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Russian Visa Application Form Details

The document is an online visa application form for Pankaj Maurya, a male Indian national, applying for a single-entry tourist visa to Russia from November 21, 2025, to December 20, 2025. The application includes personal details such as passport information, purpose of visit, and confirmation of data accuracy. Pankaj has no relatives in Russia, no previous trips to the country, and does not have health insurance valid in Russia.

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maakalimandir001
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10 views3 pages

Russian Visa Application Form Details

The document is an online visa application form for Pankaj Maurya, a male Indian national, applying for a single-entry tourist visa to Russia from November 21, 2025, to December 20, 2025. The application includes personal details such as passport information, purpose of visit, and confirmation of data accuracy. Pankaj has no relatives in Russia, no previous trips to the country, and does not have health insurance valid in Russia.

Uploaded by

maakalimandir001
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

ON-LINE VISA APPLICATION FORM 20002-45740718 \ 21.11.

2025 20:37:59
Russian Visa Centre (New Delhi)

1. Nationality (if you formerly had INDIA USSR


or Russian citizenship, please indicate
when and why you lost it).

2. Surname (as in passport). MAURYA

3. First name, other names, patronimic


PANKAJ (as in passport).

4. Date of birth (dd/mm/yyyy). 10/07/1985

5. Sex. MALE

6. Passport.
Passport No:
C7232218
Date of issue: 10/01/2023
Valid until: 17/02/2035
7. Purpose of visit. TOURISM

8. Category and type of visa. COMMON TOURIST

9. Number of entries. SINGLE

10. Date of arrival and departure. 21/11/2025 - 20/12/2025

11. Host organisation you intend to NONE visit.

12. Route of journey (destination MOSCOW points).

Photograph and signature. Service information (automatically generated).

Application form recipient: Russian Visa Centre (New Delhi)

Basis (voucher, dir. No, inv. No): NONE


The estimated date of visit to the RC:
Application No (web-site): 45740718
The date of processing: 21/11/2025
Place for Application No (VAC):
photograph
The date of processing by the VAC:

Request No in Russian Consulate (RC):

I hereby agree to the processing and electronic


transfer of
form
my for
personal
the purposes
data in of
making a decision on visa issuance. I declare that data provided in the
application form are full and correct. I am aware that any false
information may be a cause for the denial of v
of the previously issued visa and may lead to other consequences provided
Date (dd/mm/yyyy), personal for by the legislation of the Russian Federation. Subject to the receipt
signature of visa, I pledge to leave the territory of the Russian Federation before
the visa expiration date. I am aware that valid visa does not automatically
allow to enter the territory of the Russian Federation. In case of denial
of entry, I will not seek any compensation for potential losses.

Page 1 of 2
13. Children under 16 years and otherrelatives
written in your passport.
Do you travel with children under NO
16 years or other relatives written
in your passport?
14. Your permanent address, telephone JAMALPUR SARDAHA AZAMGARH
number, fax number, E-mail.

15. Current/latest place of work. NONE

16. Information about your previoustrips


to Russia.
How many times have you been to Russia? -
17. Information about health insurance.
Do you have health insurance that NO
is valid in Russia?
18. Other names used in the past NONE
(maiden, pen-name, religious, etc.).

19. Your place of birth (if you were AZAMGARH UTTAR PRADESH born
in Russia, please specify when and which country you
emigrated to).

20. Additional information about


yourrelatives.
Do you currently have relatives in
Russia?
NO
Page 2 of 2

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