ISSUED FREE

FORM A/ IM 35 (Regulations 6)

Department of Immigration & Emigration

APPLICATION FOR THE ISSUE/ EXTENSION OF A RESIDENCE VISA FOR SRI LANKA
To be completed in Block Letters For office use only Application No Visa Number
Day Month Year
BOI SL Parents CIT (5/2) Clergy DPL Dual Other : Ex-SL NGO Official Private.Sec Reg IND Int: Gov Relig.Work RGS Spouse State.Sec Student SSRV

Affix a photograph

Date of Arrival/Expiry Period granted 1. Details of Passport i) Number

Day Month Year

Years

Months

Date of Issue :

ii) Place of Issue

Day Month Year

iii) Date of Issue 2. Details of previous Passport held, if any i) Number

Day Month Year

iv) Date of Expiry

ii) Place of Issue

Day Month Year

iii) Date of Issue 3. Name in Full as shown in Passport:

iv) Date of Expiry

4. Nationality: 5. If naturalized, i) Date iii) Former Nationality 6. Gender * 7. Date of Birth 8 Country & Place of birth 9. Civil Status * 10. If Married i. Single i) Full name of Spouse: i. Place ii. Married ii. Country iii. Widowed iv. Divorced i) Male
Day Month Year Day Month Year

ii) Place of naturalization

ii) Female

ii)Nationality: iii) Passport No

iv) Postal Address:

Day

Month

Year

iv) Date of expiry 11. Applicants Height in centimetres 12. Any identification Marks of Peculiarities:

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13. Address: i) In the country of domicile

ii) During staying in Sri Lanka:

14. Occupation/ Profession which Residence Visa is Appling for 15. Contact Numbers Tel Fax 16 Category of applying for Residence Visa* (a). i) Board of Investment (BOI) iv) Student vii) Religious x) Non Government Organization (NGO) xii) Other, (b). i) Investor* SLRs / US$ Specify ii) Expatriate iii) Dependant ii) Public Sector v) Ex- Sri lankan viii) Registered Indian iii) Private Sector vi) Spouse ix) Diplomatic Missions xi) Inter-Governmental organizations Mobile E-Mail

17 Salary/ income per mensem

18 If an employee, name and address of employer i) Name

ii) Address

iii)Contact Numbers

i) Telephone iii) Fax No

ii) Mobile No iv) E-mail

19 If in business and/ or owning landed property in Sri Lanka full particulars of same Name and address of business/ Land, property Shares owned Business registration No./ Dead No/ date

20 Reasons for applying for a Residence Visa

21 Residence visa applying for* i) First Issuance

Day Month Year

ii) Extension

22 Date of arrival for Residence Visa 23 Particulars of the prior approval Have you obtained prior approval* If Yes, i) Date of Entry visa issued ii) Place of issuance of Entry Visa
Day Month Year

Yes
Day Month Year

No

iii) date of landing endorsement granted

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24 Period for which a Residence visa is required 25 Was a Residence visa issued previously, If so, state i) Visa Number
Day Month Year

Months/Years

ii) Date of issue iii) Purpose of which it was issued iv) Period for which it was issued Years Months
Day Month Year

v) Particulars of the Passport on which the permit was issued i) Passport No

Day Month Year

ii) Date of issue iv Place of issue

iii) Date of expiry 26 i) Number of present residence Visa of spouse or parent, if any
Day Month Year

ii) Date of issue visa 27 Particulars of applicant's own children (only for whom application is also made Children under 16 should be included) Name Date of Birth Gender Place of Birth

28 (Particulars of responsible persons, relations or friends in Sri Lanka to whom reference can be made regarding applicant or who are likely to undertake responsibility, if required, for applicant's maintenance and repatriation from Sri Lanka Full Name Nationality Address Contact No. Relationship

29 Any other reason to urge in support of application

30 Finger mark of the applicant

I solemnly declare that the information furnished by me in this application is true and that I have not wilfully suppressed any information that is required, that in the event of issue of visa I shall comply with the terms and conditions subject to which the visa is granted, and that I shal not engage myself in any employment, paid or unpaid, or in any business or trade other than the purpose of visa is granted, and that I shall notify the Controller of Immigration and Emigration of any change in my addresses during my stay in Sri Lanka.

Date: .

Signature of applicant

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Instructions
1 Any person whose admission has been authorized would be prevented from landing or may be required to leave Sri Lanka if, it
is found that he has given false or misleading information or suppressed any information that he is required to give on to give on his application.

2 An application for Residence Visa should be made at least one month before (a) the date of intended travel. (b) in the case of
first issue of the date of expiry of the Residence Visa in the case of extension

3 Applicant is required to submit two copies of his photograph ( 3.5cm x 4.5cm ) for issuance of visa 4 Fee and tax for the grant or issue of a Residence Visa is Rs. 20,000.00 for each period of 12 months or part thereof reckoned

from the date of grant or issue. Holders of Diplomatic or Official passport is exempt visa requirement, if the purpose of the visit is official or Diplomatic. a. If the purpose of the visit is not official visa, fee and tax should be paid by the Applicant.

b. If an MOU has been signed with the Government of Sri Lanka to exempt visa tax, the amount of Rs.10,000.00 will not be charged. But visa fee of Rs. 10,000.00 should be paid. c. Ex-Sri Lankans and Registered Indians under the Indo-Ceylon Agreement should pay Rs.10,000.00 for visa & tax. d. Foreign spouses of Sri Lankans will be granted Residence Visa free of charge. However, an application processing fee is charged e. Applicants under 16 years of age will be given Residence visa free of charge

5 An application for a Residence Visa in respect of a child under sixteen years may be completed and must be signed by the
child's either parents or by the duly authorized guardian

6 * To be marked (x) relevant cage 7 There should be forwarded with application any documentary evidence available to prove the facts set out therein particularly
the statement in columns (14),(15), (16), (17), (18),(19) and (20)

8 Copy of data page of applicant's passport is required. 9 If married to a Sri Lankan, a copy of marriage certificate with original are necessary 10 The applicant may be required to submit further information and proof as may be deemed necessary.

Office Use Only

Special Note Finger Mark Affix an applicants photograph here

Visa Endorsement

Tax Endorsement

Received Passport Date Signature of Applicant

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