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    VisaApplicationForm Example

    Uploaded by

    Wisheth Randika
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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    VisaApplicationForm Example

    Uploaded by

    Wisheth Randika
    5 views2 pages
    Aaaaaa

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    5 views2 pages

    VisaApplicationForm Example

    Uploaded by

    Wisheth Randika
    Aaaaaa

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Paste passport photo here.

    Please print or write in block letters (Do NOT staple or tape.) Photo
    should be taken within the last
    VISA APPLICATION FORM TO ENTER JAPAN6 months.

    Please provide the city,


    state/ province and country
    (Paste photo here)
    in which you were born.
    45mmx45mm

    or 2inX2in
    *Official use only

    Please tick the appropriate box.

    Surname (as shown in passport) KENNEDY


    Given and middle names (as shown in passport) John Andrew
    Other names (including any other names you are or have been known by)
    n/a
    Date of birth 06/06/1985 Place of birth Southport Queensland Australia
    (Day)/(Month)/(Year) (City) (State or Province) (Country)

    Sex: Male Female Marital status: Single Married Widowed Divorced


    Nationality or citizenship Australian
    Former and/or other nationalities or citizenships USA
    ID No. issued to you by your government (NB. Australian citizens do not have this number)
    Passport type: Diplomatic Official Ordinary Other
    Passport No. A11223344
    Place of issue Brisbane Date of issue 10/03/2015
    (Day)/(Month)/(Year)

    Issuing authority Australian Government Date of expiry 10/03/2020


    (Day)/(Month)/(Year)

    Purpose of visit to Japan Sightseeing


    Intended length of stay in Japan 12 days
    Date of arrival in Japan 18 November 2015 Date of departure in Japan 30 November 2015
    Port of entry into Japan Narita Airport Name of ship or airline JQ 19
    Names and addresses of hotels or persons with whom applicant intends to stay
    Name Hotel Kayuukaikan Tel. 03-3230-1230

    Address 8-1 Sanbancho, Chiyoda-ku, Tokyo 102


    Dates and duration of previous stays in Japan February 4 ~ March 4, 2007; 1 month
    Your current residential address (if you have more than one address, please list them all)

    Address 8/ 38 Southport Rd, SOUTHPORT, QLD, Australia 4215


    Tel. (07) 55-888-888 Mobile No. 0412 345 678
    Email johnakennedy@kennedymail.com
    Current profession or occupation and position Company Employee/ Student
    Name and address of employer
    Name Australia Trade Inc/ (Name of School/ University) Tel. (07) 55-555-555

    Address 95/302 Surfers Paradise Blvd, QLD, Australia 4217


    *Partner's profession/occupation (or that of parents, if applicant is a minor):

    Guarantor or reference in Japan (Please provide details of the guarantor or the person to be visited in Japan)
    Name Mr Robert Taylor Tel. 03-3230-1111

    Address 2-2-1 Kasumigaseki, Chiyoda-ku, Tokyo 100


    Date of birth 01/04/1980 Sex: Male Female
    (Day)/(Month)/(Year)
    Relationship to applicant brother-in-law
    Profession or occupation and position Company employee
    Nationality and immigration status Australian, Intra-company transferee
    Inviter in Japan (Please write 'same as above' if the inviting person and the guarantor are the same)
    Name same as above Tel.

    Address
    Date of birth Sex: Male Female
    (Day)/(Month)/(Year)
    Relationship to applicant
    Profession or occupation and position
    Nationality and immigration status
    *Remarks/special circumstances, if any
    Have you ever: Please check the appropriate box for each question.
    ● been convicted of a crime or offence in any country? Yes No ■

    ● been sentenced to imprisonment for 1 year or more in any country?** Yes No ■

    ● been deported or removed from Japan or any country for overstaying your visa or violating Yes No ■

    any law or regulation?


    ● been convicted and sentenced for a drug offence in any country in violation of law Yes No ■

    concerning narcotics, marijuana, opium, stimulants or psychotropic substances?**


    ● engaged in prostitution, or in the intermediation or solicitation of a prostitute for other Yes No ■

    persons, or in the provision of a place for prostitution, or any other activity directly
    connected to prostitution?
    ● committed trafficking in persons or incited or aided another to commit such an offence? Yes No ■

    ** Please tick “Yes” if you have received any sentence, even if the sentence was suspended.
    If you answered “Yes” to any of the above questions, please provide relevant details.

    “I hereby declare that the statement given above is true and correct. I understand that immigration status and period of stay to be
    granted are decided by the Japanese immigration authorities upon my arrival. I understand that possession of a visa does not entitle
    the bearer to enter Japan upon arrival at port of entry if he or she is found inadmissible.”
    “I hereby consent to the provision of my personal information (by an accredited travel agent, within its capacity of representing my visa
    application) to the Japanese embassy/consulate-general and (entrust the agent with) the payment of my visa fee to the Japanese
    embassy/consulate-general, when such payment is necessary.”

    Date of submission 20/10/2015 Signature of applicant


    (Day)/(Month)/(Year)
    * It is not mandatory to complete these items.
    Any personal information gathered in this application as well as additional information submitted
    If application is for aforminor,
    the visa application
    parents or a legal
    (hereinafter referred to as "Retained Personal Information”) will be handled appropriately in accordance with the Act on the
    representative can sign here. Please indicate
    Protection of Personal Information Held by Administrative Organs (Act No. 58 of 2003, hereinafter, “the Act”). Retained Personal
    the relationship
    Information will only be used for the purpose of processing the visa application (e.g.
    and to the extent signed
    necessary forby
    the mother).
    purposes
    stated in Article 8 of the Act.

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