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Consular Services  

Telex Form

FAX NO.00975-5-252992
TELEX FORM

(TO BE FILLED-IN CAPITAL LETTERS WITH BLACK INK)

Fax Message No.____________ Dated:__________________

From: CONGENDIA,PHUENTSHOLING, BHUTAN
TO: INDEMBASSY / HICOMMIND / CONGENDIA ________________________________

The Following person has applied for Visa:-

1. Name in Full :                           _____________________________________________________ (M/F)

2. Father’s/Husband’s name :   _____________________________________________________

3. Nationality :                               _____________________________________________________

4. Date of Birth :                         ______________________________________________________

5. Place of Birth :                        ______________________________________________________

6. Occupation / Job :                  ______________________________________________________

7. Passport No. :                        ______________________________________________________

8. Date of Issue of Passport:     _____________________________________________________

9. Full Home address of applicant: ___________________________________________________
      In his/her country                        ___________________________________________________
                                                          _____________________________________________________

10. Full address & Tel No. of:     ______________________________________________________
     applicant in Bhutan                   ____________________________________________________
                                                         ______________________________________________________


Please convey your clearance by return FAX.


 
 
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