CONSULATE GENERAL OF INDIA HOUSTON(USA) 
(FAX NOS.00-1-713-627-2034 OR 713-993-9347 OR 713-626-2450) 
ADDITIONAL FORM TO BE FILLED IN BY NON-RESIDENTS IN BOLD CAPn AL 
	, 	LETTERS, ALONGWITH VISA APPLICATION FORM 
NAME OF THE APPLICANT: 

FATHER'S/HUSBAND'S NAME: 
NATIONALITY: 
DATE & PLACE OF BIRTH: 
PPT. NO. WITH~DA TE AND PLACE OF ISSUE: 
OCCUPATION: 
PERMANENT ADDRESS (In country of origin) 
LOCAL COMPLETE ADDRESS: 
TYPE OF VISA HOLDING FOR STAY IN USA: 

DA TED: 
NO.HOU/C/406/ 
TO INDEMBASSY/HCI/CGI 

SIGNA TURE OF THE APPLICANT FOR OFFICE USE ONLY" 
	/2006 	DATED: 

	THE ABOVE MENTIONED 	NATIONAL (S) HAS/ 
	HA VE APPROACHED THIS POST FOR GRANT OF 	MONTH 
(S) SINGLE/DOUBLE/MULTIPLE ENTRY TOURISTIBUSINESSNISITOR VISA FOR INDIA. 

GRA TEFUL FAX CLEARANCE WITHIN 72 HOURS OTHER WISE VISA WILL BE ISSUED PRESUMING YOUR NO OBJECTION AND AS PER MHA INSTRUCTIONS. 

'- 

VICE CONSUL (CONS.)