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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.
YOSHIHIRO HOTTA
a I Name:
International Manpower Development Organization (IM) Japan
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:
Tokyo.
Date of Birth:
17 April, 1969
Country of Birth
Japan
ID in applicant’s
Country:
N/A
Passport number:
TR2009114
Passport issue
Date:
9 July, 2014
Passport validity date:
9 July, 2024
Passport Issuing authority:
Ministry of Foreign Affairs, Japan
Visa number:
Cons/2369/A3/18
Visa issue date:
17 August, 2018
Visa Category:
Employment Contract.
Visa validity date:
17 August, 2021
Visa issuing authority:
Embassy of Peoples Republic of Bangladesh, Tokyo.
Date of
application for
visa extension
N/A
Duration of stay in Bangladesh according to
visa status:
As Required
Place of visa issue
From:
Tokyo.
Land phone
Number:
E-mail address:
Cell phone
number:
01730595730
Date of first
arrival in
Bangladesh:
23 September, 2018
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:
Ref No. 03.219.344.00.00.0000.16471.18072019
1 (One) year
Validity date of
Work
Permit:
20 July 2020
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:
Yes
Are you engaged
With any other
occupation in Bangladesh:
No
If applicant
Engaged with other job then clarify of that:
N/A
Apartment # A4, 4th Floor, Scenic Villa,
Resident address in Bangladesh:
House # 23, Road # 6, Baridhara, Dhaka.
General Manager
2. Your designation in your office:
Bachelor of Arts (Economics)
3. Educational Qualification and institution’s name:
JOSAI UNIVERSITY. JAPAN
International Manpower Development Organization (IM)
4. Employment History (in Bangladesh & Abroad):
In Bangladesh from 21 July, 2019 to Present;
Note: Duration of Corona Period he was outside of Bangladesh.
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: YOSHIHIRO HOTTA
SIGN:
DATE: