Indonesia Tourist visa Application

Transcription

1 Indonesia Tourist visa Application Please enter your contact information Name: Tel: Mobile: The latest date you need your passport returned in time for your travel: 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.com. 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 - add $23 FedEx Standard Overnight - add $30 FedEx Priority Overnight - add $38 FedEx Saturday delivery - add $68 FedEx First Overnight - add $113 Prepaid self addressed mailer - $0 Local pick up in Chicago - $0 Name: Company: Address: City: State: Zip:,, T: (021) E: info@visahq.com

2 Proof of status. Copy of Green Card (both sides) or other proof of legal status in the US (such as copy of I-20, US visa, H1B approval notice, etc. VisaHQ cannot assist US B1/B2 visa holders at this time.) Driver's license. Copy of driver's license, state issued ID, or major utility bill (Water, Gas, Electric, Sewage) for the most recent month, showing the applicant's name and current address. Itinerary. Copy of round trip tickets or confirmed itinerary. Yellow Fever Vaccination. If the applicant has traveled within the last 90 days to any of the Yellow Fever Countries an International Certificate of Vaccination for Yellow Fever will be required. Bank statement. Copy of the applicant's most recent monthly bank statement. The statement must clearly show the applicant's name as the account holder, the balances of the accounts, and the date of the statement. 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. below. Approval. Approval tification issued by the Clearing House of the Department of Foreign Affairs or Indonesian Immigration. See Citizens of Israel must obtain an approval from the authorities in Indonesia prior to applying for a visa. To obtain an approval please follow the following instructions: 1. Contact your sponsor or counterpart in Indonesia this could be a hotel, travel agent or an individual to pursue the Authorization (Otorisasi) at the Clearing House of the Department of Foreign Affairs or with Indonesian Immigration. 2. Once the Authorization has been approved, the original will be sent to the Indonesian Embassy or Consulate nearest to you to apply with VisaHQ it must be sent to the Consulate in New York. A tification (Pemberitahuan) of the approval is sent to your sponsor in Indonesia. Your sponsor needs to send this document to you to present with your application. Additional required documents for minors (under 18): - Birth Certificate. A NOTARIZED copy of the applicant's birth certificate. - Letter of Consent. A NOTARIZED letter of consent signed by both parents, specifying who will be traveling with the child and authorizing the Consulate to issue a visa to the child. There are restricted regions in Indonesia. The four regions are: Maluku, Poso, and Irian Jaya/West Papua. Applicants seeking to visit the restricted regions must obtain special authorization from Indonesian authorities.,, T: (021) E: info@visahq.com

3 Indonesia tourist visa fees for citizens of Israel Type of visa Validity Processing time Embassy fee Service fee Total Single entry up to 90 days 6 business days $50.00 $79.00 $ This order is subject to Terms of Service, posted on VisaHQ website. All fees and requirements may change without notice.,, T: (021) E: info@visahq.com

4 Credit Card Authorization Form By signing this form i accept VisaHQ.com Terms of Service and authorize to charge my credit card for the amount of $ Name on the Credit Card: Credit Card number: Exp. date: / Credit Card Billing Address: Signature: Comments: Thank you! We accept all major credit cards.,, T: (021) E: info@visahq.com

5 V I S A R E Q U I S I T I O N F O R M THE CONSULATE GENERAL OF THE REPUBLIC OF INDONESIA 5 EAST 68TH STREET. NEW YORK. NY PHONE: FAX: Date : I. GENERAL Length of Stay in Indonesia : Type of Visa : Day[s] Month[s] Year[s] Transit Single Visit Multiple Visit Limited Stay PHOTOGRAPH 2" X 2" II. For Transit Purpose Country of Destination : Port of Departure : Flight / Vessel Name : For Visit Purpose Purpose of Visit : Country of Destination : Place of Visit : Flight / Vessel Name : For Limited Stay Purpose Purpose of Limited Stay : Address in Indonesia : Province : Port of entry into Indonesia : Date of entry : PERSONAL DATA First Name : Middle Name : Family / Surname : Sex : Marital Status : Place of Birth : Date of Birth : Nationality : Address : Province / State : Occupation / Position : Name of Company : Address : Tourism Convention Family Visit Sports Study Arts Commercial Others Work Joint Family Social Others Male Female Married Single Professional Government Sales Student Housewife Others Province / State :

6 III. PASSPORT INFORMATION Passport or Travel Document Number : Place of Issue : Date of Issue : Date of Expire : Type of Passport* : * Fill If Type Passport Family: Personal Family NO. RELATIVE [S] SEX DATE OF BIRTH [DD-MM-YYYY] NAME: * Relative [s]: 1=Hunband, 2=Wife, 3=Child Sex: M=Male, F=Female IV. SPONSORSHIP IN INDONESIA Type of Sponsor : Name of Company : Address : Province / State : Individual Government International Institution Company N. G. O. Others V. MISCELLANEOUS Have you ever been to Indonesia before? Are you in posession of any other countries travel documents? : : Do you have previous visa to enter Indonesia? : Has your visa application been denied before? : Have you ever been forced to leave Indonesia? : Have you ever comitted a crime or any offence? : Return/Through Ticket/Airline Co. : Place of Issue : Date of Issue : Date of Expire : I hereby declare that the statements given above are true and I understand that even if granted a visa, admission at the airport remains the discretion of the Immigration authorities in Indonesia. Applicant s Signature Print Full Name * Passport must be valid at least six months. T H E C O N S U L A T E G E N E R A L O F T H E R E P U B L I C O F I N D O N E S I A I N N E W Y O R K