Needed Details for Iranian Visa Authorization 

1- First Name      : 
2- Surname         :
3- Gender           : 
4- Father Name   : 
5- Date of Birth    : 
6- Place of Birth   : 
7- Nationality       : 
8- Occupation      :
9- Passport No.   :
10-Date of Issue  : 
11-Place of Issue: 
12-Date of Expiry:
13- Iranian Consulate for collecting the visa : 
14- Have ever been in Iran?
15- Planned date of Entry to Iran :
16- Duration of Stay : 
17- Planned Entry point : 
19- Itinerary : 
20- Permanent Tel. :
21- Procedure (Normal/Urgent) :

A passport copy is usually required which can be sent by email or fax. [00-1-309-2137922 - based in USA]