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
C. Company/Firm
Nationality Japanese 2 nd Nationality
(In case of dual
citizenship,
mention
the name)
N/A
Place of Birth: Kanagawa, Japan Date of Birth: 13 th October, 1968
Country of
Birth
Japan ID in applicant’s
Country:
N/A
Passport
number:
TZ1012754 Passport issue
Date:
10 April 2014
Passport
validity date:
10 April 2024 Passport Issuing
authority:
Embassy of Japan in Indonesia
Visa number: A3327253 Visa issue date: 04 April 2023
Visa Category: E Visa validity date: 14 September 2023
Visa issuing
Authority:
Department of
Immigration &
Passports (DIP)
Date of
application for visa
extension
N/A
TOKUYUKI MATSUYA
Male Taisei Corporation
Duration of
stay in
Bangladesh
according to
visa status:
As Required
Place of visa issue
From:
Agargaon, Dhaka
Land phone
Number:
N/A E-mail address: matuya-t@ce.taisei.co.jp
Cell phone
number:
01847-544372 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:
17 th 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-19Mar2023-00021
1 Year
Validity date
of
Work
Permit:
16 th March, 2024 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
1. Resident address in Bangladesh:
2. Your designation in your office:
3. Educational Qualification and institution’s name:
4. Employment History (in Bangladesh & Abroad):
April, 2021-at Present : Manager (Estimation Section), Civil Engineering Dept in Bangladesh.
Sept. 2020-31 March 2021 -Manager (Estimation Section), Civil Engineering Dept in Myanmar.
July, 2015-31 August,2020 -Deputy Project Manager and Project Manager "CP1A Hoa Lac
Science and Technology City Development Project, Vietnam.
April, 2012-30 June, 2015 -Project Manager, IID Land Development Phase-2, Indonesia.
April, 2008-31 March, 2012 -Construction Manager, Srilanka, Highway Project.
January, 2005-31 March,2008 -Construction Manager in Malaysia, Sewerage Plant Project.
Catharsis Building 10th Floor, House 133, Road 12,
Banani, Dhaka-1212, Bangladesh
Head Manager of Civil
Bachelor in Civil Engineering, Faculty
of Engineering.
Hokkaido University
April, 1994-31 December, 2004- Management of 8 Construction site 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:
7. Is your spouse(S) residing with you in Bangladesh? If yes please furnish:
SL
No
Name Pass port
Number
Relation With You
NAME: TOKUYUKI MATSUYA
SIGN:
DATE:
Attached with Passport
No.