Visa Application Form 25. PLACES YOU PLAN TO VISIT: 26. PERIOD OF VISA: 15 Days delhi, jammu Three Months X Six Months Yes No One Year Five Years Ten Years X

27. HAVE YOU EVER VISITED INDIA BEFORE?

28. IF YES ABOVE, GIVE DETAILS: j7/38 rajori garden, n delhi-110027 Address where you stayed: 30/07/2007 to 15/08/2007 Dates Stayed (dd/mm/yyyy): delhi, amritsar jammu Places Visited: 29. COUNTRIES VISITED IN THE LAST 10 YEARS: india china uk 30. HAVE YOU VISITED INDIA ON TOURIST VISA IN THE LAST 2 MONTHS? 31. HAVE YOU BEEN REFUSED AN INDIAN VISA OR EXTENSION OF THE SAME PREVIOUSLY? Yes No X If yes above, give details: 32. ARE YOU HOLDING A VALID "NO OBJECTION TO RETURN TO INDIA" ENDORSEMENT? Yes No X If yes above, give details: 33. OBJECT OF JOURNEY: Yes X No Visa Issued At: washington dc

faimily visit
Yes X No

34. ARE YOU TRAVELING ON BEHALF OF A COMPANY If yes, give details: 35. EXPECTED DATE OF DEPARTURE FROM USA: 36. EXPECTED DATE OF ARRIVAL IN INDIA:

18/07/2011
dd/mm/yyyy

10/08/2011
dd/mm/yyyy

37. PORT OF ARRIVAL IN INDIA

n delhi

38. ARE ANY CHILDREN IN YOUR PASSPORT ACCOMPANYING YOU? Yes No X If yes above, give details: 39. NAME, ADDRESS AND PHONE OF TWO REFERENCES: (a) In India:
Name: Address: Phone: jasbir singh j7/38 rajori garden, n delhi, 110027 25460876 Cell Phone:

(b) In applicant's country:

Name: Address: Phone: gurdeep s bawa 12506 gey fox ln, potomac, MD, 20854 3018380460 Cell Phone: 3019086333

I, jugmohan singh hereby undertake that I shall utilize my visit to India for the purpose for which the visa has been applied for and shall not, on arrival in India, try to obtain employment or set up business or extend my stay for any other purpose.

Signature: If applicant is younger than 18 years old, application should be signed by both parents and/or guardians. Place: Date: silver spring, MD, United States 18/5/2011

Application ID: 697379305 - Generated on: 05/18/2011 2:43pm EST

India Visa Checklist - Applying In Person

Tourist Visa: A Tourist visa is given to those visiting India for tourism or other non-business related purposes. Applicants volunteering, working with charities or working with non-profit organizations must apply for an Employment visa. 5 year and 10 year Tourist visas are available only to US citizens under a bilateral arrangement. There should be a gap of at least 2 months between two separate visits to India on a Tourist visa. For Tourist visa holders who wish to visit India within 2 months of their last visit, an application for a Permit to Re-enter India is necessary. No Permit is needed if the visa holder is traveling to multiple countries on the same itinerary and the trip follows the itinerary exactly. The visa holder must carry a copy of the itinerary to show the Immigration Officer. All non-US passport holders are only eligible for up to a Six (6) month Tourist visa. Irrespective of the duration of validity of visa, on each visit maximum period of stay in India is limited to 6 months (180 days). Please note the visa is valid beginning on the day it is issued. So a 6 Month visa issued on January 1 would be valid until June 30. Your visa application will not be processed without all items listed below. If all items are not provided, your application may be returned to you. When applying in person on behalf of someone else, only the following people are allowed to apply: * Relative of Visa Applicant * Co-worker of Visa Applicant (with Employee Identification) * Travel companions of Visa Applicant (same Itinerary)
India Visa Checklist: * Please check the box for the items you are including in your application package. * Documents should be provided in the same order as they appear on this checklist. * Photos should be attached using the instructions on the visa application. 1. Visa Application Print and sign the application. 2. Passport Passport must have a minimum validity of six months from the date of application with at least two blank visa pages. Last 2 amendment pages are not acceptable. Must be the actual passport not a copy because your visa will be stamped in the actual passport. 3. Photographs 2 latest identical passport size photographs (black/white or color) depicting front pose against light background on photographic paper. No glasses are allowed to be worn in the photo. Follow the instructions on the India Visa Application on how to affix the photos to the application. 4. Proof of Address Applicants must submit a photocopy with proof of residence/address that matches the present address on the visa application exactly. Photocopy of state issued ID (Driver License or ID), major utility bill (Water, Gas, Electric, Sewage) or a copy of a lease containing both the landlord and tenant signatures must be submitted. Do not cut your drivers license copy down to a smaller size. Please leave the copy on regular sized paper. If you don't bring a copy, we will make a photocopy for you for $2.00.The following items are not accepted: cell phone bill, credit card statement or bank statement. The address cannot include a P.O. box.For minors, a proof of address from both parents or a legal guardian may be submitted instead. 5. For Minors Only - Copy of Birth Certificate
For
Applicant

Use

For Office Only

For minors only (under 18), a photocopy of the birth certificate or any government issued document that shows parents name, date of birth and nationality. Depending on your nationality at birth, these are the documents that are accepted. US Born: Only birth certificates are accepted for applicants born in the US. Indian Born: Those born in India can use their birth certificate, old Indian passport or school leaving certificate. All Others: Those not born in the US or India should submit a birth certificate or any government document from the country of origin that has parents name, date of birth and nationality. Must be translated into English and notarized.You should not send the originals - we cannot be responsible for original documents. If you don't bring a copy, we will make a photocopy for you for $2.00. 6. Parents' Passport Copies A copy of the vital page(s) containing the picture and signature page of both parents signed passports. For Minor Applicants only. 7. Former Indian Nationals naturalized before June 1, 2010 US Citizens who received US citizenship before June 1, 2010 do not have to obtain a renunciation certificate if proof of renunciation can be provided. One of the following must be produced as proof: Your cancelled Indian passport with stamp stating the passport is canceled due to obtaining US (or any non Indian country) citizenship or, If not cancelled, then please provide your most recent Indian Passport.If you do not have your most recent passport you must provide the following:Affidavit of Loss (https://www.indian-visa.com/pdf/Affidavit_Of_Loss.pdf) Copy of your naturalization certificateCopy of your birth certificate or a school leaving certificateRenunciation Fee of $20.00. This should be a separate money order payable to 'Travisa Outsourcing' Two (2) copies of the completed renunciation form https://indiavisa.travisaoutsourcing.com/pdf/Renunciation_Form.pdf should be included. On the renunciation form, 'Original Indian passport not surrendered and claimed as lost/misplaced' should be writtenIf available, a photocopy of the Indian passport information should be included 8. Former Indian Nationals naturalized after May 31, 2010 Former Indian nationals applying for an Indian visa are required to surrender citizenship of India immediately if not done already. Same day processing time will not be available, and the overall processing time will be increased. If the applicant has already renounced Indian citizenship, one of the following must be produced as proof: A Certificate of Renunciation issued by a Consulate of India or, An Indian Passport that contains a stamp that specifically renounces the citizenship. If the applicant has NOT renounced their Indian citizenship, or cannot show proof, the following must be provided: Two (2) copies of the completed renunciation form - https://www.indian-visa.com/pdf/Renunciation_Form.pdf. This form is current as of May 14, 2010. Disregard all prior versions. Renunciation fee of $175.00 paid with a separate Money Order payable to 'Travisa Outsourcing'. Most recent Indian passport. Applicant must provide photocopies of the first three pages of the passport and the last two pages of the passport.If you do not have your most recent passport you must provide the following:Affidavit of Loss (https://www.indian-visa.com/pdf/Affidavit_Of_Loss.pdf) Copy of your naturalization certificateCopy of your birth certificate or a school leaving certificateRenunciation Fee of $175.00. This should be a separate money order payable to 'Travisa Outsourcing' Two (2) copies of the completed renunciation form https://indiavisa.travisaoutsourcing.com/pdf/Renunciation_Form.pdf should be included. On the renunciation form, 'Original Indian passport not surrendered and claimed as lost/misplaced' should be writtenIf available, a photocopy of the Indian passport information should be includedPlease note that a renunciation declaration along with payment of $175.00 is required in all cases of acquisition of foreign nationality by an Indian citizen after May 31, 2010, even though that Indian passport is claimed to have been lost. 9. Naturalization Certificate A copy of the Naturalization Certificate is required: If your most recent Indian passport expired or is due to expire on or after January 1, 2005 If your US passport is issued on or

after June 1, 2010 while naturalization took place on or before May 31, 2010. If a minor gained naturalization through his/her parents and possesses no separate naturalization certificate then a notarized written statement signed by both parents is required stating the circumstances that their child received his/her naturalization status and why the child does not possess his/her own certificate. A copy of the Naturalization Certificate is required for all applicants applying in the Houston jurisdiction. 10. Potential Penalty Fees Required Once a person acquires citizenship of another country, it is obligatory to surrender Indian citizenship and Indian passport should not be used for travel 3 months beyond the date of acquisition of citizenship. If the Indian passport is retained for more than 3 years after acquisition of citizenship of another country, a penalty of $250.00 will be charged except where the Indian passport expired before January 1, 2005. In addition, a penalty of $250.00 will be charged for each case of misuse of the Indian passport for travel after 3 months of acquisition of citizenship of another country subject to a maximum penalty of $1250.00. Drop off completed requirements to the following location:

Travisa India Outsourcing Visa Section 1010 Wisconsin Ave, NW Suite #100 Washington, DC 20007 Dropoff Date/Time: Friday May 20, 2011 09:20am Pickup Hours: 4:30pm - 6:00pm EST (Same Day 5:30pm - 6:00pm)

Application ID: 697379305 - Generated on: 05/18/2011 2:43pm EST