Security Clearance
Form-2
(To be filled by applicant)
Reference:
Subject: Personal Information.
Please find the information furnished here under for your ready reference.
MIZUKI HONDA
a I Name:
Nippon Koei Bangladesh Ltd.
Female
b I Sex: M C. Name of Company/firm
Nationality
Japanese
2nd Nationality
(In case of dual citizenship,
mention
the name)
N/A
Place of Birth:
Tokyo, Japan
Date of Birth:
29th January 1996
Country of Birth
Japan
ID in applicant’s
Country:
N/A
Passport number:
TT2494792
Passport issue
Date:
25th August 2022
Passport validity date:
7th May 2029
Passport Issuing authority:
Ministry of Foreign Affairs, Japan
Visa number:
A2444266
Visa issue date:
22nd February 2023
Visa Category:
E
Visa validity date:
22nd May 2023
Visa issuing authority:
Embassy of the People’s Republic of Bangladesh, Tokyo, Japan
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
Land phone
Number:
N/A
E-mail address:
A8847@n-koei.co.jp
Cell phone
number:
+81-3-5276-7769, 01402-190294
Date of first
arrival in
Bangladesh:
14th October, 2022
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:
26th March 2023
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-13Mar2023-00016
1 year
Validity date of
Work
Permit:
28th February, 2024
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:
No
"Concord Kabir Tower" Apt #8B (8th floor), 31 Rd 100, Gulshan 2, Dhaka 1212, Bangladesh
Resident address in Bangladesh:
Manager
2. Your designation in your office:
Bachelor of Liberal Arts
3. Educational Qualification and institution’s name:
Saitama University
Please see next page.
4. Employment History (in Bangladesh & Abroad):
Jun. 2020 - Sept. 2022 ：International Marketing and Promotion Dept., Nippon Koei Co., Ltd.Nov. 2019 – May, 2020：Legal and Compliance Dept., Nippon Koei Co., Ltd.Apr. 2019 - Oct. 2022 ：Accounting Dept., Nippon Koei Co., Ltd.
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: MIZUKI HONDA
SIGN:
DATE: