REPBLICA DEL ECUADOR

EMBAJADA DEL ECUADOR EN CANAD

SECCIN CONSULAR

VISA CERTIFICATE No.

DATE:
VISA SPECIFICATIONS
TYPE OF VISA:

__________________________

CATEGORY:

Non-immigrant______________

VALID UNTIL:

__________________________

PERSONAL INFORMATION
NAMES AND LAST NAME:

__________________________________________

NATIONALITY:

_________________________________________

PLACE AND DATE OF BIRTH:

_________________________________________

PASSPORT NUMBER:

_________________________________________

ISSUED BY:

_________________________________________

CURRENT ADDRESS:
(AT ORIGIN COUNTRY)

_________________________________________

ADDRESS IN ECUADOR:

_________________________________________

ACTIVITY TO DEVELOP IN ECUADOR: ________________________________________

PARTIDA ARANCELARIA:

CONSULAR FEES: US$

COMMENTS:

------------------------------------------------APPLICANT SIGNATURE

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NOTE: The aplicant must register the visa in the General Direction for Foreigners (Direccin General de Extranjera) within 30
days upon arrival in Ecuador. (Except 12 I, II, III, IV, and X)