APPLICATION FORM
( Visa Extension and
Registration Extension )
Application Id : 130226XU1XO2 Final Submission Date : 13/02/2026
Personal Details
Surname DENNIS Given Name EMILY BAWOH
Sex Female Date of Birth 27/09/2004
Height 165 Age as on today Year(s) : 21, Month(s) : 4, day(s) : 17
Place of Birth MONROVIA Father's Name DARIOUS D DENNIS
Mother's Name OLIVIA D DENNIS Spouse's Name
Religion CHRISTIAN Identification NONE
Mark
Present LIBERIA Previous LIBERIA
Nationality Nationality
Manner of Birth SII Student Id
acquiring present
nationality
Date of acquiring present nationality
Whether holding dual nationality? If yes, provide the following:- No
Name of the country of second nationality
Passport No. of second country
Date of Issue
Expiry Date
Whether travelled on this passport earlier to India No
Whether person of Indian Origin No
Address Details
Address of last residence (Outside India)
Address JOCOBS TOWN
City PAYNESVILLE Country LIBERIA
Address intended for longer stay in India (Registration)
Address [Link]. 16, NEW SUNDER NAGAR
City/District LUDHIANA State PUNJAB
Phone Number Mobile Number 9878408324
Pin Code 142021
Any Other Address in India
Address
City/District State
Phone Number Mobile Number
Pin Code
Email/Occupation/Profession Details
E-Mail Id dennisemily652021@[Link]
Profession/Occupation STUDENT
Passport and Visa Details
Passport Number PP0191237 Place of Issue LIBERIA, MONROVIA
Date of Issue 06/04/2022 Expiry Date 06/04/2027
Visa Details
Visa Number VL7680266 Place of Issue LIBERIA, MONROVIA
Date of Issue 01/01/2026 Expiry Date 28/02/2026
Valid For Multiple Entry Visa Type STUDENT VISA
Special endorsement, if any
Organization/Company/Institute/Hospital Details
Name PUNJAB COLLEGE OF TECHNICAL EDUCATION
Address JHANDE, FEROZEPUR ROAD
State PUNJAB City LUDHIANA
Telephone Number 0161-2888500 Email ID studentwelfare@[Link]
Employer EPFO ID Establishment ID
Arrival Details
Place of embarkation/boarding for India ROBERTS INTERNATIONAL AIRPORT
Date of arrival in India 21/09/2022
Place of disembarkation/arrival in India DELHI
Mode of Journey Air Flight/ Ship/ Bus/ Train
No.
Purpose of visit to India Studies
Person to be contacted in Case of Emergency
Name Relationship
Address
City Country
Phone Number
Category Others
Military service details
Organisation
Designation Rank
Place of Last Posting
Country of Last Posting
Previous Registration Details in India
Registration Place of Registration Visa Type Duration From To
Number
PB12/RCF/LBR/776/202 LUDHIANA, PUNJAB STUDENT VISA 01/01/2026 28/02/2026
2
Details of family members/attendant/dependents, if any accompanying.
Name Nationality Passport Number Relationship
Current Registration Details
Are you registered in current locality Yes Current Registration No. PB12/RCF/LBR/776/2022
FRRO/FRO in the current visit?
Visa Extension
Whether previously in India? No
Whether permission to stay in India has been previously refused?
Whether permission to extend stay in India has been previously granted?
Period of Extension requried Year(s) 0 Month(s) 3 Day(s) 0
Reason for extension HAVING RE-APPEARS
In case of Missionary - Nature Medical Certificate No.
of work
Registration Extension Details
Current Registration Valid 28/02/2026
Upto
Required for period of Year(s) 0 Month(s) 3 Day(s) 0
Reason of Delay HAVING RE-APPEARS
Registration office address
Office Name : FRO LUDHIANA
Address : CP, LUDHIANA,Ph-2414943
OR SSP OFFICE LUDHIANA
RURAL,JAGRAON ,ph-224048
City/District : LUDHIANA
State : PUNJAB
Pin Code : 141001
Phone Number : 000000