1. Sponsor's Name: ___________________________________________________________

2. Nationality: ________________________________________________________________

3. Sponsor's address: __________________________________________________________

4. Sponsor's Occupation: _______________________________________________________

5. Sponsor's earnings __________________________________________________________
(Certificate from employer to be attached)

6. Other evidence of financial standing:
a) I hold $_________________________ in ___________________________________ bBank
b) I own property/properties situated at ___________________________________________
_____________________________________________________________________________
(to be supported by bank pass book/letter from bankers, in case of property, title deed to
property or other evidence of ownership of imnovable property in the foreign country concerned)

7. PARTICULARS OF SPONSOR'S PASSPORT:

Passport No.____________________________ Date of issue:__________________________
Place of issue___________________________

8. Name, addresses and exact relationship of dependents in India who are being sponsored:

9. Purpose of visit to Panama:

10. Duration of visito to Panama: From __________________ to _______________________

I, ______________________________ son of ______________________________________
Hereby solemnly declare that I undertake to bear the cost of passage of the above named person
from India to Panama and back in dollars and to maintain him/her during his/her stay in Panama.

Dated:

Signature: __________________________________________

Name: ______________________________________________