KBRI ~ Layanan Kekonsuleran & Ketenagakerjaan

VISA APPLICATION FORM

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Select No Visa

GENERAL

Port of Entry to Indonesia
Date of Entry
Length of Stay in Indonesia	Day(s) Month(s) Year(s)
Type of Visa	Single Visit Transit Limited Stay Multiple Visit
	Multiple & Limited Visas Required Imigration's Approval/Authorization

FOR VISIT PURPOSE

Type of Visa
Country of Destination
Place of Visit
Flight/Vessel Name & No

FOR TRANSIT PURPOSE

Country of Destination
Place of Visit
Flight/Vessel Name & No

FOR LIMITED STAY PURPOSE

Purpose of Stay	Tourism Convention Family Sports
Addres in Indonesia
City
Phone Number

PERSONAL DATA

Name

Sex

Status

Place of Birth

Date of Birth

Nationality

Address in Bahrain

Area

Block

Road

Bldg

Flat

Occupation

Name of Company

Address

City

Phone Number

PASSPORT INFORMATION

Passport/Travel document
number

Place of Issue

Date of Issue

Date of Expire

Type of Passport

Family Details for Holder of Family Passport :

No	Relation	Sex	Date of Birth	Name
1
2
3

City

Phone Number

SPONSORSHIP IN INDONESIA

Type of Sponsor
Sponsors Name
Address
City
Phone Number

Required documents which should be submitted are as follows (File allows jpg, png) | maximun file 1 MB

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Passport
Bahrain Residence Permit
One coloured passport size photograph
Sponsorship Letter
Invitation letter/Guarantee letter
Travel itinerary
Hotel Reservation
Bank Statement
CPR
Asuransi
Vaksin

MISCELLANEOUS (please circle the answer)

Have you ever been to Indonesia before ?	:	Yes No
Are you in possession of other countries Travel Document ?	:	Yes No
Do you have previous visa to enter Indonesia?	:	Yes No
Have you ever been forced to leave Indonesia?	:	Yes No
Have you ever been commited a crime or any offence?	:	Yes No

Return/Through Ticket/Airlines Company
Place of Issue
Date of Issue
Date of Expire

For Afghanistan, Guinea, Israel, Liberia, Nigeria, Somalia and Cameron Nationality Should have approval from Imigration Office In Jakarta Indonesia.

I hereby declare that the statements givenabove are true and I understand that even if granted visa, admission at the airport/seaport remains the discretion of the Imiigration Authorities in Indonesia.

Note : Fees for Visa application is non-refundable.