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Security Clearance
Form-2
(To be filled by applicant)
Reference:
Subject: Personal Information.
Please find the information furnished here under for your ready reference.
Yuji Kato
a I Name:
Tokyo Consulting firm Limited
Male
b I Sex: M C. Name of company/firm C.
Nationality
Japan
2nd Nationality
(In case of dual citizenship,
mention
the name)
No
Place of Birth:
AICHI
Date of Birth:
08 August 1973
Country of Birth
Japan
ID in applicant’s
Country:
N/A
Passport number:
TZ1352033
Passport issue
Date:
19 March 2019
Passport validity date:
19 March 2029
Passport Issuing authority:
Consulate General of Japan
Visa number:
A 2339697
Visa issue date:
4 March, 2021
Visa Category:
Business
Visa validity date:
4 March, 2022
Visa issuing authority :
Tokyo, Japan.
Date of
application for
visa extension
14 June, 2021
Duration of stay in Bangladesh according to
visa status:
90 days
Place of visa issue
From:
Agargao, Dhaka.
Land phone
Number:
E-mail address:
Cell phone
number:
01728485858
Date of first
arrival in
Bangladesh:
20 March, 2021
Name of the Immigration checkpoint
While
Arriving first time
in
Bangladesh:
Hazrat Shahjalal International Airport, Dhaka. Immigration police, Bangladesh.
Date of last visit in Bangladesh:
Name of the
immigration cheek point while
Arriving last time
In
Bangladesh
N/A
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
Resident address in Bangladesh:
Proposed Country Manager
2. Your designation in your office:
3. Educational Qualification and institution’s name:
4. Employment History (in Bangladesh & Abroad):
In Japan from DD/MM/YYYY to Present;
As a Proposed Country Manager (Attending the Conference, Business Meeting)
5. Travel record for the last 3 years:
6. Are you engaged with any social/ cultural activities apart from your present occupation in Bangladesh? If yes please provide details: No
7. Is your spouse(S) residing with you in Bangladesh? If yes please furnish:
SL
No
Name
Pass port
Number
Relation With You
NAME: YUJI KATO
SIGN: √
DATE: