RESTRICTION ON ENTRY AND RESIDENCE APPLICATION FORMS FOR PERMIT/PERMISSION
Exemptions
Foreigners
Competent Authority
FORM - I
Application for issue of permit for visit/residence in the islands or for issue of fresh permit when original permit has been renewed three times
6.
Date of birth
7.
Profession (with name of the employer, if any)
| From To | Island visited or which applicant resided | No.& Date of permit |
| 1 | ||
| 2 | ||
| 3 |
women
need not furnish photographs)
Place:
Date:
Specimen
signature of L.H.T. impression of applicant and his wife* which shall be
detached and affixed to the permit.
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*ORDERS
OF THE COMPETENT AUTHORITY IF THE APPLICATION IS REJECTED
The
above application is rejected for the following reasons:-
1.
2.
3.
etc.
Place:
Date:
Signature
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*Delete not applicable
N.B: 1) All persons above 18 years of age except ladies accompanying their husbands shall make separate applications.
2) Fee of Rs. 50/- per application to be remitted at the office of the
Secretary to Administrator, UT of Lakshadweep, Willingdon island, Kochi
3,by cash or by DD on Syndicate Bank.
AFFIDAVIT / UNDERTAKING
I,
.. son of Shri.
aged
.. years
. (full address)
.. native of
island in Lakshadweep do hereby solemnly state
and undertake as follows:
1. That I have been awarded
contract of the work of
. by
. Department
and the work has to be completed expeditiously;
2. That the work is to be
undertaken in
.. island in the Union Territory of
Lakshadweep;
3. That there is no skilled
workers required for the purpose available from among the islanders and a
"No Objection Certificate" has been issued to that effect by the
Village (Dweep) Panchayat of
. Island, vide
..;
4. That I purpose to engage
and take the following persons(s) from the mainland to the island for the
execution of the above said work;
| Sl.No | Name , Fathers name & Address | Age |
5. That the above said
person(s) are accompanying me to the island to work under me and to the best of
my knowledge and information his/their antecedent and conduct are good;
6. That I hold myself
responsible for all acts of commission and omission of the above said person(s)
during his/their stay in the island and undertake to sent him/them back to
mainland immediately if the authorities of the Administration direct me to do so
with or without giving reasons and that I shall report to the Registration
Officer concerned as soon as he/they leave the island.
The particulars furnished above are true and correct to the best of my
knowledge and belief.
Signature
Name &
Seal of
Attesting Officer
FORM II
ADMINISTRATION OF THE
UNION TERRITORY OF LAKSHADWEEP
F.No .. Kavaratti island,
Dated
the..................
O R D E R
Sub:-
International Tourist Resort, Bangaram - Visit of tourists - permission granted.
WHEREAS the Casino Hotel,
Wellingdon Island, Cochin vide their letter No
..
dated
. has applied
for permission for bonafide foreign tourists having valid visa and passport for
visiting India as a tourist whose particulars are furnished in the Appendix to
visit the International Tourist Resorts at Bangaram Island from
. to
AND WHEREAS the said Casino Hotel have certified that they have checked
the travel documents of the tourists and found them to be correct and have also
undertaken on behalf of the tourists to ensure abidance by the rules and
directions under L.M.A islands (Restriction on Entry and Residence) Rules, 1967
as applicable to such permit holders, and that they will hold themselves
responsible for all the omissions and commissions of the said tourists, and that
they have under taken to send the said tourists back to mainland immediately if
and when the Administration directs them to do so with or without assigning
reasons.
Permission, is, therefore, granted to the said tourists whose particulars
are furnished in the appendix attached (same for as shown appendix to Form I) to
visit Bangaram island from
.. to
.
through the transit island of
Agatti/ Kavaratti.
Secretary to Administrator
FORM - I
To
The Secretary to the Administrator,
Union Territory of Lakshadweep,
Wellingdon Island,
Cochin - 682 003
Sub:-
International Tourist Resort, Bangaram - Permit for tourists - Application-
Submitted.
Dear Sir,
I am to inform you that the
. (No.) bonafide foreign tourists
having valid visa and passport for visiting India as tourist, whose particulars
are furnished in the appendix (in duplicate) have been booked by us to stay on
Bangaram Island. We have checked
their passport, visa and other travel document and found them to be in order.
We hereby declare that the information furnished in the appendix is
correct and true to the best of our knowledge and belief and certify that they
are bonafide foreign tourists visiting Bangaram International Tourist Resort. We also undertake on behalf of the said guests that they will
abide by the rules and directions under Lakshadweep Minicoy & Amindivi
Islands (Restriction on Entry and Residence) Rules, 1967 as applicable to permit
holders. We also hold ourselves
responsible for all the omissions and commissions of these guests and we
undertake to send them back to mainland immediately if the Administration
directs us to do so with or without assigning reasons.
It is, therefore, requested that permission may please be accorded for
their visit to Bangaram from
.. to
.
Through the transit island of Agatti/Kavaratti.
Yours faithfully,
APPENDIX TO FORM - I
| S.No | Name & Home Address with surname underlined(In block capitals) | Male or Female | Date and Place of Birth | Nationality | Passport No. & Date of expiry for visit to India by which office/country passport Issued | Period of Visit to Bangaram | Remarks |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 |
-------------------------------------------------------------------------------------------------------------------Note:-
This Form should be furnished in duplicate.
One copy to be deleted and duly signed by the Secretary to the Administrator should be attached with
the order of the Secretary to the Administrator as his office copy.
FORM II
(See rule 6)
Sir,
I, Shri./Smt./Kumari*
..
son/daughter/ wife* of (late*) Shri.
holder of the enclosed permit No.
..
dated
. . issued under
the Lakshadweep Islands (Restrictions on Entry and Residence) Rules, 1967, do
hereby request that the said permit may kindly be renewed up to
. Endorsed for
Island(s)* for the following reasons:-
1.
2.
3.
etc.
Place:
Date:
Signature/L.H.T. impression of applicant
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(OFFICIAL USE ONLY)
*ORDERS OF COMPETENT AUTHORITY IF APPLICATION FOR
RENEWAL/ENDORESEMENT IS REJECTED
The above application is rejected for the following reasons:-
1.
2.
3.
The permit is returned herewith:
Place:
Date:
Signature
---------------------------------------------------------------------------------------------------------------------*Delete
if not applicable
DECLARATION
I declare that Shri./Smt.
S/o
who is my
is
accompanying me to Island and will be staying with me at the Island that I hold
myself responsible for all his commissions and omissions during his/her stay in
the Island. That I undertake to
send him/her back to mainland immediately the Administration direct me to do so
with or without giving reasons and that I shall report to the Registration
Officer concerned as soon as he/ she leaves the Island.
Signature :
Place:
Name :
Date:
Address :
Issued to Shri.
on
remitting the fee of Rs.50/-
vide challan No.
.. dated
.