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. Fathers/Husbands 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.