GOVERNMENT OF THE UNION OF MYANMAR IMMIGRATION DEPARTMENT APPLICATION FOR VISA ON ARRIVAL Pleaseattach 2 Photographs Please Indicate l)rpe of Visa]leguested taken witl1in the 0 Tourist Visa D Business Visa 0 Entry Visa(Social) 0 Transit Visa last 6 months (4x6cm) Family nall1e First name Middle name I II I I I I I I I IIIIIIIIII IIIIIIIIII Name Nationality ...................................................................................... .. 0 .Male 0 Female 0 Male 0 Female Name, Date and Place of Birth of Minor Children(if accompanying) • • ~., 0 , • 0 , 0 • t •, 0 , 0 e0 , <I",", Date of Birth 0 t •, •,,, t, o • o o t • •, • e, o,,., • o • • Yl I. I I I t t t t tot •, o o o o toot t • • MIIJ t" • t to • o • o o • DIIJ t • o "• to" t • o • o o • • o toto Place ofBirth .............................................. :. Oc~upation ....................................................................................................... ;..................................... . Passport Number I I. L I dsf Place of issue .................................................... Date of issue Yl I I ·I] vi I I II MIIJ DIIJ nliJ Date of expiry lVIIIJ Pertnanent/Current Address .................................................................................................................... . Tel .. ., ... ~ .................................. E111ail .................................... . Address in Myann1ar .............................................................................................................................. . Tel .................... ., .................... Email .................................... . Date of Arrival in Myanimir .................... Flight No .................... Vessel's t1atne .................................. . Attention for Applicants - Apart from the professions mentioned in this visa application form applicants are not to engage in any sort of work with of without charges. - Application shall abide by the laws of Union ofMyanmar and shall not interfere in the Internal affairs of the Union of Myanmar. - Legal action will be taken against those who violate or contravene any provision of the existing laws, rules and regulations of the Union of Myanmar. ' I hereby declare that I fully understand the above mentioned conditiOi1S, that the particulars given above are true and colTect and that I will not engage in any activities irrelevant to the purpose of entry herein. Date ... .... ........... ..... ............. ...... ..... ..... Signature of applicant ..................................... . (FOR OFFICIAL USE ONLY) Application/Reference No,...................................... Visa No ........................................................ . Date of Issue ............................................... . Visa Fee ....................................................... . 0 Entry Visa(Social) 0 Transit Visa Authol'ized Signature .................................. . 0 Tourist Visa 0 Business Visa