Sri Lanka living in New Brunswick

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1 Sri Lanka living in New Brunswick Please enter your contact information Name: Tel: Mobile: The latest date you need your passport returned in time for your travel: The Embassy of Indonesia in Ottawa is closed every Friday. Please plan accordingly. Indonesia tourist visa checklist Filled out and signed Indonesia tourist visa application form. The form is enclosed. Original Passport. Passport must have at least 6 months remaining validity and have at least 1 visa page. 2 Photographs. Standard passport photographs 2x2 inches on a white background. Payment. Credit Card Authorization form, Certified Check, or Money Order payable to VisaHQ.ca. Return mailer. Prepaid self-addressed return label or payment for FedEx. If you wish to prepay return shipping, please add the shipping fee to the total and provide return address: FedEx 2nd day delivery - From $33 FedEx Priority Overnight - From $34 FedEx First Overnight - From $54 FedEx Saturday delivery - From $62 Prepaid self addressed mailer - $0 Local pick up in Ottawa - $0 Name: Company: Address: City: State: Zip: * Actual prices may vary based on location per FedEx.com.

2 Proof of Status. Copy of the front and back of valid Permanent Resident Card or other proof of legal status in Canada (such as study permit, work permit, refugee/protected person status document) e-ticket. Copy of e-ticket, printed on 1 page double sided Employment Letter. A letter from your employer/school (on business letterhead, with contact details), stating that a leave of absence has been granted and that you will be returning to your current job. If you are self-employed, include a copy of your business license and tax return. If you are retired please submit proof of your retirement fund. Letter of invitation. If visiting friends or family in Indonesia, a letter of invitation stamped by the Ministry of Foreign Affairs. Requirements for minors traveling without parents Letter of consent.a Letter of Consent signed by both parents and Certified by the Provincial Notary Public.

3 Indonesia tourist visa fees for citizens of Sri Lanka living in New Brunswick Type of visa Validity Processing time Embassy fee Service fee Money order Fee HST Total Single entry up to 90 days 5 business days $65.00 $59.00 $10.00 $7.67 $ This order is subject to Terms of Service, posted on VisaHQ website. All fees and requirements may change without notice.

4 Credit card authorization form By signing this form i accept VisaHQ.ca Terms of Service and authorize to charge my credit card for the amount of $ Name on the Credit Card: Credit card number: Exp. date: / CVC: Credit Card Billing Address: Signature: Comments: Thank you! We accept all major credit cards.

5 EMBASSY OF THE REPUBLIC OF INDONESIA 55 PARKDALE AVENUE, OTTAWA, ON K1Y 1E5 VISA APPLICATION FORM This form is completed on your computer or in CAPITAL LETTERS TYPE OF VISA REQUESTED Single entry Can only be used for one entry, valid for 90 days after the date of issuance with a maximum stay of 60 days Multiple entry Can be used for multiple entry within 1 year with a Maximum stay of 60 days per visit Limited Stay Needs authorization letter from Directorate General of Immigration in Jakarta, Indonesia Diplomatic and Special / Service Passport Single entry with a maximum stay of 30 days 1 (one) Photo staple or glue the photo here 1 Applicant s Full Name as mentioned in your passport Family Name: Given Names: Gender: Male Female Place of Birth (City Country): Date of Birth (DD/MM/YYYY): Marital status : Married Single Other: Nationality: Passport Number: Type of Passport: Ordinary Diplomatic / UNPL Special/service Passport Place of Issuance: Passport Date of Issue (DD/MM/YYYY): Passport Date of Expire (DD/MM/YYYY): 2 Applicant s home address in Canada Number and name of Street Apt. / Unit No. Home Phone: Area code / Number City Province Postal Code Mobile: Area code / Number address : 3 Full Time Occupation / Student Name of Company / Educational Institution; Position: Number and name of Street : Work Phone: Area code / Number City Province Postal Code Mobile: Area code / Number

6 4 Purpose of Travel Tourism Family Visit Study Internship Press & Media Film Making Arts Sports Workshop Seminar Conference Business/Commercial Industry Mining Agriculture Official Visit/Meeting Diplomatic Posting Others: 5 Length of stay and Flight / Cruise Ship information to and from Indonesia Length of Stay (days) Date of Entry City and Port of Entry City and Port of Exit Date of Exit Flight / Cruise Ship Number Flight / Cruise Ship Number 6 Hotel Name and Address in Indonesia (first arrival) Hotel Name: Hotel Address : City & Province: Phone Number: 7 Indonesian Sponsor (not applicable to Tourism) Name of Sponsor Sponsor s Title/Position Work Phone: Area code / Number Name of Company / Institute Fax Number : Area code / Number City / Province Postal Code Mobile (if any) : Area code / Number 8. Are you in Possession of other Country s Valid Passport Yes No If Yes, Specify the Country: 9 Does any of the following apply to you Yes No Please Specify: a b c d Have you ever travelled to Indonesia Has your visa application for Indonesia ever been denied Have you ever been ordered to leave Indonesia Have you ever been arrested or convicted of a criminal act? 1. I hereby declare that the statement given above is true and correct to the best of my knowledge. Applicant s Signature and Date 2. I understand that possession of a Visa does not automatically entitle the bearer to enter Indonesia upon arrival if he or she is found inadmissible. 3. I understand that any false or misleading statement may result in permanent refusal of a visa or denial of entry into Indonesia. 4. I am also aware that failing to comply with the above requirements, I will be liable to prosecution or expulsion. Date :

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