Visa Application Form - Ministry Of Foreign Affairs Of The Republic Of Tajikistan
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1
2Annex 2
MINISTRY OF FOREIGN AFFAIRS OF THE REPUBLIC OF TAJIKISTAN
to the Governmental Decree of the
Republic of Tajikistan
VISA APPLICATION FORM
#122 from 27.02.2009
Fill out the application form with capital letters (marked with black type)
1. Passport number
2. Place of issue: country
City (town)
District
3. Citizenship
4. Date of issue
5. Date of Expire
Place for color photo
6. Surname (Last name)
Size 3x4 cm
7. First name
8. Middle (other) name
9. Date of Birth
10. Place of Birth: District
City (town)
Country
11.Nationality
12. Sex
13. Marital status:
Married
Single
Male
Female
Divorced
14. Permanent address (country, city (town), street, house or apartment`s number, zip code):
15. Telephone number: Office
Fax:
Mobile:
E-mail address:
16. Name and address your office, institution or type of activity: Name
Address:
17. Position (if you are a student write “student” if retired, write “retried”). Describe your work (activity):
18. Date of arrival to Tajikistan
19. Date of departure from Tajikistan.
20. Number of entries: (single, double, multiple,
(for extension of visa, indicate the duration of
exit visa)
stay)
21. PURPOSE OF VISIT (the category of visa will be identified according to the purpose of visit; therefore, indicate the exact and complete purpose of your visit).
22. Place of stay in the Republic of Tajikistan (name and full address of the hotel. If it is a diplomatic representation, private house, state agency or other place,
indicate the full address):
23. Telephone number of the
place of your stay: Office:
Fax:
Mobile:
E-mail address:
24. Who will pay for your trip (is case of need, consular officer may request prove
25. Have you visited Tajikistan previously? Date and duration of your previous
of availability of funds, necessary to stay in the Republic of Tajikistan)
stay in the Republic of Tajikistan?
26. Have you ever been issued a Tajik visa? If «YES»:
When:
Where:
What type (category):
For how long:
27. Have you ever been refused a visa? If «YES»:
When:
Where:
What was you purpose of visit:
For how long requested:
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