Embassy of Pakistan 3517 International Court N.W Washington, D. C. 20008 info@embassyofpakistanusa.org (Visa Application Form) Your photographs must be: Passport size (45mm high x 35mm wide) PART-I A recent and likeness, showing full face with no hat, helmet or sunglasses although you can wear every day glasses 1. TYPE OF VISA APPLIED FOR: Diplomatic Official Military Business Tourist Family Transit Journalist Others (specify) 2. Purpose of visit: 3. Duration of Stay : 4. Visa required for: 01 month 06 months 1 year 02 years 05 years 5. Number of Entries : Single Double Multiple 6. i) Port of Entry in Pakistan_ ii. Port of Departure from Pakistan _ iii. Place (s) to be visited in Pakistan : a. b. c. d. 7. SECTION -I (APPLICANT S PARTICULARS) i. Name as in Passport: First Middle Last ii. Date of Birth: dd/mm/yyyy iii. Place of Birth: City Country iv. Sex: Male Female v. Blood Group vi. Marital status: Single Married vii. ix. Identification mark: viii. Native language Nationality: (a) Present (b) Previous P-1
x. Religion: 8. PASSPORT DETAILS: Type of Passport/ Diplomatic Official/Service Ordinary UN Travel Document Passport Number: Date of issue: Issuing authority Place of issue Date of Expiry 9. ADDRESS & CONTACT DETAILS: a. Address in USA/Country of Origin Telephone: i) Home ii) Work iii) Cell b. Address in Pakistan Telephone: i) Home ii) Work iii) Cell E-mail: 10. Is your visit sponsored? Yes No If yes, give details. Name of Sponsor Address Contact Number 11. DETAILS OF PROFESSION : a. Profession : _ b. Employer s/sponsor s details (in Pakistan/abroad (if applicable) Name Address Home Office Cellular Email address b) In case of military services, (armed forces and allied services), Please fill in the proforma: Annexure A P-2
12. DETAILS OF JOBS HELD IN THE PAST: a. Designation b. Department c. Duration (from-to)_ d. Duties e. Job address & Phone No. f. Name, address and contact numbers of the supervisor or a colleague, (use extra sheet if required): 13. Are you applying visa from a third country? Yes No If yes, please provide copy of Residence/Work Permit of that country 14. SECTION-II (FAMILY DETAILS) i. Name of mother ii. Nationality of mother ii. Name of father iv. Nationality of father v. Spouse details: Name_ Nationality Date and place of birth Profession: Name, address and contact number of the employer of spouse (if any) 15. Do you have any children? Yes No If yes, please provide details for each of your child. Name Date of birth 16. Please list any accompanying person / family member (including children) travelling with you to Pakistan. Full Name 1. 2. 3. Date of Birth Passport No. (if any) Address P-3
17. Do you have any bank account in Pakistan : Yes No Bank Name Branch A/C Number Address Verifier details 18. TRAVEL HISTORY: i. Have you ever visited Pakistan during last five years? Yes No if yes, please provide details: Date Destination/Address Purpose Duration 1. 2. 3. 4. 5. ii. Details of other countries visited, during last two years: Date Destination/Address Purpose Duration 1. 2. 3. 4. iii. Have you ever been refused a visa for any country, including Pakistan? Yes No iv. Have you ever been refused entry on arrival in Pakistan? Yes No If yes, please provide details of refusal. 1. 2. 3. 4. P-4
19. Have you ever been deported, removed or ordered to leave any country, including Pakistan? Yes No If yes, please provide details of refusal. 1. 2. 3. 4. 20. Do you have any criminal convictions or been charged in any country? Yes No If yes, please provides details. Date Country Offence Sentence 21. DECLARATION: I declare that the information given in this form is correct to the best of my knowledge and belief and if any of the particulars furnished above are found to be incorrect or withheld the visa is liable to be rejected/cancelled at any time. Date INSTRUCTIONS TO NOTE (Signature of Applicant) I) THE APPLICANT MUST SEND CURRENT VALID PASSPORT FOR VISA. II) APPLICANT MUST FILL OUT ALL COLUMNS WITH APPROPRIATE INFORMATION. APPLICATION WILL NOT BE ACCEPTED IF ANY COLUMN IS LEFT BLANK. APPLICANTS ARE REQUIRED TO ATTACH A COPY OF THE PASSPORT. III) ALL NON-US PASSPORT HOLDERS MUST ATTACH A COPY OF VISAS OR US PERMANENT RESIDENCE CARD WITH COVER LETTERS/LETTER OF INVITATIONS FROM THEIR ORGANIZATION/SPONSORS. IV) FIVE YEAR MULTIPLE ENTRY VISA FOR THE APPLICANT OF PAKISTAN ORIGIN ARE REQUIRED. ALSO ATTACH A COPY OF EXPIRED/VALID PAKISTANI PASSPORT OR COMPUTERIZED NATIONAL ID CARD. THE CHILDREN WHO ARE BORN IN AMERICA MUST ATTACH COPY OF THEIR BIRTH CERTIFICATE ALONG WITH ONE OF THE PARENTS PAKISTANI ID/ PASSPORT. V) FOR FOREIGN SPOUSE, A COPY OF MARRIAGE CERTIFICATE ALONG WITH COPY OF PAKISTANI PASSPORT/PAKISTANI NATIONAL ID OF THE HUSBAND/WIFE IS REQUIRED. VI) FOR DETAILED INSTRUCTIONS, CONSULT THE WEBSITE AT WWW.EMBASSYOFPAKISTANUSA.ORG P-5
PROCESSING CERTIFICATE (FOR OFFICIAL USE NOT TO BE FILLED BY APPLICANT) 1. Date of receipt of visa application 2. Registration No. 3. Visa fee received 4. Additional documents received_ a. b. _ c. d. _ 5. Particulars of official who checked the visa form for its corrections and supporting documents: Name: Designation: Date: Signature: 6. Details of clearance received from Ministry of Interior. No. Date: _ 7. Decision of office Incharge: a. Accepted b. Regretted c. Type of visa issued: d. Duration: e. Single Entry f. Multiple Entry g. No. of entries: Date: (Signature of Visa Issuing Authority) P-6