Security Clearance
Form-2
(To be filled by applicant)
Reference:
Subject: Personal Information.
Please find the information furnished here under for your ready reference.
UTPAL DEY
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:
GOGHAT, WEST BANGAL
Date of Birth:
24 August, 1989
Country of Birth
India
ID in applicant’s
Country:
N/A
Passport number:
N6992266
Passport issue
Date:
17 February, 2016
Passport validity date:
16 February, 2026
Passport Issuing authority:
Regional Passport Office, Kolkata
Visa number:
A 2124358
Visa issue date:
06 November, 2020
Visa Category:
Employment
Visa validity date:
05 May, 2021
Visa issuing authority :
Deputy High Commission, Kolkata, 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:
Calcutta, India
Land phone
Number:
E-mail address:
signalnippon@gmail.com
Cell phone
number:
01847198851
Date of first
arrival in
Bangladesh:
28 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:
28 November, 2020
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-04Dec2020-00001
1 (One) year
Validity date of
Work
Permit:
27 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, Dhaka Metro Rail Project
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, Testing & Commissioning Engineer (Signaling)
2. Your designation in your office:
Diploma in Electronics Engineering
3. Educational Qualification and institution’s name:
Swami Vivekanand University, Madhya pradesh-India
Nippon Signal Company Limited
4. Employment History (in Bangladesh & Abroad):
In Bangladesh from 1 March, 2020 to Present;
In India Radharani Rail Engineering Systems Pvt. Ltd. (Technician) From January, 2014 to August, 2016.
In India FRAUSCHER SENSOR TECHNOLOGY (Process Member, installation, Testing & Communication) From August, 2016.
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: UTPAL DEY
SIGN:
DATE: