VISA EXTENSION
(Form-2)
(To be filled by applicant)
Reference:
Subject: Personal Information.
Please find the information furnished here under for your ready reference.
Chiaki Uchida
a Name:
N/A
Female
b Sex: M C. Name of company/firm
Nationality
Japanese
2nd Nationality
(In case of dual citizenship, mention the name)
No
Place of Birth:
Chiba
Date of Birth:
18th October 1984
Country of Birth
Japan
ID in applicant’s
Country:
Passport number:
TR8044280
Passport issue
Date:
7th April 2017
Passport validity date:
7th April 2027
Passport Issuing authority:
Ministry of Foreign Affairs
Visa number:
A 3746015
Visa issue date:
29th November 2024
Visa Category:
FE
Visa validity date:
30th April 2025
Visa issuing authority:
Embassy of the People’s Republic of Bangladesh in
Tokyo, Japan
Date of
application for
visa extension
N/A
Duration of stay in Bangladesh according to
visa status:
As Required
Place of visa issue From:
Tokyo, Japan
Land phone
Number:
E-mail address:
chiakinak@gmail.com
Cell phone
number:
01814114159
Date of first arrival in Bangladesh:
15th January, 2025
Name of the Immigration checkpoint
While Arriving first time in
Bangladesh:
Hazrat Shahjalal International Airport
Date of last visit in Bangladesh:
15th January, 2025
Name of the
immigration cheek point while Arriving last time In
Bangladesh
Hazrat Shahjalal International Airport
Date of enrolment
In foreigner’s
Registration office
N/A
Do you possess Any Work permit?
No
Number & duration of work permit:
N/A
Validity date of Work
Permit:
N/A
Please mentioned
the date, if you have applied for extension of your
work permit:
N/A
Do you pay tax to Bangladesh
Government
No
Does your office
Activity have any affiliation with the
offices of
Bangladesh
Government:
N/A
Are you engaged
With any other
occupation in Bangladesh:
No
If applicant
Engaged
with other job
then clarify of that:
N/A
House No: 08, Apartment: A6, Road No: 11, Baridhara, Dhaka-1212.
1. Resident address in Bangladesh:
4 - 2 - 6 - 502, Akemi, Urayasu, Chiba, Japan - 279 – 0014.
2. Address in Abroad:
3. Reason for Visa Extension:
Support Family Member
4. Sponsor’s name and address
Tokyo Electric Power Services Company Ltd. (Bangladesh Branch Office)
House No: 47, Flat -A4, Road No- 06, Block-C, Banani, Dhaka-1212, Bangladesh.
5. Your designation in your office (if any)
Master of Linguistics
N/A
6. Educational qualification and institution’s name:
Doshisha University
7. Travel record for the last 3 years
Attached with Passport
8. In case of the Bangladeshi national’s spouse or dependent, Copy of the birth certificate or national certificate of the Bangladesh national.
N/A
9. Is your spouse(s) residing with you in Bangladesh? If yes, please furnish:
SL No
Name
Passport
Number
Relation With You
01.
Yusuke Uchida
TS0417439
Husband
NAME: Chiaki Uchida
SIGN:
DATE: