VISA AND PASSPORT REQUEST FORM

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N VISA AND PASSPORT REQUEST FORM *********************************************************************************** TRAVELER INFORMATION: Last Name (Traveler 1): First Name: Last Name (Traveler 2): First Name: Return Documents to: Home or Business (Name & c/o): EXACT address (No P.O.Boxes): Apt/Ste#: City: State: Zip Code: Phone (required): Email: Date you need your passport (Please allow maximum processing time for regular processing) Optional insurance: $9.00 per passport: in the unlikely event that your passport is lost or damaged in transit from GenVisa. This will cover your full out of pocket visa(s) and passport replacement costs up to $2,000. Please check one of the boxes below. Yes, I have added an additional $9.00 per person for the optional insurance. [FedEx Signature required upon delivery.] No, I decline the optional insurance and understand that in the unlikely event my passport is lost or damaged, Generations Visa Service liability is limited to $100. [No signature required upon delivery.] Services Requested: Passport: Diplomatic / Official / Regular New: Renew: 2 nd Passport: Visas: Tourist: Business: Number of Entries Country #1: Country #2: Country #3: Payment Method for Applicable Fees: 3% surcharge will be added to All credit card transactions Check (Preferred): # Name on Card: Master Card/ Visa Card: Card Number: Exp.Date: / Signature: Amount: $ SVV: ************************************************************************************ Mail materials to: GENERATIONS VISA SERVICE 2233 WISCONSIN AVE N.W. #226 WASHINGTON D.C. 20007-4119 1-800- 845-8968

INDIA TVOA - SINGLE ENTRY - $104 PER PERSON Processing time 10 business days. Add $35 to expedite within 5 business days. INDIA TOURIST VISA ON ARRIVAL Visa on Arrival Facility is available for holders of passport of following countries Australia, Brazil, Cambodia, Cook Islands, Djibouti, Fiji, Finland, Germany, Indonesia, Israel, Japan, Jordan, Kenya, Kiribati, Laos, Luxembourg, Marshall Islands, Mauritius, Mexico, Micronesia, Myanmar, Nauru, New Zealand, Niue Island, Norway, Oman, Palau, Palestine, Papua New Guinea, Philippines, Republic of Korea, Russia, Samoa, Singapore, Solomon Islands, Thailand, Tonga, Tuvalu, UAE, Ukraine, USA, Vanuatu, Vietnam. Eligibility International Travelers whose sole objective of visiting India is recreation, sightseeing, casual visit to meet friends or relatives, short duration medical treatment or casual business visit. a. Passport should have at least six months validity. b. International Travelers should have return ticket or onward journey ticket, with sufficient money to spend during his/her stay in India. c. International Travelers having Pakistani Passport or Pakistani origin may please apply for regular Visa at Indian Mission. d. Not available to Diplomatic/Official Passport Holders. Instructions for Tourist Visa on Arrival (Enabled by ETA) 1.Applicants of the eligible countries may apply online minimum 4 days in advance of the date of arrival with a window of 30 days. Example: If you are applying on 1st September then applicant can select arrival date from 5th September to 4th October. 2. Recent front facing photograph with white background and photo page of Passport containing personal details like name, date of birth, nationality, expiry date etc. to be uploaded by the applicant. The application is liable to be rejected if the uploaded document and photograph are not clear and as per specification. 3. Tourist visa on arrival (TVoA) fee is US$ 65.00 - per passenger excluding interchange charge for credit/debit cards. The fee must be paid 4 days before the expected date of travel filled by you otherwise application will not be processed. 4. TVoA fee once submitted is nonrefundable. 5. Applicant should carry a copy of ETA along with him/her at the time of travel. 6. Biometric details of the applicant will be mandatorily captured at Immigration on arrival in India. 7. The validity of visa will be 30 days from the date of arrival in India. 8. Electronic Travel Authorization (ETA) is valid for entry through 9 designated Airports i.e. Bangalore, Chennai, Cochin, Delhi, Goa, Hyderabad, Kolkata, Mumbai & Trivandrum. 9. This facility is in addition to the existing Visa services. 10. Tourist Visa On Arrival (TVoA) is allowed for a maximum of two visits in a calendar year. 11. Tourist Visa On Arrival (TVoA) once issued on arrival is non-extendable, non-convertible & not valid for visiting Protected/Restricted and Cantonment Areas.

DOCUMENTS REQUIRED: 1. Perfect legible copy of First (Data) Page of Passport in actual size (professional copy only!) 2. Professional passport photograph meeting the following requirements: a. Photo should present full face, front view, eyes open. Do not wear glasses! b. Background should be plain white background. c. No shadows on the face or on the background. d. Without borders. 3. GenVisa Order Form (enclosed) with pertinent contact and payment information. Please Note: The online visa application form is an Indian government run website; therefore GenVisa is unable to offer technical support to applicants completing their own applications. Applicants, who chose to complete online application themselves, should take great care to fill in the information correctly. Any mistakes will delay processing and/or require the process to be repeated. QUESTIONS ANSWERS APPLICANTS INFORMATION 1. Surname, as in passport 2. Given Names (first, middle) 3. Other names used (maiden, etc.) 4. Place of Birth (TOWN, State, 5. Driver s License Number 6. Religion 7. Visible Identification Marks (moles, scars, tattoos on your face or arms) 8. Education (List your highest education) 9. Marital Status Single Married Divorced Widowed 10. Spouse s Full Name as in passport 11. Spouse s Nationality 12. Spouse s Previous Nationality 13. Spouse s Place of Birth (TOWN, State, PASSPORT DETAILS 14. Passport number 15. Place of Issue 16. Date of issue (dd/mm/yyyy) 17. Date of expiry (dd/mm/yyyy) APPLICANT S ADDRESS DETAILS 18. House Number and Street (NO PO BOX)

19. City and State 20. Zip Code 21. Phone Number 22. Email Address (please print) FAMILY DETAILS 23. Father s Full Name 24. Father s Nationality 25. Father s Place of Birth (TOWN, State, 26. Mother s Full Name 27. Mother s maiden name, if known 28. Mother s Nationality 29. Mother s Place of Birth (TOWN, State, 30. Were your Grandfather/Grandmother Pakistan Nationals or Belong to Pakistan Held Area? PROFESSION/OCCUPATION DETAILS OF APPLICANT 31. Present Occupation 32. Employer/Business Name 33. Designation/Position 34. Employer s Full Address 35. Employer s Phone Number 36. Past Occupation VISIT DETAILS 37. Type of Visa TOURIST 38. Places to be visited (cities in India) 39. Number Of Entries SINGLE 40. Duration of Visa 30 DAYS 41. Date of arrival (dd/mm//yyyy) 42. Port of Arrival 43. Port of Exit 44. Have you ever visited India? If Yes, Please list details why and when? PREVIOUS VISA DETAILS

45. Has permission to visit or to extend stay in India previously have been refused? 46. Have you visited South Asian Association for Regional Cooperation (SAARC- Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka) countries in past 3 year? If yes, Please list details. 47. Countries visited in past 10 years (list just Names of the countries you have visited In last 10 years) 48. Reference Name in India (Name and Address of first hotel 49. Reference Name in United States (Name, Complete physical address and phone Number Signature: Date: Additional Information: