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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.
KINYA MIYAKAWA
a I Name:
CMSS CONSULTING LTD.
Male
b I Sex: M C. Name of company/firm C.
Nationality
JAPANESE
2nd Nationality
(In case of dual citizenship,
mention
the name)
No
Place of Birth:
CHIBA
Date of Birth:
20 FEBRUARY 1981
Country of Birth
JAPAN
ID in applicant’s
Country:
Passport number:
TT1314515
Passport issue
Date:
12 JUNE 2020
Passport validity date:
12 JUNE 2030
Passport Issuing authority:
Ministry of foreign Affairs.
Visa number:
A 2345579
Visa issue date:
21 September 2022
Visa Category:
Employment
Visa validity date:
21 December 2022
Visa issuing authority:
Embassy of Bangladesh, Japan
Date of
application for
visa extension
N/A
Duration of stay in Bangladesh according to
visa status:
3 Months
Place of visa issue
From:
Tokyo, Japan.
Land phone
Number:
E-mail address:
kinya@crisis.co.jp
Cell phone
number:
+8801870-729321
Date of first
arrival in
Bangladesh:
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
Do
Date of enrolment
In foreigner’s
Registration office
Do you possess
Any
Work permit?
Yes
Number &
duration of
work permit:
WPN-04Oct2022-00018
1 (one) year
Validity date of
Work
Permit:
One year from
02 October 2023
Please mentioned
the date,
if you have
applied for
extension of your
work permit:
N/A
Do you pay tax to Bangladesh
Government
N/A
Does your office
Activity have any affiliation with the
offices of
Bangladesh
Government:
Yes
Are you engaged
With any other
occupation in Bangladesh:
No
If applicant
Engaged
with other job
then
clarify of that:
N/A
Flat 7A, House-125, Road-19/A, Block E, Banani
Resident address in Bangladesh:
, Dhaka 1213.
Managing Director
2. Your designation in your office:
Graduation – Mechanical Department
3. Educational Qualification and institution’s name:
Kanagawa Prefectural Odawara Johoku Technical High School.
CMSS CONSULTING LTD.
4. Employment History (in Bangladesh & Abroad):
In Bangladesh from 03 October 2022 to Present as a “Managing Director”
In Japan joined in Ground Self-defense Force as an Airborne from 2007-2013
In Japan CMSS Co., Ltd. head office worked from 2014 to 2022 As a “Security Manager”
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: KINYA MIYAKAWA
SIGN:
DATE: