OA0000004687316

Part 1 Personal Information Part 3 Travel Documents Passport No: Place of Issue: Date of Issue: Date of Expiry: Last Visa No.: Last Visa Issue Date: Place of Issue: Type of Visa: TT2375907 22/07/2022 22/07/2032 02/08/2024 A 3945742 19/03/2024 AGARGAON E MINISTRY OF FOREIGN AFFAIRS Part 4 Payment Information Name of the Bank: Cheque/Bank Transfer/Chalan/Scroll No.: Date: Part 7 Document Check List Type of Visa Enrollment: Visa Extension Name of the Branch of Bank: Date of last visit to Bangladesh Part 5 Extension of Visa Part 2 Visa Information Payment Mode: Payment Currency: Part 6 Visa Office / Bangladesh High Commission Office Information Bangladesh High Commission: AGARGAON Recommendation from concern Ministry Authority Security Clearance / Security Certificate Father's / Husband's / Mother's Visa copy Passport Copy, Last Visa and Last Arrival Page Father's / Husband's / Mother's Passport copy N. O. C from Sri Lankan High Commission Bi-Lateral Agreement / Multilateral Agreement Trade license of the sponsoring Company Payment Slip Over stay Payment Slip Marriage Certificate Birth Certificate Work Permit Affidavit Photo Income Tax Certificate of the Company TIN TIN Certificate of the Company Others √ √ √ √ √ √ √ √ MARRIED Current Location: Last / Surname(as in the passport): Permanent Address: Contact no. at permanent address: Email: Address in Bangladesh: Date of Birth: Bangladesh Place of Birth: Present Nationality: Nationality at Birth: Occupation: Marital Status: MASANORI AZUMA 2-48 MINAMISIHNOZA-CHO, EDOGAWA-KU, TOKYO 090-4293-2040 azuma.masanori@kusuhara.co.jp AZHAR COMFORT COMPLEX, LEVEL-3, 130/A MIDDLE BADDAH, PRAGOTI SARONI, DHAKA 1212 01824442107 25/12/1974 TOKYO Japanese Japanese PRIVATE SERVICE Sex: Contact no. in Bangladesh: First Name(as in the passport): MALE Last / Surname on Visa: MASANORI AZUMA First Name on Visa: Country of Birth: Japan Date of Arrival in Bangladesh: 02/08/2024 2 Year(s) Duration of Proposed Extension: Purpose of Extension of Visa: Intended Number of Entries: Type of Visa: Visa No: A 3945742 E Date of Issue: EMPLOYMENT AGARGAON Place of Issue: 19/03/2024 Date of Expiry: 02/10/2024 Name of the Father/Mother/Spouse: MULTIPLE