Intake form · Government of India – e-Visa

India e-Visa Intake Form

Travelling to India from Canada? Fill in the India e-Visa intake form and we'll help you complete the online tourist, business or medical e-Visa application.

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This is an information form only. Fill in whatever you know to the best of your knowledge. Every question is optional, so skip anything you're unsure about. We'll call or message you for the rest.

Your contact details

Full name *

Email *

Mobile number with country code *

Section 1 · Personal

Personal details

Other names used (maiden name, nickname, alias)

Sex

Date of birth

Place of birth (city and country)

Section 2 · Marital status

Marital status

Current marital status

Date of marriage or start of common-law relationship

Spouse or partner's first name

Spouse or partner's last name

Section 3 · Passport

Passport

Passport number

Country that issued the passport

Passport issue date

Passport expiry date

Section 4 · Contact

Contact information

Current address where documents can be mailed (with postal code)

Section 5 · Trip

Your trip to India

Type of e-Visa

Expected date of arrival in India

Port of arrival and port of exit

Places you will visit in India

Reference contact in India (name, address, phone)

Previous Indian visa number and date (if any)

Countries visited in the last 10 years

Your occupation and employer

Section 6 · Other

Anything else

Anything else we should know