Application For A Short-Stay Visa - Republic Of Cote D'Ivoire (Page 2 of 2) in pdf

Application For A Short-Stay Visa - Republic Of Cote D'Ivoire Page 2

26. Date of arrival

27. Date of departure

FOR EMBASSY/

CONSULATE USE ONLY

28. Border of first entry or transit route

29. Means of transport

30. Name of host or company in Cote d'Ivoire and contact person in host company. If not applicable, give

name of hotel or temporary address in the Cote d'Ivoire

Name

Telephone and telefax

Full address

e.mail address

31. Who is paying for your cost of travelling and for your costs of living during your stay?

Myself

Host person/s

Host compagny (State who and how and present corresponding documentation

32. Spouse's name

33. Spouse's date and place of birth

34. Children (Applications must be submitted separately for each passport)

Name

First name

Date of birth

35. clause

I hearby pledge to accept no paid or any employment during my stay in Côte d’Ivoire, to make no attempt to

remain in the country indefinitely and leave Ivorian territory upon expiry of the visa which may be granted to me.

My signature commits my responsibility and, in case of misrepresentation, makes me liable to prosecution as

provided by law as well as to refusal of visa in future.

36. Applicant's home address

37. Telephone number

38. Place and date

39. Signature (for minors, signature of custodian/

guardian)

Application For A Short-Stay Visa - Republic Of Cote D'Ivoire Page 2