Form 14a - Application For An Entry Visa
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3FORM 14A
Notes:
Affix a recent
IMMIGRATION ACT [CHAPTER 133, SECTION – 55(1)]
Passport-size
PASSPORTS ACT [No. 33 of 2007]
* Tick (√) where appropriate
photograph
here
APPLICATION FOR AN ENTRY VISA
PART I – PARTICULARS OF APPLICANT
Name:
Name as in Travel Document
Alias
Date of Birth:
Sex:*
Male
Female
D D
M M
Y
Y Y Y
Marital Status:*
Single
Married
Separated
Divorced
Widowed
Country of Birth:
State/Province of Birth:
Race: (
e.g. Malay, Indian,
Chinese, Caucasian, etc)
Nationality:
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:
Address in Country of Origin
Country of Origin:
Division/State/Province of Origin:
Prefecture of Origin
County/District of Origin
Address :
________________________________________________________________________________________________
IMM 14
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THIS FORM IS ISSUED FREE
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