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Appendix - 1 |Related to rule 4 (3), 5 (2) & 6 (5)|

Application Form For Diplomatic / Official / Tourist Visa

(For Entry)

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To. The lmmigration 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 follows. 1st 2nd 3rd 1. Name: ... ... ... ... .................. .................. 2. Nationality: ... ... ... ... ... ... 3. Place of birth : ... ... ... ... ... ... ... ... ... ... ... ... ... 4. Date of birth ... ... ... ... ... ... ... ... 5. Permanent Address : ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6. Temporary Address in Nepal : ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7. Occupation : ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8. Particulars of Passport :(a) Passport No. : ... ... ... ... ... ... ... ... ... ... (b) Date of issue : ... ... ... ... ... ... ... ... (c) Date of Expiry : ... ... ... ... ... ... ... ... 9. Object of Journey Official / Trekking / Expedition / Business / Pilgrimage / Holiday / Pleasure / Conference / Rafting / Others. 10. Intended length of stay : ... ... ... ... ... ... day / week / month 11. Next port of call ... ... ... ... ... ... ... ... 12. Means of support in Nepal (State amount in foreign currency): 13. Particulars of previous visit, If any: (a) How many time: ... ... ... ... ... ... (b) Year and month of last visit : ... ... ... ... ... ... (c) Stay period of last visit : ... ... ... ... ... ... ... 14. Passport No. and country (if you are holding more than one passport of any other country) ... ... ... ... ... ... ... ... ____________________ Signature of Applicant _________________________________________________________________________________________ FOR OFFICIAL USE ONLY :Types of visa granted: ... ... ... ... ... ... ... ... ... Flight No ... ... ... ... ... ... ... Reasons for gratis (if granted): ... ... ... ... ... ... Arrival Date ... ... ... ... ... ... Entry visa No. : ... ... ... ... ... ... ... ... ... ... Date of visa validity : ... ... ... ... ... ... ... ... Visa issued on : ... ... ... ... ... ... ... ... ... ... ________________ Visa sticker No. : ... ... ... ... ... ... ... ... ... Visa issung officer Visa issued at : ... ... ... ... ... ... ... ... ... ... Code No ... ... ... (If issued at the e ntry Point)

1. 2. 3. 4. 5. 6. 7.

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