Machine Readable Visa Application Form - D.I.P Form-4 - Free of cost

Sep 19, 2026

Upload by Kurz

Machine Readable Visa Application Form (D.I.P Form-4) issued by the Government of the People’s Republic of Bangladesh, Department of Immigration & Passports. The form collects applicant personal details, travel document information, payment details, and the new visa purpose and planned stay, including entry count and arrival/expiry dates. It also provides sections for visa extension and no-visa-required (NVR) travel, transit/on-arrival visa details, document check list, declaration and signatures, police verification, and official-use fields.

LanguageEnglish

CategoryForms

FormatPDF

Pages4

Reading Time2 min

AccessFree to download

Personal details

Travel document details

Payment details

New visa

Extension of visa

No visa required (NVR)

Transit/On arrival visa

Check list

Declaration and signatures

Police verification

General instructions

Applicant’s Photograph Measuring 45 mm x 35mm D. I. P Form-4(Free of cost) Government of the People's Republic of Bangladesh Department of Immigration & Passports Machine Readable Visa Application Form 􀀁 This Form Should Be Filled Up In 'Capital Letters'. Put (􀀁) In Appropriate Box. 􀀁 Please Go Through The General Instructions Before Filling Up The Visa From. 􀀁 Name of Office/ Bangladesh Mission : PERSONAL DETAILS 01. Full Name : (as in the passport) First/ Given Name (S) Last/ Surname 02. Permanent address: Contact no: E-mail: 03. Address in Bangladesh: ~~ ~~ Contact no: E-mail: 04. Date ofBirth: / / D D / M M / YYYY 05. Sex: Male Female Others 06. Place of Birth: 07. Present Nationality: 08. Nationality at Birth: 10. Marital Status : Unmarried Married 09. Occupation: Widower/Widow TRAVEL DOCUMENT DETAILS 11. Passport No: 12. Type of Passport 13. Place of Issue: 14. Date of issue: ~~ ~~D~~ ~~D~~ ~~/~~ / ~~M~~ ~~M~~ ~~/~~ ~~~~ ~~ 15. Date of Expiry: ~~ ~~D~~ ~~D~~ ~~/~~/ ~~M~~ ~~M~~ ~~/~~/ ~~YYYY~~ ~~ 16. Date of last visit to Bangladesh: /~~ ~~D~~ ~~~~ ~~/~~ ~~M~~ ~~M~~ ~~/~~ ~~YYYY~~ ~~ 17. Last Visa No: Date of Issue: / / 19. Place of Issue: D D / M M / YYYY 20. Date of Expiry: ~~ ~~D~~ ~~D~~ ~~/~~/ ~~M~~ ~~M~~ ~~/~~/ ~~YYYY~~ ~~ PAYMENT DETAILS 21. Name of the Bank and Branch: 22. Cheque/ Bank Transfer/ Chalan/ Scroll No: 23. Amount deposited 24. Date: / / (Taka/ US$) D D / M M / YYYY NEW VISA 25. Purpose of Visit: Tourism Employment Business Official Study Investment Transit Others Diplomatic 26. Duration of Proposed Stay in Bangladesh: 27. Tentative Date of Arrival in Bangladesh: ~~ ~~D~~ ~~D~~ ~~/~~ /~~M~~ ~~M~~ /~~/~~ ~~YYYY~~ ~~ 28. Intended Number of Entries: Single Re Entry Multiple (Please Specify) EXTENSION OF VISA 29. Name of the Father/Mother/Spouse/ Other (Relation) : 30. Date of Arrival: / / 31.Visa No: 32.Type of Visa: in Bangladesh D D / M M / YYYY 33. Date of issue :~~ ~~D~~ ~~D~~ ~~/~~/~~M~~ ~~M~~ ~~/~~ / ~~YYYY~~ ~~ 34. Date of Expiry : ~~ ~~D~~ ~~D~~ /~~/~~ ~~M~~ ~~M~~ /~~/~~ ~~YYYY~~ ~~ 35. Place of Issue: 36. Purpose of Extension of Visa: 37. Duration of Proposed Extension: 38. Intended Number of Entries: Single Re Entry Multiple NO VISA REQUIRED FOR TRAVEL TO BANGLADESH 39. Father’s name : Nationality: 40. Mother’s name: Nationality: 41. Spouse’s name: Nationality: 42. Date of Arrival in Bangladesh :~~ ~~D~~ ~~D~~ ~~/~~ ~~~~ ~~M~~ ~~/~~ ~~~~ ~~ 43. Visa No: 44. Date of Issue: D D / M M / YYYY 45. Date of Expiry: D D / M M / YYYY 46. Place of issue: 47. Type of Visa: 48. Reason For Proposed NVR: 49. Amount of Investment (For Investor): 50. Name and Address of Company: | | | --- | | | | | TRANSIT/ON ARRIVAL VISA 51. Date of Arrival in Bangladesh: ~~ ~~D~~ ~~D~~ ~~/~~ ~~~~ ~~M~~ ~~/~~ / ~~YYYY~~ ~~ 52. Name of check post: 53. Travelled by (Vessel’s/ Flight/Vehicle Name & No): 54. From: 55. Purpose of Visit to Bangladesh: 56.Duration of Proposed Stay: CHECK LIST Recommendation from concern Ministry/ Authority Security Clearance/Security Certificate Father’s/ Husband’s/Mother’s Visa Copy Passport copy, Last Visa & Last Arrival Page Father’s/ Husband’s/Mother’s Passport Copy N. O. C from Sri Lankan High Commission Bi-Lateral Agreement/ Multilateral Agreement Trade license of the sponsoring Company Payment Slip Over stay payment Slip Marriage Certificate Birth Certificate Work Permit Affidavit Photo Income Tax Certificate of the Company TIN TIN certificate of the company Others I, hereby, declare that statement given above is true and will not request to refund my paid visa fee even if my application is declined. Place ~~ ~~ Date ~~ ~~D~~ ~~D~~ ~~/~~ ~~~~ ~~M~~ ~~/~~ / ~~YYYY~~ ~~ Signature POLICE VERIFICATION Memo No : Information’s are found: Date

FAQs

What is D.I.P Form-4 in this document?

It is the Machine Readable Visa Application Form labeled as D.I.P Form-4 (Free of cost).

Which main information categories must the applicant fill in?

The form requests personal details, travel document details, payment details (if applicable), visa purpose and planned stay, and—depending on the case—extension or NVR/transit sections.

What are the general submission and compliance instructions?

Attach a 45mm x 35mm color photograph with white background, fill required sections and tick appropriate boxes, attach essential supporting documents and payment receipt, and note that visa fee paid is non-refundable; the authority’s decision is final.

Sep 19, 2026

Upload by Kurz