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REPUBLIC OF KENYA

IMMIGRATION DEPARTMENT
APPLICATION FOR EXTENSION OF A VISITOR'S PASS
Surname of the visitor (IN CAPITALS): CYER
Other names MAROR JUACH
Nationality SOUTH SUDANESE
Passport No 562620 Place and date of issue IMM-DEPT-RSS,JUBA 2023-11-20
Address in Kenya 00100 Nairobi 100
Date of entry to Kenya 2023-11-23 Port of entry SIRARE
I wish to stay in Kenya for a further period of 2 WEEKS Days
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Signature of Declarant
Date...........................................
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Signature of Visitor
Note.- If your stay exceeds 90 days from the date of entry please note that you are required
to register as an alien in Kenya.
FOR OFFICIAL USE ONLY
R ..........................................................
Visitor's Pass extended valid until
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Signature of Officer

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