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VISA APPLICATION FORM

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
Email
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 | maximun file 1 MB
Upload Foto | File allows jpg, png
Passport | File allows jpg, png, pdf
Bahrain Residence Permit | File allows jpg, png, pdf
Sponsorship Letter Bahrain | File allows jpg, png, pdf
Invitation letter/Guarantee letter | File allows jpg, png, pdf
Travel itinerary | File allows jpg, png, pdf
Hotel Reservation | File allows jpg, png, pdf
Bank Statement | File allows jpg, png, pdf
CPR | File allows jpg, png, pdf
Insurance | File allows jpg, png, pdf
Vaccination | File allows jpg, png, pdf
Marriage Certificate | File allows jpg, png, pdf
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 Immigration Authorities in Indonesia.

Note : Fees for Visa application is non-refundable.