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REGISTRATION FORM FOR INDIAN NATIONALS

EMBASSY OF INDIA

HAVANA
 

REGISTRATION FORM FOR INDIAN NATIONALS

1 PERSONAL PARTICULARS

i) Name
ii) Father’s name
iii) Spouse name
iv) Date & place of Birth
v) Date of arrival in the country

2 PASSPORT DETAILS

i) Passport Number
ii) Date of issue
iii) Place of issue
iv) Date of expiry

3 CONTACT DETAILS

i) Residential address
ii) Telephone No. residence
iii) Mobile number
iv) Email address

4 EMPLOYMENT DETAILS

i) Name of the Company/Firm
ii) Office address
iii) Contact details
iv) Date of joining of Company/Firm

5 PERMANENT ADDRESS IN INDIA

6 DOCUMENTS TO BE ATTACHED

i) Passport copy
ii) Copy of office/local Identity card (if any)


Place :
Date :

(Signature of the applicant)

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