APPLICATION FORM
( Registration )
2609248DSE5N
Application ID No. 2609248DSE5N Final Submission Date Thu Sep 26 09:59:38 IST 2024
FOR OFFICE USE ONLY
Reg. No. S 1 2 5 M M R 2 0 2 4
Personal Details
SII Student ID
Surname VICITTA Paste your
Given Name VICITTA Recent passport size
Sex Male Date of Birth 20/05/1989 Height (in cm) 6 photograph here
Age as on today Year(s) 35 Month(s) 4 Day(s) 6
Place of Birth THEGON,BAGO,MYANMAR (BURMA)
Father's Name U AYE LWIN
Mother's Name DAW TIN THAN
Spouse's Name
Religion BUDDHISM Any Identification mark(s) preferably NO
visible
Present nationality MYANMAR (BURMA) Previous nationality MYANMAR (BURMA)
Manner of acquiring present nationality Birth
Date of acquiring present nationality
Whether holding dual NO
nationality? If yes, Name of the country of second nationality
provide the following:- Passport No. of second country
Date of Issue
Date of Expiry
Whether travelled on this passport earlier to
India
Whether person of Indian Origin NO
Address of last residence (Outside India)
Address DHAMMADUTA BUDDHIST UNIVERSITY
City BAGO Country MYANMAR (BURMA)
Address intended for longer stay in India (Registration)
Address NEW INTERNATIONAL BOYS HOSTEL
City/ District VARANASI State UTTAR PRADESH
Pin Code 221005
Phone Number 08252060792 Mobile Number
Any Other Address in India
Address BHU
City/ District VARANASI State UTTAR PRADESH
Pin Code 221005
Phone Number 08252060792 Mobile Number
Email/Occupation/Profession Details
E-Mail Id
[email protected]Profession/Occupation STUDENT
Passport Details
Passport Number MI409855 Place of Issue MYANMAR (BURMA), BAGO
Date of Issue 02/01/2024 Expiry Date 01/01/2029
Visa Details
Visa Number VL7610416 Place of Issue MYANMAR (BURMA), YANGON
Date of Issue 30/08/2024 Expiry Date 27/02/2025
Valid For Multiple Entry Visa Type STUDENT VISA
Special endorsement, if any NO
Organization/Company/Institute/Hospital Details
Name BHU
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2609248DSE5N
Application ID No. 2609248DSE5N
Address NEW INTERNATIONAL BOYS HOSTEL
State UTTAR PRADESH City VARANASI
Telephone Number 9453885577 Email ID
Employer EPFO ID Establishment ID
Arrival Details
Place of embarkation/boarding for India YANGON,YANGON AIRPORT,MYANMAR (BURMA)
Date of arrival in India 15/09/2024
Place of disembarkation/arrival in India KOLKATA AIRPORT
Mode of Journey Air Flight/ Ship/ Bus/ Train No. 8M607
Purpose of visit to India Studies
Previous Registration Details in India
Registration Number Place of Registration Visa Type Duration From To
Details of family members/attendant/dependents, if any accompanying.
Name Nationality Passport Number Relationship
Person to be contacted in Case of Emergency
Name SILANANDA Relationship FRIEND
Address BHU City VARANASI
Country INDIA Phone Number 9044326807
Category Others
Military service details
Organisation Designation
Rank Place of Last Posting
Country of Last Posting
Signature of the Applicant
Date_ _ _ _ _ _ _ _ _ _ _ _ _
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2609248DSE5N
Application ID No. 2609248DSE5N
List of mandatory and non mandatory documents
Mandatory Documents.
1. Photo : Applicant's Photo
2. Visa : Indian Visa
3. Residence proof : Residence Certificate from Hostel/Updated Form 'C' generated by Hotel/Lodge or Registered/Notarized Lease Deed, Utility Bill, Copy of photo-ID of the landlord along
with declaration and Tenant Police Verification
4. Passport : Bio-Data page of Passport along with page bearing last Indian Immigration arrival stamp
5. Financial resource proof : NRO account details and Scholarship letter, whichever is applicable
6. Bonafide certificate : Bonafide Certificate to be obtained from a UGC or AICTE recognized Institute/College/University mentioning Foreign Students’ Information System (FSIS) No.,
course undertaken, duration of course and e-mail ID of the Institute/College/University
Registration office address
Office Name : FRO VARANASI
Address : L.I.U. Office, Madagin, Kotwali Campus, Varanasi
City/District : VARANASI
State : UTTAR PRADESH
Pin Code : 221002
Phone Number : 2502655
Office opening time: 10.00 closing time: 17.00
There is no need to submit hard copy to concerned
FRRO/FRO
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