Mozambique Visitor visa Application

Transcription

1 Mozambique Visitor visa Application Please enter your contact information Name: Tel: Mobile: The latest date you need your passport returned in time for your travel: Mozambique visitor visa checklist Filled out and signed Mozambique visitor 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 - From $29 FedEx Standard Overnight - From $42 FedEx Priority Overnight - From $43 FedEx Saturday delivery - From $60 FedEx First Overnight - From $72 Prepaid self addressed mailer - $0 Local pick up in New York - $0 Name: Company: Address: City: State: Zip: * Actual prices may vary based on location per FedEx.com.

2 Itinerary. Copy of round trip tickets or detailed itinerary for the duration of the trip (Applicant's name must be on itinerary). Invitation Letter. Copy of an invitation letter from family or friends in Mozambique. resident. Host's Passport. Copy of inviting host's passport (if Mozambican) or the "DIRE" (permanent resident permit) if host is a permanent Additional required documents for minors (under 18) Birth certificate. A copy of the applicant's birth certificate. Notarized Letter of consent. A 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. Must be notarized. Parents' passport copies. Copies of the information pages of both parents' passports..

3 Mozambique visitor visa fees for citizens of United States of America Type of visa Validity Processing time Embassy fee Service fee Total Single entry up to 60 days 4-5 business days $ $79.00 $ Multiple entry up to 90 days 4-5 business days $ $79.00 $ 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.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.

5 PEDIDO DE ENTRADA EM MOCAMBIQUE REQUEST FOR ENTRY VISA TO MOZAMBIQUE RECIBO PREENCHER COM LETRA LEGIVEL RESERVADO AOS SERVICOS: TO BE FILLED IN LEGIBLE LETTERS FOR OFFICIAL USE: VISTO UMA ENTRADA Single entry DATA DE EMISSAO.../.../.. VALIDADE MULTIPLAS ENTRADAS Multiple entries./.../ APELIDO Surname NOME COMPLETO Full name NOME DE SOLTEIRA Maiden name PAIS E LOCAL DE NASCIMENTO Country and place of birth DATA DE NASCIMENTO Date of birth SEXO Sex ESTADO CIVIL Marital status NACIONALIDADE Nationality PASSAPORTE Passport PROFISSAO/OCUPACAO Profession/Occupation DATA DE EMISSAO Date of issue / /. Validade Validity / /. CARGO QUE OCUPA Position you hold NACIONALIDADE DO PASSAPORTE Passport nationality INSTITUICAO, ORGANIZACAO OU EMPRESA ONDE TRABALHA Institution, organization or firm you work ENDERECO DA RESIDENCIA PERMANENTE Address of the permanent residence Adress: Mobile: ESTEVE ALGUMA VEZ EM MOCAMBIQUE? SIM NAO Have you ever before been in Mozambique? Yes No JA FOI RESIDENTE EM MOCAMBIQUE? SIM NAO Have you ever been a resident in Mozambique? Yes No PORQUE SAIU DE MOCAMBIQUE? DATA DE SAIDA Why did you leave Mozambique? Date of exit }./../. INDIQUE AS INSTUICOES E EMPRESAS A QUE ESTEVE LIGADO Mention the institutions and firms to which you were attached O PREENCHIMENTO INCORRECTO OU INCOMPLETO IMPLICA RESPOSTA TARDIA, DEVOLUCAO OU INDEFERIMENTO INCOMPLETE OR INCORRECT FILLING IN OF THIS FORM MAY RESULT IN DELAY DEVOLUTION OR REJECTION

6 DETALHE OS MOTIVOS DA ENTRADA EM MOCAMBIQUE In detail give reasons for your entry in Mozambique TEMPO DE ESTADA EM MOCAMBIQUE Length of stay in Mozambique FRONTEIRA DE ENTRADA Entry border DATA DE ENTRADA Date of entry././ FRONTEIRA DE SAIDA Exit border DATA DE SAIDA Date of exit././ ENDERECO DA HOSPEDAGEM EM MOCAMBIQUE Address of residence in Mozambique PROVINCIA Province DISTRITO District CIDADE City AVENIDA/RUA Avenue/street CASA House FAMILIARES/AMIGOS RESIDENTES EM MOCAMBIQUE Relatives, friends living in Mozambique NOME COMPLETO Full name NACIONALIDADE Nationality PARENTESCO Relationship ENDERECO Address DATA Date }././..... Signature of applicant or of the applying entity ASSINATURA RECONHECIDA POR SEMELHANCA A EXISTENTE NO..... EMITIDO A.../ / EM RESERVADO AOS SERVICOS For official use DATA DE RECEPCAO.../ /.... ASSINATURA DO FUNCIONARIO DATA DE ENTREGA.../ /.