<p> EMBASSY OF INDIA, BUITENRUSTWEG 2, 2517 KD THE HAGUE Tel. (070) 3469771/4273812 - Fax (070) 3617072 / (070) 3462594 - Telex 33543 INDEM NL - TIMINGS: 10.00 to 12.00 hours VISA APPLICATION FORM TICK APPROPRIATE BOX BELOW (): Type of Duration of visa & fee in NLG visa 3 Months 6 Months 1 Year 5 Years Transit € 12  - - - - Tourist - € 50  - - Business € 50  € 50  € 80  € 160  IMPORTANT Journalist € 50  € 50  € 80  - AFFIX TWO Employment - - € 80  - PHOTOGRAPHS Student - - € 80  - HERE Family visa for € 50  € 50  € 80  € 160  Ex-Indian Transfer of Visa € 6  INSTRUCTIONS</p><p>FOR NON-TOURIST VISAS, PLEASE SEE THE INSTRUCTIONS OVERLEAF (PART B & C). IF PASSPORT IS TO BE RETURNED BY POST, PLEASE ATTACH A SELF-ADDRESSED ENVELOPE WITH € 6 POSTAGE STAMP AFFIXED ON IT. IF VISA APPLICATIONS IS SENT BY POST.</p><p>VISA WILL BE Places to be visited Purpose of visit VALID FROM DATE OF ISSUE PART-A</p><p>Mr/Ms/Mrs Last name First name Middle name</p><p>Father’s/Husband’s name</p><p>Place/date of birth: Place Day Month Year</p><p>Address: Phone No. Residence</p><p>City: Phone No. Work Profession/Employment Passport No. Date Place of issue Expiring on</p><p>Children included in the applicant’s passport. To be filled ONLY when children are accompanying the applicant. Name Place & date of birth Sex Identification mark, if any.</p><p>Present nationality Any other nationality held, previous or present.</p><p>Whether visa has been refused previously? If so, give details. I ...... hereby undertake that I shall utilise my visit to India for the purpose for which visa has been applied and shall not on arrival in India, try to obtain employment or set-up business or extend my stay for any other purpose. I fully understand that if any of the particulars furnished above are found to be incorrect or if any of the information is found to be withheld, the visa is liable to be cancelled at any time. DATE...... Signature of the applicant ...... </p><p>PART-B (FOR NON-TOURIST VISAS)</p><p>The following documents should be enclosed with the application form:</p><p>(i) Business Visa:Sponsorship from company/organisation sponsoring the visit to India (ii) Family Visa: Proof of Indian nationality and details of residence abroad (iii) Student Visa: Letter of admission from recognised school/ college/university/educational institution in India (iv) Conference Visa: Letter of invitation from conference organisers in India (v) Employment Visa: Appointment/contract letter giving details of employment (vi) Journalist Visa: Letter from sponsoring/inviting agency or organisation giving details such as places to be visited, people to be interviewed etc. (vii) Transit Visa: Valid ticket for outbound journey from India. This visa is valid only for seventy two hours on disembarcation at the transit point in India for onward journey.</p><p>PART-C (FOR NON-TOURIST VISAS)</p><p>Name & address of two references: In the country of applicant: (1)</p><p>(2)</p><p>In India: (1)</p><p>(2)</p><p>PART-D (FOR AFGHAN NATIONAL HOLDING DUTCH TRAVEL DOCUMENT)</p><p>Name & address of two references: In the country of applicant: (1)</p><p>(2)</p><p>In India: (1)</p><p>(2)</p><p>DECLARATION to be made by applicants seeking to stay for more than one year: “I hereby undertake that I shall subject myself to a medical test, including for AIDS, within one month of arrival in India. In case I am found positive for AIDS, I will leave India”.</p><p>Signature of applicant</p>