Form 14 - Application For A Visit Pass/visa & Visit Pass/ An Entry Visa

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FORM 14
Notes:
IMMIGRATION ACT [CHAPTER 133, SECTION – 55(1)]
* Tick (√) where appropriate
Affix a recent
** Delete where appropriate
Passport-size
photograph here
APPLICATION FOR A*
VISIT PASS
VISA & VISIT PASS
ENTRY VISA
PART I – PARTICULARS OF APPLICANT
Foreign Identification No. (FIN):
Sex:*
(leave blank if not applicable)
Male
Female
Date of Birth:
For Malaysians Only (including old or new Malaysian IC)
D D
M M
Y
Y Y Y
Identity
Card No.:
Marital Status:*
Single
Married
Separated
Divorced
Widowed
Colour:*
Red
Blue
Name:
Family Name/Surname
Given Name
Alias:
Family Name/Surname
Given Name
(leave blank if not applicable)
Name in Chinese Characters:
(If applicable)
Country of Birth:
State/Province of Birth:
Race: (
e.g. Malay, Indian,
Chinese, Caucasian, etc)
Nationality:
Religion/Denomination:
:
Type of Travel Document Held:
(e.g. Passport, Certificate of Identity,
Document of Identity, etc)
Travel Document No.:
Travel Document
Issued Date:
Expiry Date:
D D
M M
Y
Y Y
Y
D D
M M
Y
Y Y Y
Country of Issue:
Place of Issue:
Disembarkation/Embarkation form no.:
(This form is the immigration white card issued to arriving foreigners)
IMM 14
-1-

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