Applicant’s

D. I. P Form-4(Free of cost)
Passport-Size
Photograph

Government of the People's Republic of Bangladesh

Department of Immigration & Passports
Machine Readable Visa/No Visa Required (NVR) Application Form

 This Form Should Be Filled Up In ‘Capital Letters’. Put (√) In Appropriate Box
 For NVR Sought Information with * is mandatory
 Please Go Through The General Instructions Before Filling Up The Visa Form
 Name of Office/Bangladesh Mission: Bangladesh Assistant High Commission, Birmingham, UK

PERSONAL DETAILS

01. Full Name*: _____________________________________________ ________________________________________

(as in the passport) First/Given Name(s) Last/Surname
02. Permanent address*: _____________________________________________________________
_____________________________________________________________
Contact no*: _____________________ E-mail: ________________________
03. Address in Bangladesh*: _________________________________________________________________
__________________________________________________________________
Contact no*: _____________________ E-mail: ________________________

04. Date of Birth*: ________/________/_________ 05. Sex: Male Female Others

DD MM YYYY
06. Place of Birth*: ____________________________ 07. Present Nationality*: ____________________
08. Nationality at Birth*:___________________________ 09. Occupation*: ____________________________
10. Marital Status*: Unmarried Married Widower/Widow Divorced

TRAVEL DOCUMENT DETAILS

11. Passport No*: _____________________________ 12. Type of Passport*: _________________________
12. Place of Issue*: ___________________________
14. Date of Issue*: ________/________/_________ 15. Date of Expiry*: ________/________/_________
DD MM YYYY DD MM YYYY
16. Date of last visit to Bangladesh: ________/________/_________
DD MM YYYY
17. Last Visa No: ____________________________ 18. Date of Issue: ________/________/_________
DD MM YYYY
19. Place of Issue: ___________________________ 20. Date of Expiry: ________/________/_________
DD MM YYYY

PAYMENT DETAILS
21. Name of the Bank and Branch: _______________________________________________________________________
22. Cheque/ Bank Transfer/ Chalan/ Scroll No: ________________________________________________________
23. Amount deposited: __________________________ 24. Date: ________/________/_________
DD MM YYYY
 NEW VISA
25. Purpose of Visit: Tourism Employment Business Official Diplomatic
Study Investment Transit Others_____________________________
(Please Specify)
26. Duration of Proposed Stay in Bangladesh: ________________________
27. Tentative Date of Arrival in Bangladesh: _______/________/_________
DD MM YYYY

28. Intended Number of Entries: Single Re-entry Multiple

EXTENSION OF VISA

29. Name of Father/Mother/Spouse/Other(Relation): _________________________________________

30. Date of Arrival: _____/______/_________ 31. Visa No.______________ 32. Type of Visa: _______________
in Bangladesh DD MM YYYY

33. Date of Issue: _____/_____/_________ 34. Date of Expiry: _____/_____/_________

DD MM YYYY DD MM YYYY

35. Place of Issue: ___________________________

36. Purpose of Extension of Visa: _________________________________________
37. Duration of Proposed Extension: _____________________________________
38. Intended Number of Entries: Single Re-entry Multiple

NO VISA REQUIRED FOR TRAVEL TO BANGLADESH

39. Father’s Name*:______________________________________________ Nationality*: _______________________

40. Mother’s Name*: _____________________________________________ Nationality*: _______________________
41. Spouse’s Name*: _____________________________________________ Nationality*: _______________________
42. Intended Date of Arrival in Bangladesh*: ____ /____/_________ 43. Last Visa No._________________
DD MM YYYY
44. Date of Issue: _____/_____/_________ 45. Date of Expiry: _____/_____/_________
DD MM YYYY DD MM YYYY

46. Place of Issue: _________________________ 47. Type of Visa: ______________________

48. Reason for proposed NVR: ________________________________________________________________________
49. Amount of Investment (For Investor): ___________________________________________________________
50. Name and Address of Company: __________________________________________________________________
_________________________________________________________________

TRANSIT/ON ARRIVAL VISA

51. Date of Arrival in Bangladesh: ________/________/_________ 52. Name of Check Post: ______________
DD MM YYYY
53. Travelled by (Vessel’s/Flight/Vehicle Name & No): _______________ 54. From: ____________________
55. Purpose of Visit to Bangladesh: ________________________ 56. Duration of Proposed Stay: __________
 CHECK LIST

Recommendation from concern Ministry/ Authority Marriage Certificate

Security Clearance/Security Certificate Birth Certificate
Father’s/ Husband’s/Mother’s Visa Copy Work Permit
Passport copy, Last Visa & Last Arrival Page Affidavit
Father’s/ Husband’s/Mother’s Passport Copy Photo
Bi- Lateral Agreement/ Multilateral Agreement TIN
Income Tax Certificate of the Company TIN certificate of the company
Trade license of the sponsoring Company Payment Slip
Over stay payment Slip Others __________________________________________
I, hereby, declare that statement given above is true and will not request to refund my paid visa fee
even if my application is declined.
Place:____________________________ _______________________________________________________________________

Date: ________/________/_________ Signature

DD MM YYYY

POLICE VERIFICATION

Memo No: Date: ________/________/_________

DD MM YYYY

Information’s are found: Correct Incorrect

If not correct: Reasons: ____________________________________________________________________

____________________________________________________________________
____________________________________________________________________

______________________________ _____________________________________
Signature and Seal of Inquiry Officer Signature and Seal of Issuing Officer

FOR OFFICIAL USE

Reference No: _________________ Date: ______________ Amount of Fee:________________

Visa No: _________________ Date: _______________ Date of Expiry: ___________________

Number of Entries: Extension Re-entry Multiple _______Entries NVR

Recipient’s Signature Authorized Signature

Date: Date & Seal
 General Instructions
1. Attach a colour photograph (45mm x 35mm) with glue at the top left corner of the form.
Photograph has to be white background.
2. Personal details, Travel Document details, Payment details (as applicable) must be filled up.
3. Apply according to your necessity and fill up the required option of New visa/ Extension of
visa/ Transit permit/ On arrival visa/ No Visa Required (N.V.R)
4. Apply with required documents. Application with missing documents will not be received.
5. Use Tick mark (√) in the check Box.
6. Deposit the visa fee (if applicable) to the respective bank counter and attach payment
receipt on the top of the application form.
7. Receive delivery slip after the submission of application form and check the content of the
delivery slip before going out from the office.
8. Paid visa fee is non-refundable.
9. Lodge your passport as per tentative call date for getting visa.
10. Reissuance of visa sticker due to applicant’s mistake needs to be paid again as per payment
list.
11. In some cases, Visa call date subjects to police verification Report/ Security Clearance from
MOHA/ Work Permit from BOI/BEPZA/ N.G.O/ Bureau/ Recommendation from Ministry or
organizations concerned.
12. The authority’s decision on issuing visa is final.