EMBASSY OF NEPAL,BRASILIA(BRAZIL)

SHIS QI-11,CONJUNTO-3,CASA 20,LAGO SUL

BRASILIA DF
Phone:0055 61 3541 1232/1843
Email: embaixadanepal@gmail.com

VISA APPLICATION FORM, NEPAL

(For Tourist, Official and Diplomatic Visa)

All Visas can be obtained either from the entry point or the Nepalese Embassy
abroad.
No fee is charged for Official and Diplomatic visa.
Tourist Visa Fee Effective from 18 September 2015 (note: Visa Fee in US Dollar
remains the same. Only the Visa Fee in Brazilian Real has been re-adjusted)
Multiple Entry (15 days) = US$ 25 or 75 Reais
Multiple Entry (30 days) = US$ 40 or 120 Reais
Multiple Entry (90 days) = US$ 100 or 300 Reais

Affix your
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H. E. Ambassador/Consul General/Consul,
I wish to travel to Nepal and therefore, request for Diplomatic /Official /Tourist Visa.
1. First name:

2. Middle name:

3. Last name:

4. Date of birth:

5. Place of birth:

6. Occupation:

7. Permanent address:
8. Phone no.:

9. Email:

10. Passport no.:

11. Place of issue:

12. Date of issue:

13. Date of expiry:

14. Temporary address in Nepal:

15. Purpose of visit:
16. Expected date of arrival in Nepal:
18. Number of previous visits:

17. Duration of stay:

19. Year, month and duration of last visit:

20. Requested visa:

21. Fee enclosed (cash/money order):

22. Date of application:

23. Signature of the applicant:

FOR OFFICIAL USE ONLY

1. Type of visa:

2. Fees/reason for waiver, if gratis:

3. Visa entry number:

4. Date of issue:

5. Date of expiry

6. Visa Sticker no.:

......................
Issuing Officer