1. High Commission Of India Nairobi
Jeevan Bharti Building,Harambee Avenue
Nairobi,Kenya,P.O. Box 30074-00100
Paste your unsigned
recent color photograph.
Size: 2” X 2”
http://www.hcinairobi.co.ke/
+254 20 2222566
Visa Application Form
Signature
KENNV0058C14
A. Personal Particulars (As in Passport)
Surname (As in Passport)
FEINSTEIN
Given Nam e (As in Passport) AYELET
Web File Number :KENNV0058C14
Previous/other Name if any
Female
15-AUG-1973
RAMAT GAN
025671991
NONE
ISRAEL
Sex
Date of birth
Place of Birth Town/City
Citizenship /National ID No
Visible identification marks
Current Nationality
Marital Status
Religion
Country of Birth
Educational Qualification
Nationality by Birth/ Naturalization
BY BIRTH
Date of issue ( dd/mm/yyyy )
27-OCT-2009
26-OCT-2019
Any Other Previous/Past Nationality
B. Passport Details
13824053
ISRAEL
Passport No.
Place of issue
Date of expiry (dd/mm/yyyy)
Any other Passport/Identity Certificate held (if yes ,please fill in the following) NO
Country of issue
Web Registration Date : 22-JAN-2014
Married
JEWISH
ISRAEL
PROFESSIONAL
Place of issue
Passport/IC No
Date of issue(dd/mm/yyyy)
Nationality/status
C. Applicant’s Contact Details
Present
address
42 KAPUTEI RD
NAIROBI
NAIROBI, KENYA 01000
Phone No
254718988163
Email address ayullaf@gmail.com
Mobile /Cell No
Permanent 42 KAPUTEI RD
Address
NAIROBI
NAIROBI
D. Family Details
Relation
Name
Nationality
Prev. Nationality
Place/Country of Birth
Father’s
TZVIKA EDELSTEIN
ISRAEL
ISRAEL
ISRAEL
Mother’s
SARA EDELSTEIN
ISRAEL
ISRAEL
ISRAEL
Spouse
ERAN FEINSTEIN
ISRAEL
ISRAEL
ISRAEL
Were your Grandfather/Grandmother(Paternal/Maternal) Pakistan Nationals Or belong to Pakistan held area : NO
E. Details of Visa Sought
TOURIST VISA
(Month) 3 Month
DELHI
Type Of Visa Required
Period of Visa
Port Of Arrival
(Visa shall be valid from the Date of Issue and not from the Date of Journey)
AYELET FEINSTEIN
No of Entries
Expected Date of Journey
Port of Exit
Single
16-MAR-2014
DELHI

2. TOURIST VISA
Places to be Visited
DELHI
Purpose of Visit : TOURISM
F. Previous Visit Details
Have You Ever visited India ?
Address where You stayed in
India
NO
Web File Number :KENNV0058C14
Required Detail of
,
Cities in India Visited
Type of Visa
Visa Issued Place
Countries visited in last 10 years
Visa Number
Date of Issue
Have you been refused an Indian Visa or extension of the same previously or deported from India ?
If yes above mention when and by whom with control
No/Date
G. Profession/Occupation Details of Spouse
Present Occupation HOUSE WIFE
Designation/Rank
MD
Employer name/business 3G DIRECT PAY LIMITED
Employer Address LANDMARK PLAZA NAIROBI KENYA
Phone Number
254700404699
Past occupation if any
Are/have you worked with Armed forces/ Police/ Para Military forces ? NO
Organization
Designation
Place of Posting
Rank
H. Address of Place of Stay / Hotel
Place/Hotel Name
Address of Place / Hotel
I. Details of Two Reference
In India
Nam e NONE
Address NONE
Phone
00000000
Number
In
ERAN FEINSTEIN
State
Phone No.
KENYA
42 KAPUTEI RD NAIROBI
0700404699
J. DECLARATION:
a.
b.
c.
d.
I do not hold any other passport(s) other than those detailed above.
I have read and understood all the conditions for the visit to India and I am willing and able to abide fully by them.
I declare that the information given in the form is complete and correct and the visit to India will be undertaken for the
purpose indicated in the application.
I understand that in case the information provided in the form is found to be incorrect, I will be liable for denial of visit/ entry
or deportation and/ or other penalties during the visit as provided by Indian law.
22-JAN-2014
Date :……………………….
..……………………………………
Applicant’s signature (as in Passport)