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Appendix - 1

[Related to rule 4(3), 5(2) & 6(5) ]

APPLICATION FORM FOR DIPLOMATIC/

OFFICIAL/ TOURIST VISA

(FOR ENTRY)

To,

The Immigration Officer

Immigration Office T. I. A.

 

       I Would like to travel Nepal, Please kindly issue me Diplomatic / Official / Tourist visa

for entry. My biodata and other details are as follows.

 

                                1st                                                            2nd                                                          3rd

 

1.         Name : …                                                                                          

2.         Nationality: …                             3. Sex:                   

4.         Place of birth: …                              5. Date of birth: …          

6.         Permanent Address: …                                               

7.         Temporary Address in Nepal: …                                       

8.         Occupation: …                                          ...        

9.         Particulars of Passport :

            (a)   Passport No. : …                    

            (b)   Date of issue : …                    

            (c)   Date of Expiry: …                  

10.      Object of journey : Official /  Trekking  / Expedition  /  Business  / Pilgrimage / Holiday / Pleasure / Conference / Rafting /Others.

11.      Intended length of stay: …            … day / week / month

12.      Next port of call: …            … …     

13.      Means of support in Nepal (State amount in foreign currency):

14.      Particulars of previous visit, if any:

            (a)   How many time : …          

            (b)   Year and month of last visit : …              

            (c)   Stay period of last visit : …                 

15.      Passport No. and country  (If  you  are holding more than one passport of any other

            Country) …         … …         

16.      Flight No. … …           

17.      Arrival Date: … …                                                                                                  

                                                                                                                                Signature of Applicant

                                                                                                                                                                                                                                                                       

                       FOR OFFICIAL USE ONLY:-

1.         Types of visa granted: …                                                      

2.         Reasons for gratis (if granted): …                  

3.         Entry visa No. …               

4.         Date of visa validity: …                                                            _____________________

5.         Visa issued on: …                                                Visa issuing officer

6.         Visa sticker No.: …                                                                     Code No. … … …       

7.        Visa issued at: …                                                            (If issued at the entry Point)