Security Clearance
Form-2
(To be filled by applicant)
Reference:
Subject: Personal Information.
Please find the information furnished here under for your ready reference.
ESHWAR RAO KOTA
a I Name:
Nippon Signal Company Limited
Male
b I Sex: M C. Name of company/firm C.
Nationality
Indian
2nd Nationality
(In case of dual citizenship,
mention
the name)
No
Place of Birth:
SALUR, ANDHRA PRADESH
Date of Birth:
20 October, 1986
Country of Birth
India
ID in applicant’s
Country:
N/A
Passport number:
L8319448
Passport issue
Date:
02 April, 2014
Passport validity date:
1 April, 2024
Passport Issuing authority:
VISAKHAPATNAM
Visa number:
A 1618357
Visa issue date:
19 October, 2020
Visa Category:
Employment
Visa validity date:
15 April, 2021
Visa issuing authority :
NEW DELHI, INDIA
Date of
application for
visa extension
N/A
Duration of stay in Bangladesh according to
visa status:
As Required
Place of visa issue
From:
NEW DELHI, INDIA
Land phone
Number:
029820666
E-mail address:
signalnippon@gmail.com
Cell phone
number:
029820666
Date of first
arrival in
Bangladesh:
2 November, 2020
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-09Nov2020-00025
1 (One) year
Validity date of
Work
Permit:
1 November 2021
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
CP-7 project office, Block I, Sector 16,
Resident address in Bangladesh:
Road: Sonargoan Janapath, Diabari, Uttara, Dhaka-1230, Bangladesh
Installation Manager (Signaling)
2. Your designation in your office:
Diploma in Electronics & Communication Engineering
3. Educational Qualification and institution’s name:
State Board of Technical Education & Training, A.P.
Nippon Signal Company Limited
4. Employment History (in Bangladesh & Abroad):
In Bangladesh from 1 March, 2020 to Present;
In India SVP Services (Site Engineer) From January, 2011 to December, 2012.
In India Quatro Rail Tech Sluations Limited (Assistant Project Manager) From April, 2015 to July, 2018.
In India TVM Signalling and Transportation Systems Private Limited, (Associate Project Lead –Signalling Systems) From February, 2013 to October, 2014.
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: ESHWAR RAO KOTA
SIGN:
DATE: