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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 .
a I Name:
b I Sex: M C. Name of company/firm C.
Nationality Japanese 2 nd Nationality
(In case of dual
citizenship,
mention
the name)
No
Place of Birth: KANAGAWA Date of Birth: 27 September 1968
Country of
Birth
Japan ID in applicant’s
Country:
N/A
Passport
number:
TR4988403 Passport issue
Date:
10 Nov 2015
Passport
validity date:
10 Nov 2025 Passport Issuing
authority:
Ministry of Foreign Affairs
Visa number: A2345469 Visa issue date: 14 September 2022
Visa Category: Employment Visa validity date: 14 December 2022
Visa issuing
authority:
High Commission
of People’s
Republic of
Bangladesh.
Date of
application for visa
extension
N/A
Duration of
stay in
Bangladesh
according to
visa status:
90 days Place of visa issue
From:
Tokyo, Japan
HIDEHARU TOYAMA
Male TAISEI CORPORATION
Land phone
Number:
E-mail address: tooyama@ce.taisei.co.jp
Cell phone
number:
+880 18 81114498 Date of first
arrival in
Bangladesh:
11 September 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:
26 September 2022
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-01Oct2022-00004
1 (One) year
Validity date
of
Work
Permit:
25 September 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:
No
Are you
engaged
With any other
occupation in
Bangladesh:
No If applicant
Engaged
with other job
then
clarify of that:
N/A
1. Resident address in Bangladesh:
2. Your designation in your office:
3. Educational Qualification and institution’s name:
4. Employment History (in Bangladesh & Abroad):
Shanta Debonair, Plot No. 42, Road No. 18,
Block- B, Banani Dhaka 1213. Bangladesh.
Deputy General Manager
Civil Engineer Faculty of
Engineering
THE UNIVERSITY OF TOKYO
TAISEI CORPORATION
In Bangladesh from 26 September 2022 to Present;
In Japan “Taisei Corporation” started in 1992 from 1993 worked in Civil Engineer design
department as a position of “Civil Engineer”
In Japan he worked in Domestic Infrastructure Construction project from 1994 to 2001.
In J apan joined another Project as name of USA LRT Project” and worked till 2002.
In Taiwan he joined another Metro project and till 2006 he was worked in there.
In Dubai he worked in UAE Dubai Highway Bridge project and till 2010 he worked.
In Pakistan he worked in a highway and till 2019 he worked and return back to his
country Japan and till 2022 he worked in Japan.
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: HIDEHARU TOYAMA
SIGN:
DATE: