VISA APPLICATION FORM TO ENTER JAPAN

(Photo)
Name in full __________________________________________________________
(Surname)

Approx. 45mm X 45
mm

___________________________________________________________________

2in X 2in

(Given and middle name)

Different name used, if any______________________________________________

Date
and
place
birth________________________________________________________________________________________
(Day)
(Month)
(Year)
(City)
(Province)
(Country)

of

Sex ________________Marital status: married __________ single__________
Nationality

or

citizenship

_____________________________________________________________________________________________________
Former

nationality,

if

any

_____________________________________________________________________________________________________
Purpose

of

journey

to

Japan

__________________________________________________________________________________________________
Length

of

stay

in

Japan

intended

______________________________________________________________________________________________
Route

of

present

journey:

Probable

date

of

entry

__________________________________________________________________________________
Port

of

entry

into

Japan

____________________________

Name

of

ship

or

airline

_____________________________________________________
Passport

(refugee

or

stateless

should

note

the

title

of

travel

document)

_______________________________________________________________
No. _____________________Diplomatic, Official, Ordinary Issued at __________________________ on
__________________________________
Issuing

authority

____________________________valid

until

_______________________________________________________________________
Criminal

record,

if

any

_______________________________________________________________________________________________________
Home

address

____________________________________________________________________________________________________________
___________________________________________________________________

tel.

__________________________________________________
Profession

or

occupation

____________________________________________________________________________________________________
Name

and

address

of

firm

or

organization

to

which

applicant

belongs

_________________________________________________________________
____________________________________________________________________

Tel.

_______________________________________________
Post

or

rank

held

at

present

__________________________________________________________________________________________________
Principal

former

____________________________________________________________________________________________________

positions

I understand that immigration status and period of stay to be granted are decided by the Japanese immigration authorities upon my arrival. if any _______________________________________________________________________________________ I hereby declare that the statement given above is true and correct. I understand that possession of a visa does not entitle the bearer to enter Japan upon arrival at port of entry if he or she is found inadmissible. Date of application _____________________________________ (Day) (Month) (Year) Signature of applicant __________________________________________________ *These items are not essential to be filled . ______________________________________________ Relationship to applicant _____________________________________________________________________________________________________ * (Remarks) Special circumstances.* Partner’s Profession/occupation (or Parents’ Profession/occupation) _________________________________________________________________ Address of hotels or names and addresses of persons with whom applicant intends to stay _______________________________________________________________________________________________________________ __________ Dates and duration of previous stays in Japan_____________________________________________________________________________________ Guarantor or reference in Japan: Name__________________________________________________________________________________________ Address ________________________________________________________________ tel.

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