APPLICATION FORM FOR ENTRY VISA

GOVERNMENT OF THE UNION OF MYANMAR
IMMIGRATION DEPARTMENT
APPLICATION FORM FOR ENTRY VISA

1. Full name of applicant (in block letter) …………………………………………….………

2. Father’s name (in full) ………………………………………………………………..…….

3. Present Address …………………………………………………………………….………

4. Full address in Myanmar ………………………………………………………….….…….

5. Nationality……………………………………….. Sex……………………………..…….

6. Occupation/ Profession …………………………………………………………………….

7. (a) Date of birth …………………………………………………………………….…..…..

(b) Place of birth ……………………………………………………………………………

8. (a) Number of Passport ……………………………………………………………………..

(b) Date of Issue of Passport …………………………………………………………....…..

(d) Issuing Authority ………………………………………………………………..…..…..

(e) Date of Expiry of Passport ………………………………………………………….......

(f) Countries for which Passport is Valid ………………………………………….….……

9. Name and Age of Children (Below Seven Years) ……………………………………..…...

Accompanying the applicant ……………………………………………………………..…

10. Whether any Visa / Immigrating Permit has been refused and Reasons for refusal ………

…………………………………………………………………………………………….……

11. Object of journey to Myanmar and destination …………………………………………....

12. Name and address of reference or gueranter in Myanmar …………………………..…….

13. Probable length of stay in Myanmar …………………………………………………..…..

14. Return Visa or Entry Visa for the, No. ………………………………………..……

Country of destination Date. ………………………………………...….

Validity ……………………………………..….

15. Particular of previous visit if any to Myanmar ………………………………………....….

…………………………………………………………………………………………….……

16. Number and date of issue of visa or Immigration Permit ……………………………...….

…………………………………………………………………………………………….……

CERTIFICATE

I here by certify that the particulars stated above are correct and that signature subscribed below is my signature and I known that I am liable to prosecute if any of the particular furnished is found to be false.

I also submit here with there copies of my photograph.

Date ……………… SIGNATURE