Security Clearance
Form-2
(To be filled by applicant)
Reference:
Subject: Personal Information.
Please find the information furnished here under for your ready reference.
ROHIT NANDAN SINGH
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:
Gorakhpur, Uttar Pradesh, India
Date of Birth:
15 October, 1986
Country of Birth
India
ID in applicant’s
Country:
N/A
Passport number:
Z4167757
Passport issue
Date:
14 November, 2017
Passport validity date:
13 November, 2027
Passport Issuing authority:
Regional Passport Office, Lucknow
Visa number:
091011121955917
Visa issue date:
26 December, 2019
Visa Category:
Employment
Visa validity date:
25 December, 2019
Visa issuing authority :
Bangladesh High Commission, 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:
E-mail address:
Cell phone
number:
+8801818-042578
Date of first
arrival in
Bangladesh:
04 January, 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-09Jan2020-00008
11 months 29 days
Validity date of
Work
Permit:
03 January 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
Interface Testing & Commissioning Manager (Signalling)
2. Your designation in your office:
Diploma in Electrical Engineering
3. Educational Qualification and institution’s name:
Directorate of Board Technical Education, Uttar Pradesh
Nippon Signal Company Limited
4. Employment History (in Bangladesh & Abroad):
In Bangladesh from 04 January, 2020 to Present;
In QATAR Thales Gulf. (Technical Team Lead) February, 2018 to December, 2019.
In India Nippon Signal Co, Ltd. (Dy. Manager) From June, 2015 February, 2018
In India KEC INTERNATIONAL LTD. (Assistant Manager) From July 2011 to June, 2015.
In India ANSALDO STS INDIA PVT. LTD. NOIDA (Project Engineer) From December, 2009 to July, 2011.
In India ANSALDO STS INDIA PVT.LTD. NOIDA (Site Engineer) From April, 2009 to December, 2009.
In India ANSALDO STS INDIA PVT.LTD. NOIDA (Site Supervisor) From January, 2007 to March, 2009
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: ROHIT NANDAN SINGH
SIGN:[
DATE: