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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.
TOSHINORI TERAURA
a I Name:
Moririn Co., Ltd.
Male
b I Sex: M C. Name of company/firm C.
Nationality
Japan
2nd Nationality
(In case of dual citizenship,
mention
the name)
N/A
Place of Birth:
Osaka
Date of Birth:
12 February 1966
Country of Birth
Japan
ID in applicant’s
Country:
N/A
Passport number:
TS2546614
Passport issue
Date:
24 January 2019
Passport validity date:
24 January 2029
Passport Issuing authority:
Ministry of Foreign Affairs
Visa number:
A 2469361
Visa issue date:
18 March 2021
Visa Category:
Employment
Visa validity date:
12 June 2021
Visa issuing authority:
Department of Immigration and Passports, Agargaon, Dhaka.
Date of
application for visa extension
01 March 2021
Duration of stay in Bangladesh according to
visa status:
As required
Place of visa issue
From:
Dhaka
Land phone
Number:
E-mail address:
toshinori.teraura@moririn.co.jp
Cell phone
number:
+880 192 777604
Date of first
arrival in
Bangladesh:
25 January 2020
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:
15 January 2021
Name of the
immigration cheek point while
Arriving last time
In
Bangladesh
Do
Date of enrolment
In foreigner’s
Registration office
N/A
Do you possess
Any
Work permit?
Yes
Number &
duration of
work permit:
WPN-21Jan2021-00007
1 (one) year
Validity date of
Work
Permit:
14 January 2022
Please mentioned
the date,
if you have
applied for
extension of your
work permit:
N/A
Do you pay tax to Bangladesh
Government
Yes
Does your office
Activity have any affiliation with the
offices of
Bangladesh
Government:
No
Are you engaged
With any other
occupation in Bangladesh:
No
If applicant
Engaged
with other job
then
clarify of that:
No
ANZ Park Shore, House: 6C, Plot: 41, Road: 35, Gurshan-2.Dhaka-1212
Resident address in Bangladesh:
Gulshan 2, Dhaka, Bangladesh.
Country Manager
2. Your designation in your office:
Graduation;
3. Educational Qualification and institution’s name:
Doshisha University; Department of Law.
Moririn Co., Ltd.
4. Employment History (in Bangladesh & Abroad):
In Bangladesh from 15 January 2021 to Present;
Moririn Co., Ltd. Oref; G Nagoya Sales Department Manager;
March 2017 to February 2020
Moririn Co., Ltd. Knit Material; G Nagoya; Sales Department; March 2007 to February 2017.
Moririn Asia Co., Ltd. March 2001 to February 2007.
Moririn Co., Ltd. Nagoya; Sales Division; March 1999 to February 2001.
Moririn Co., Ltd. Bandung; Representative Office; March 1996 to February 1999.
Moririn Co., Ltd. Jakarta; Representative Office; March 1993 to February 1996.
Moririn Co., Ltd. head office yarn department; joined on April 1988.
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: TOSHINORI TERAURA
SIGN:
DATE: