FORM OF APPLICATION FOR THE GRANT OF NO OBJECTION RETURN TO INDIA Note.- If any of the particulars furnished below are found to be incorrect or if any information is found to have been with held the granted is liable to be cancelled at any time. 1. Name in full (Surname in full) : _________________________ 2. Father's/Husband name : _________________________ 3. Address in India - (A) Permanent : _________________________ _________________________ (B) Present : _________________________ _________________________ 4. Nationality : _________________________ 5. Place and Date of Birth : _________________________ 6. Profession or present occupation : _________________________ 7. Number and date of passport, place of issue and upto : _________________________ which it is valid 8. Number and date of Visa for India where issued : _________________________ 9. Date and place of arrival in India : _________________________ 10. Purpose of visit to India : _________________________ 11. Whether resident in India previously, and if so, for : _________________________ what period 12. Date of expiry of authorised period of residence in : _________________________ India and the authority which granted the extension : _________________________ 13. Whether permission to extend stay in India has been : _________________________ granted, refused previously and if so, when 14. (A) The country to which the foreigner desires to : _________________________ Proceed and object of such journey (B) The expected period of stay in that country : _________________________ (C) Probable date of return to India : _________________________ 15. Reasons for returning to India : _________________________ 16. Name and address of persons in India who furnished : _________________________ financial guarantees for maintenance and repatriation on behalf of the applicant when he entered India. Dated ____________________________ Signature ________________________________
