DELHI AIRPORT
e-Visa Paste your unsigned
recent color photograph.
ENABLED BY ETA Size: 2" X 2"
e-Visa Application Form
Signature
I004W079B519
A. Personal Particulars (As in Passport)
Surname SAYROU
Given Name AXEL
Previous Name
Gender MALE Marital Status SINGLE
Date of Birth 01/04/1994 Religion SIKH
Place of Birth LES LILAS Country of Birth FRANCE
File Ref No : I004W079B519
Nationality FRANCE
Identification
marks MOLE UNDER THE RIGHT EAR
B. Passport Details
Passport No. 17DD87947 Date of Issue 04/07/2017
Place of Issue BOBIGNY Date of Expiry 03/07/2027
Any other Passport/Identity Certificate held (if yes ,please fill in the following) NO
Country of Issue Place of Issue
Passport/IC No. Place of Issue
C. Applicant's Contact Details
Present Address 10 RUE DE ROME BOBIGNY SEINE SAINT DENIS
Mobile Email [email protected]
D. Family Details
Relation Name Nationality Prev. Nationality Place of birth
Father's SAYROU BRUNO FRANCE FRANCE DRAVEIL
Mother's AYOT ANNE CAROLINE FRANCE FRANCE CHATEAU THIERRY
Spouse's
Were your Parents/Grandparents (paternal/maternal) Pakistan Nationals or Belong
to Pakistan held area. NO
E. Visa Details
Visa Service eTourist Visa(for 1 Year)
Period of visa 365 days No. of entries Multiple
Journey Date 20/11/2019 Port of Exit DELHI AIRPORT
F. Purpose Details
Purpose of Visit MEETING FRIENDS/RELATIVES
1) Places to be visited1 ARMITSAR DELHI HAZUR SAHIB ANANDPUR SAHIB
2) Places to be visited2
3) Have you booked any room in Hotel/Resort etc. through any
Tour Operator? NO
4) Name of the tour operator
5) Address of the tour operator
6) Name of Hotel/Resort etc
7) Place/City of Hotel/Resort etc
8) Details of the Friend/Relative SINGH JAGJIT
9) Address BAINS AWAN VPO MIANI 144202
10) State PUNJAB
11) District HOSHIARPUR
File Ref No : I004W079B519 :: Registration Date :08/NOV/2019
12) Phone no +919815239404
13) Have you ever been arrested/ prosecuted/ convicted by ARRESTED DURING A DEMONSTRATION BECAUSE OF
Court of Law of any country? WEARING A KIRPAN IN FRANCE (PARIS).
14) Have you ever been refused entry / deported by any
country including India? NO
15) Have you ever been engaged in Human trafficking/ Drug
trafficking/ Child abuse/ Crime against women/ Economic
offense / Financial fraud? NO
16) Have you ever been engaged in Cyber crime/ Terrorist
activities/ Sabotage/ Espionage/ Genocide/ Political killing/
other act of violence? NO
17) Have you ever by any means or medium, expressed views
that justify or glorify terrorist violence or that may encourage
others to terrorist acts or other serious criminal acts? NO
18) Have you sought asylum (political or otherwise)in any
country? NO
19) evisa_fee 40
G. Profession/Occupation Details
Present
Occupation WORKER Designation/Rank
Employer name/business CFM
Employer Address 86 RUE DE L ETOILE Employer Phone
H. Details of Two Reference
In India In FRANCE
Name SINGH JAGJIT DHRAMVIR SINGH
BAINS AWAN VPO MIANI
144202 10 RUE DE ROME
Address PUNJAB
Phone +919815239404 +33616954921
I. DECLARATION
a. I do not hold any other passport(s) other than those detailed above.
b. I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them.
c. I declare that the information given in the form is complete and correct and the visit to India will be undertaken for the purpose
indicated in the application.
d. I understand that in case the information provided in the form is found to be incorrect, I will be liable for denial of visit/ entry or
deportation and/ or other penalties during the visit as provided by Indian law.
Date :08/NOV/2019
