IM: 32 REPUBLIC OF SRI LANKA Form “B” Regulation 68 APPLICATION FOR A VISA Passport No: ……………………………………. Date of expiry: ………………………. Date of Issue: ………………………………. Place of Issue: ………………………. Details of Previous Passports held, if any: …………………………………..…………….. 1. Name in Full: ………………………………………………………………………….. (Surname first in BLOCK letters) Name of Father ……………………………………………………………………….. 2. Nationality …………………………………………………………………….…..……. If Naturalised, date and place of Naturalisation and former nationality …………. 3. a. Date of Birth: …………………… b. Place of Birth: …………………….. 4. Civil Status, (Single, Married, Widower, Widow or Divorcee) ……………………………… 5. If married, where spouse is resident and full Postal Address …………………... …………………………………………………………………………………………. 6. Applicant’s height: ………………feet, …………..inches ………………..cm 7. Any identification marks or peculiarities ……………………………………..…… 8. Applicant’s address: (a). Permanent ……………………………………………………..…………………. ……………………………………………………………………………………….. Tel No: (Res.)……………………………. (Office)……………………….…..…. E-mail: ……………………………………. (b). Address during stay in Sri Lanka …………………………………………………..……………………………………… ………………………………………………………………………………………… 9. Profession or Occupation ……………………………………………………… 10. Name and address of employer if any …………………………………………. ………………………………………………………………………………….. 11. If in business where business is ……………………………………………….. …………………………………………………………………………………. 12. Whether previously in Sri Lanka? If so, last place of residence and date of leaving ………………………………………………………………………… Particulars of visa or Residence Permit last obtained (a) If visa, give date of issue and period of validity ……………………………. (b) If residence Permit, give date of issue, period of validity, permit No: and purpose issue …………………………………………...…………..………… …………..………………………………..…………………………………… 13. Whether permission to visit Sri Lanka or extend stay in Sri Lanka has been refused previously and, if so, by whom and when or whether application has been has been made now or previously to any Sri Lanka visa office abroad? If so, full particulars and position of such application ……………………………………. ………………………………………………………………………………….. 14. Object of present visit? …………………………………………………………. 15. Route and mode of travel to Sri Lanka ………………………………………… 16. Period for which visit visa is required …………………………………………. 17. (a) Name and address of a person in Sri Lanka who can furnish information regarding applicant and security for maintenance and repatriation of the applicant, if so required……………………………………………………… ……………………………………………………………………………….. (b) Name & address of a responsible person in applicant’s own country who can furnish information regarding applicant: ……………………………………. ……………………………………………………………………………….. 18. How much money will the applicant have with him or have available for himself on arrival in Sri Lanka ………………………………………….……… ……………………………………………………………………………………… 19.Any other reason to urge in support of application ……………………………………………………………………………………… I hereby declare that to the best of my knowledge and belief the foregoing statements are true, that I shall not engage my self in any employment, paid or unpaid, on arrival in Sri Lanka and that I shall leave Sri Lanka before the date of expiry of the period of my authorised stay in the Island. I also undertake to notify the Controller of Immigration and Emigration, Colombo, immediately any change of my address while in Sri Lanka occurs. Date: ……………………. Signature: ……………….…….. Note: 1. Fee for a visit visa is charged on a reciprocal basis. Holders of diplomatic or official passports will be granted or issued visas free or charge. 2. An applicant must submit two copies of his photograph 4.5 x 3.5 cm for issue of visa. 3. Those travelling to Sri Lanka on visa issued by this High Commission should note that they must enter Sri Lanka within 3 months of the date of issue and therefore applications should be submitted not more than 3 months prior to the intended visit to Sri Lanka Client Declaration form. I accept that I should read and fully understand the Terms & Conditions shown on the website www.thetravelvisacompany.co.uk of The Travel Visa Company Ltd (Hereafter referred to as ‘the Company’). Before signing this declaration I am aware that if I do not understand any of the Terms and Conditions, I can ask any staff member of the Company, telephone [01270 250 590] or email [[email protected]]. I am fully aware that the Company has no involvement in the visa assessment and decision‐ making process. Whether a visa is to be issued or not and what type of visa is issued, as well as its period of validity, number of entries and duration of stay shall be wholly up to the discretionary decision of the relevant Embassy, High Commission or Consulate General. I will fully accept any decision made by said Embassy, High Commission or Consulate General. I agree to pay the application fee in full, which is non‐refundable, to the Company, according to the price initially quoted to me by a registered company staff member, regardless of whether my visa is granted or not by the relevant Embassy, High Commission or Consulate General. I am fully aware that all time‐frames quoted by staff members of the Company are predictions based upon experience and previous applications. Embassies can extend the processing time on individual applications at their discretion and the Company shall not be responsible or liable for any delay experienced during the application process. I am also aware that I might have to provide additional supporting documentation at the request of the relevant Embassy, High Commission or Consulate General. I agree that I will carefully check all the information on the Visa when I receive my passport and I am aware that any queries about the Visa should be addressed to a staff member of the Company immediately. I understand that if I apply by post, or request return delivery by post of my processed application, the Company shall not be responsible or liable for any delay, delivery to a wrong address, damage to or loss of the documents, as a result of the negligence of any mail service or company. I agree that the Company shall not be responsible or liable for any consequences as shown below: a) The Visa becoming invalid and cannot therefore be used as a result of my own fault or any act by a third party acting on my behalf; or, b) In the event that I am refused to board an aircraft or to enter my proposed destination due to my failure to check all the information printed on my Visa; or, c) My Visa can’t be used due to any other reasons of my own doing. d) In the event that I am refused to board an aircraft or to enter my proposed destination due to reasonable denial made by the authority concerned or an immigration officer. Printed Name (in capital): ………………………………………………………………………………… Signature: Date: …………………………………………………………………………………. …………/…………/………….. client of Transindus Client Order Form Name: Telephone Number: Email Address: Postal Address: Post Code Date of travel to Visa required country: Do you require your passport for any reason before the above date? / Yes / No If yes, please specify the date you need your passport returned by: / Full Name (Printed): Applicant Signature: Date: / / /
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