Visa - Concierge Service (Personal Information Form)
This form is to advise Visa And More that you are requesting the complete Visa documentation. In order to properly process your request, please submit this form and submit your other documents as per the check list. The applicant do solemnly and sincerely declare that the particulars stated here are true, and the applicant make this solemn declaration conscientiously believing the same to be true.

Visa And More Concierge Service provides you a Concierge Specialist to manage the entire application process including document preparation and review, upgraded shipping, priority submission and more beginning within 4 business hours of your request. It's a complicated world out there. Let us simplify it for you.

From start to finish, you are assigned a Concierge Specialist, making sure all complications are minimized and that every document is prepared correctly. Concierge Specialist ensures that every step of the process is being watched and that you can go about your day with confidence that your passport and/or visa request is in the best possible hands. Once a request is made, Visa And More's Concierge Service begins by assigning a dedicated Specialist who will reach out to you to discuss your needs and make the process as simple, quick and hassle free.

Additional Concierge Service Highlights:

Assistance with document preparation and review to minimize any rejections or delays;
Application forms completed and delivered for signature;
Secondary personal review of all documents prior to submission;
Review and recommendation of most appropriate visa and service level based on needs;
Personalized updates during all phases of the process via preferred method of contact;
Visa And More Concierge Service — Additional fee per traveler: $195 in addition to Foreign Embassy/Consulate Fees.
$75 per additional destination/service.

For questions : Call 832-413-3669 OR Email : services@thevisaandmore.com

Email address *
1. Nationality
1.1 Date of Birth *
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1.2 Expected Date of Departure *
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1.3 Expected Date of Arrival *
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1.4 Type of Visa Sought
1.5 Purpose of Visit
Your answer
2. Surname (Last Name/as per your PASSPORT) *
Your answer
2.1 Given Full Name (as per your PASSPORT) *
Your answer
3. Sex *
4. Town/City of Birth *
Your answer
4.1 Country of Birth *
5. Driving License/ID No. (If not applicable please type NA) *
Your answer
6. Religion *
7. Visible Identification Marks *
Your answer
8. Educational Qualification *
9. Did You Acquire Current Nationality By *
9.1 Previous Nationality *
10. Current Passport Number *
Your answer
10.1 Place of Issue
Your answer
10.2 Date of Issue *
MM
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DD
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YYYY
10.3 Date of Expiry *
MM
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11. Any other Country's valid Passport/Identity Certificate Held *
11.1 If yes, give the name of the Country, Date of Issue, Place of Issue and NATIONALITY mentioned therein
Your answer
11.2 Date of Becoming Citizen of Any Other Country (if any, other than USA)
MM
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DD
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YYYY
12. Present Address *
Your answer
12.1 Permanent Address
Your answer
12.2 Home Phone No.
Your answer
12.3 Mobile/Cell Phone No. *
Your answer
13. Father's Name
Your answer
13.1 Father's Current Nationality *
Your answer
13.2 Father's Previous Nationality *
Your answer
13.3 Father's Place/City of Birth
Your answer
13.4 Father's Country of Birth
Your answer
14. Mother's Name
Your answer
14.1 Mother's Current Nationality *
Your answer
14.2 Mother's Previous Nationality *
Your answer
14.3. Mother's Place/City of Birth
Your answer
14.4 Mother's Country of Birth
Your answer
15. Marital Status *
16. Spouse's Name
Your answer
16.1 Spouse Current nationality *
Your answer
16.2 Spouse's Previous Nationality *
Your answer
16.3 Spouse Place/City of Birth
Your answer
16.4 Spouse's Country of Birth
Your answer
17. Were Your Grandfather/Grandmother (Paternal/Maternal)Pakistan Nationals or Belong to Pakistan Held Area: *
17.1 If YES, provide Your Paternal Grandfather's Name
Your answer
17.2 Your Paternal Grandfather's Current Nationality
Your answer
17.3 Your Paternal Grandfather's Previous Nationality
Your answer
17.4 Your Paternal Grandmother's Name
Your answer
17.5 Your Paternal Grandmother's Current Nationality
Your answer
17.6 Your Paternal Grandmother's Previous Nationality
Your answer
18. Your Occupation/Business
18.1 Your Employer's/Business Address (in case of minor or housewife FATHER'S OR SPOUSE'S job/business information/address to be given). If retired, information of your last employer is required: *
Your answer
18.2 Your Employer's/Business Phone Number
Your answer
19. Are/were you in a Military/Semi-Military/Police/Security Organization?
19.1 IF YES, please give the Name of Organization, your Designation, Rank and Place of Posting
Your answer
20. Places Likely to be Visited *
Your answer
21. Period of Visa *
21.1 Number of Entries
22. Port of Landing in Foreign Country *
Your answer
22.1 Port of Departure From Foreign Country
Your answer
23. Have You Visited the Country for Which Visa Applied For Now? *
23.1 If yes, provide the (i) Address where you stayed
Your answer
(ii) Cities previously visited *
Your answer
23.2 Please give the details of previous visa. Type of visa granted: (if applying for first time, select NA) *
23.3 Visa Number
Your answer
23.4 Place of Issue
Your answer
23.5 Date of Issue
MM
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DD
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YYYY
23.6 Have you been refused a visa or extension of the same previously or deported from the country for which you are applying visa now? *
24. Countries visited in last 10 years (please give the names of the countries) *
Your answer
24.1 Have you visited any one or more countries listed herein in last 3 years *
Required
24.2 If YES, answer the following, If NO skip to question number 25 *
Your answer
24.3 Name(s) of the Country
Your answer
24.4 Year in which visited
Your answer
24.5 Number of Visits
Your answer
25. FIRST References' NAME (In the Country You Plan To Visit) *
Your answer
25.1 Address of Reference (In the country you plan to visit) *
Your answer
25.2 Phone Number of Reference (In the country you plan to visit) with country/area code *
Your answer
26. SECOND Reference NAME, (in the USA or your home country in case of non-US passport holder) *
Your answer
26.1 Address of Reference (In USA or your home country in case of non-US passport holder) *
Your answer
26.2 Phone Number of Reference (In USA or your home country in case of non-US passport holder) with country/area code *
Your answer
Complete this section if applying for Renunciation/Surrender of Indian Citizenship now, otherwise select "NO" for Question No.25 below and proceed to Question No.40)
27. Are You Applying For Renunciation? *
28. Have you ever held Indian Passport?
28.1 Have you renounced your Indian Citizenship?
28.2 Have you applied for Renunciation of your Indian Citizenship?
28.3 Do you have your most recent Indian passport in your possession?
29. Date of Naturalization/Citizenship
MM
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DD
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YYYY
30. Expiration Date of most recent Indian Passport
MM
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DD
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YYYY
31. Have you used the Indian Passport for travel that originated 3 months after the naturalization date?
31.1 Was your Indian Passport renewed / reissued after acquiring foreign passport?
31.2 Have you availed any consular defined miscellaneous services on your retained / not surrendered passport after acquiring citizenship of another country?
32. Have you ever changed your name?
32.1 Do you have proof for Name Change?
33. Given Name (As given in Indian Passport)
Your answer
33.1 Last Name (As given in Indian Passport)
Your answer
34. Date of Birth
MM
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DD
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YYYY
35. Nationality at Birth
Your answer
36. U.S./Foreign Passport Number
Your answer
36.1 Date of Issue
MM
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DD
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YYYY
37. Most recent Indian Passport Number *
Your answer
37.1 Date of Issue
MM
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DD
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YYYY
37.2 Date of Expiry
MM
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DD
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YYYY
37.3 Place and Country of Issue
Your answer
38. Permanent Address in India
Your answer
39. Do you have Minor Children, who are / were Citizens of India?
Additional Personal Information
Please provide below given details. Please give details if marked YES.
40.1 Have you ever been arrested/ prosecuted/ convicted by Court of Law of any country? *
40.2 Have you ever been refused entry / deported by any country including India? *
40.3 Have you ever been engaged in Human trafficking/ Drug trafficking/ Child abuse/ Crime against women/ Economic offense / Financial fraud? *
40.4 Have you ever been engaged in Cyber crime/ Terrorist activities/ Sabotage/ Espionage/ Genocide/ Political killing/ other act of violence? *
40.5 Have you ever by any means or medium, expressed views that justify or glorify terrorist violence or that may encourage others to terrorist acts or other serious criminal acts? *
40.6 Have you sought asylum (political or otherwise)in any country? *
I hereby declare that the information furnished above is correct to the best of my knowledge and belief. in case the information is found false at any stage, I am liable for legal action/deportation/blacklisting or any other action as deemed fit by the Government of India. (applicable for visa for India) If your response to any of items between 40.1 to 40.6 is YES, please give details here below
Your answer
41. Print your complete name below. *
Your answer
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Please send the following documents to services@thevisaandmore.com separately:
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