(Please read these instructions carefully before filling in the

Consulate General of Pakistan Chicago
333 N Michigan Ave, Suite 728, Chicago IL 60601
Tel: 312-781-1831 Ext 2008 fax: 312-781-1839
info@cgpkchicago.org
(Please read these instructions carefully before filling in the application form)
1. No column should be left blank. Incomplete forms with vague entries will not
Photograph must be:
be accepted. Where applicable copies of supportive documents should be
submitted along with the application form.
 Passport size 2x2
2. Applicants may use extra sheets, in case of in sufficient space in the form.
 Recent
and
true
3. Applicants may be asked to appear for an interview if required.
likeness, showing full
face, with no hat,
4. On arrival, immigration formalities are mandatory. (police registration is
helmet or sunglasses.
applicable in certain cases)
Although reading/sight
5. Attach bank statement for business visit.
glasses may be worn.
6. Applicants family” includes spouse, son, daughter, father, and mother.
7. Use BLACK INK ONLY and write in BLOCK CAPITAL ONLY
PART – 1
1. Type of Visa Applied for:
Diplomatic 
Official 
Family 
Transit 
Military 
Journalist 
Business 
Tourist 
Others  Please Specify: __________
2. Purpose of Visit:
3. Duration of Stay:
4. Visa required for:
Less than 01 Month
06 Months
1Year
2Years
5Years
5. Type of Visa
Single 
Double
Multiple
i.
Port of Entry_______________ ii. Port of Departure_______________
iii.
Places to be visited in Pakistan
a_____________b_____________c______________d______________
6. Section I (Applicants Details)
i.
Name as in Passport: __________________________________________________________
First
ii:
Date of Birth
Middle
Last
___________________
dd
/
mm /
yyyy
iii:
Place of Birth:
City:___________________
Country:____________________
iv:
Sex:
Male 
Female 
v.
vi:
Marital Status:
Single
Married 
vii:
Identification Mark:
_________________________ viii:
ix:
Nationality:
a.Present ___________b.Previous__________ c.Dual___________
x.
Religion:
___________________
xi:
PASSPORT DETAILS:
Type of Passport:
Native Language:________
Diplomatic  Official / Service  Ordinary 
UN Travel Document
Passport Number___________Place of Issue___________
Date of issue
___________ Date of Expiry___________
Issuing Authority__________________________________
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xii:
ADDRESS & EMAIL
a.
In USA
_______________________________________________________
City________________State____________Zip_________________
b.
Telephone:
Home _____________ Work _____________ Cell _____________
In Pakistan
_______________________________________________________
_______________________________________________________
xiii:
Telephone:
Home _____________ Work _____________ Cell _____________
Email:
_______________________________________________________
Is your Visit Sponsored?
Name of Sponsor
_____________
_____________
Yes  (if Yes please give details)
Address
__________________
__________________
__________________
No 
Contact Number
Home _____________
Work _____________
Cell
_____________
b: Sponsor’s Details (In Pakistan / USA – If applicable).
Name
Address
Telephone
Email:
Cell:
Work:
Home:
xiv:
Details of Profession: (Please specify Rank/Service in case of Armed Forces / Uniform Personnel)
a: ___________________________________________________________________________
Note: In case of Military Services, please fill in the attached Performa.
xv:
Details of Jobs held in the past:
a.
Designation
_____________
b.
Department
_____________
c.
Duration(from-to)_____________
d.
Duties
_____________
e.
Address & Phone No. _________________________________________________
_________________________________________________
f.
Name, address and contact details of immediate Head/any other colleague:
Use extra sheet if required
____________________________________________________________________
____________________________________________________________________
xvi:
Are you applying for a visa from a third country?
Yes 
No 
If yes, please provide a copy of Residence / Work permit of that Country
7.
i.
iii.
v.
SECTION II (FAMILY DETAILS)
Name of Mother ___________________
ii. Mother’s Nationality ___________________
Name of Father ___________________
iv. Father’s Nationality ___________________
Spouse Details:
Name___________________
Nationality ___________________
Date & Place of Birth___________________ Profession___________________
Name, address & contact details of employer of spouse (if any)
____________________________________________________________________
____________________________________________________________________
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vi.
Do you have any children?
Yes  (If yes please provide details of each child)
Name (First, Middle, Last)
vii.
No 
Date of Birth (mm/dd/yyyy)
Please list any of accompanying person / family member (including children) traveling with
you to Pakistan.
Full Name
Date of Birth
Passport Number
Address
viii.
Do you have any Bank Accounts in Pakistan? Yes  (If yes please provide details) No 
Bank Name Branch
A/C Number
Address
Verifier Details
8.
i.
TRAVEL HISTORY:
Have you ever visited Pakistan during the last five years?
Yes  (If yes please provide details) No 
Date
Destination / Address
Purpose
Duration
Purpose
Duration
1.
2.
3.
4.
5.
ii.
Details of other Countries visited during the last 2 years
Date
Destination / Address
1.
2.
3.
4.
5.
iii.
Have you ever been refused a visa for any country including Pakistan? Yes 
No 
-3-
iv.
Have you ever been refused entry on arrival to Pakistan?
Yes  (If yes please provide details of refusal) No 
v.
Have you ever been deported, removed or otherwise required to leave any country,
including Pakistan? Yes 
(If yes please provide details) No 
Date
Country
Reason
Reference Number (For Pakistan)
vi.
Do you have any criminal convictions or charged in any country?
Yes  (If yes please provide details) No 
Date
Country
Offence
Sentence
DECLARATION:
I declare that the information given in this form is correct to the best of my knowledge and belief
and if any of the particulars furnished above are found to be incorrect or withheld the visa is liable
to be rejected / cancelled at any time.
Date
___________________
Signature of the Applicant ____________________________
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