HIGH COMMISSION OF INDIA
KUALA LUMPUR
Tel. No: 00-603 62052350-54(5 lines)
Fax No. 00-603 61431190
Email: cons@indianhighcommission.com.my
ADDITIONAL FORM TO BE FILLED IN BY NON RESIDENTS (IN BOLD CAPITAL
LETTERS) ALONG WITH VISA APPLICATION FORM
Name of the applicant :___________________________________________
Father’s name :___________________________________________
Nationality :___________________________________________
Date and place of birth :___________________________________________
Ppt. No., date and place of issue: ________________________________________
Occupation :___________________________________________
Permanent address :___________________________________________
(In country of origin) ____________________________________________
____________________________________________
Type of visa holding for stay in Malaysia: ______________________________
Period of continuous stay in Malaysia: ______________________________
_______________________
Signature of applicant
_________________________________________________________________________
For office use only
To : ____________________________________________
Repeat to: _______________________________________
From: First Secretary (Consular)
Our ref :Kua/con/407/1/2003 date:_______________
The above mentioned __________________ national(s) born in _____________________
approached this mission for Single/ Double/ Multiple entry Tourist/ Business/ Entry/
Employment / Transit visa (s) to India for a period of _________. Request telex clearance.
Cost recovered.
__________________________
for FIRST SECRETARY(CONS)