FE-VISA EXTENSION
(Form-2)
(To be filled by applicant)
Reference:
Subject: Personal Information.
Please find the information furnished here under for your ready reference.
Ms. Keiko Hirono
a. Name:
N/A
Female
b. Sex: M C. Name of company/firm
Nationality
Japanese
2nd Nationality
(In case of dual citizenship, mention the name)
No
Place of Birth:
Chiba
Date of Birth:
31st October 1961
Country of Birth
Japan
ID in applicant’s
Country:
N/A
Passport number:
TT2115453
Passport issue
Date:
22nd July 2022
Passport validity date:
22nd July 2032
Passport Issuing authority:
Ministry of Foreign Affairs
Visa number:
A 4484420
Visa issue date:
18th December 2025
Visa Category:
FE
Visa validity date:
06th July 2026
Visa issuing authority:
Department of Immigration & Passports
Date of
application for
visa extension
25th June 2026
Duration of stay in Bangladesh according to
visa status:
As Required
Place of visa issue From:
Dhaka, Bangladesh.
Land phone
Number:
E-mail address:
m.hirono7@mtfoods.co.jp
Cell phone
number:
017-9227-5933
Date of first arrival in Bangladesh:
23rd May, 2026
Name of the Immigration checkpoint
While Arriving first time in
Bangladesh:
Hazrat Shahjalal International Airport
Date of last visit in Bangladesh:
17th May, 2026
Name of the
immigration cheek point while Arriving last time In
Bangladesh
Hazrat Shahjalal International Airport
Date of enrolment
In foreigner’s
Registration office
N/A
Do you possess Any Work permit?
No
Number & duration of work permit:
N/A
Validity date of Work
Permit:
N/A
Please mentioned
the date, if you have applied for extension of your
work permit:
N/A
Do you pay tax to Bangladesh
Government
No
Does your office
Activity have any affiliation with the
offices of
Bangladesh
Government:
N/A
Are you engaged
With any other
occupation in Bangladesh:
No
If applicant
Engaged
with other job
then clarify of that:
N/A
Apartment 53/2, Novera, Road No-01, South Khulshi R/A, Pahartali-4202, Khulshi, Chattogram.
1. Resident address in Bangladesh:
1-35-6 Nishinarashino, Funabashi, Chiba, Japan.
2. Address in Abroad:
3. Reason for Visa Extension:
Support Family Member (Dependent)
4. Sponsor’s name and address
Factory: Sea Resources Group Complex, Plot #1668 Ichanagar, Azimpara, Karnaphuli, Chattogram.
Corporate Office: Rangs Bhaban, 117/A level #2 Old Airport Road, Tejgaon, Dhaka -1215
5. Your designation in your office (if any)
Musashino Nutrition College
N/A
6. Educational qualification and institution’s name:
7. Travel record for the last 3 years
Attached with Passport
8. In case of the Bangladeshi national’s spouse or dependent, Copy of the birth certificate or national certificate of the Bangladesh national.
N/A
9. Is your spouse(s) residing with you in Bangladesh? If yes, please furnish:
SL No
Name
Passport
Number
Relation With You
01.
Mr. Masayuki Hirono
TZ2124623
Husband
NAME: Keiko Hirono
SIGN:
DATE: