Mail documents to: Tel: VisaHQ.com Inc. 501 Fifth Avenue Suite 1111 New York, NY 10017 (800)345-6541 Myanmar Tourist visa Application Please enter your contact information Name: Email: Tel: Mobile: The latest date you need your passport returned in time for your travel: Myanmar tourist visa checklist Filled out and signed Myanmar tourist visa application form. The form is enclosed. Original passport. Passport must have at least 6 months remaining validity and have at least 1 visa page. 3 Photographs. Standard passport photographs 2x2 inches on a white background. Payment. Credit Card Authorization form, Certified Check, or Money Order payable to VisaHQ.com. Return mailer. Prepaid self-addressed return label or payment for FedEx. If you wish to prepay return shipping, please add the shipping fee to the total and provide return address: FedEx 2nd day delivery - add $15 Name: FedEx Standard Overnight - add $20 Company: FedEx Priority Overnight - add $25 Address: FedEx Saturday delivery - add $45 FedEx First Overnight - add $65 Prepaid self addressed mailer - $0 Local pick up in New York - $0 City: State: Zip: Itinerary. Copy of round trip tickets or itinerary. Hotel Reservations. Copy of confirmed hotel reservations. VisaHQ.com Inc., 501 Fifth Avenue Suite 1111, New York, NY 10017 T: (212)697-2860 E: info@visahq.com Mail documents to: VisaHQ.com Inc. 501 Fifth Avenue Suite 1111 New York, NY 10017 Tel: (800)345-6541 Myanmar tourist visa fees for citizens of United States Type of visa Max. validity Embassy fee Our fee Processing time Total Single entry up to 90 days $20.00 $89.00 7 business days $109.00 This order is subject to Terms of Service, posted on VisaHQ website. All fees and requirements may change without notice. VisaHQ.com Inc., 501 Fifth Avenue Suite 1111, New York, NY 10017 T: (212)697-2860 E: info@visahq.com Mail documents to: VisaHQ.com Inc. 501 Fifth Avenue Suite 1111 New York, NY 10017 Tel: (800)345-6541 Credit Card Authorization Form By signing this form i accept VisaHQ.com Terms of Service and authorize to charge my credit card for the amount of $ Name on the Credit Card: Credit Card number: - Exp. date: / - - Credit Card Billing Address: Signature: Comments: Thank you! We accept all major credit cards. VisaHQ.com Inc., 501 Fifth Avenue Suite 1111, New York, NY 10017 T: (212)697-2860 E: info@visahq.com 1. CONSULATE GENERAL OF THE REPUBLIC OF THE UNION OF MYANMAR, NEW YORK APPLICATION FOR TOURIST ENTRY VISA Name in Full (Fill in Blocks) / / (First Name) (Middle Name) / (Last Name) 2. Father’s Name 3. 5. 7. 8. Date of Birth (dd/mm/yy) / / 4. Place of Birth Nationality 6. Sex (F) / (M) Occupation Personal Description (a) Color of Hair (b) Height (c) Color of Eyes (d) Complexion Passport (a) Number (b) Date of Issue (dd/mm/yy) / / (c) Place of Issue (d) Issuing Authority (e) Date of Expiry (dd/mm/yy) / / Permanent Address Contact Phone Number (Res.) (Work) (e-mail) Address in Myanmar Have you ever been to Myanmar? : Yes No (If Yes) Date of Last Visit : (dd/mm/yy) / / Purpose of entry into Myanmar Expected Date of Arrival : / / Flight No. Departure : / / Flight No. Attention for Tourists: (First Name) 9. 10. 11. 12. 13. 14. 15. 16. / PHOTO 2x2 (Middle Name) (Last Name) (a) Apart from the professions mentioned in this visa application form, applicants are not to engage in any sort of work with or without changes. (b) Applicants shall abide by the Law of the Republic of the Union of Myanmar and shall not interfere in the Internal Affairs of the Republic of the Union of Myanmar. (c) Legal action will be taken against those who violate or contravene any provision of the existing laws, rules and regulations of the Republic of the Union of Myanmar. I hereby declare that I fully understand the above mentioned conditions, that the particulars given above are true and correct and that I will not engage in any activities irrelevant to the purpose of entry stated herein. Signature of Applicant Date : ------------------------------------------------------------------ (For Official Use Only) -------------------------------------------------------------------Visa No. Date Visa Authority Contact : Signature of Office-in-Charge Consulate General of the Republic of the Union of Myanmar, New York. Tel. (212) 744 1271 / 1275 Fax. (212) 744 1290 e-mail : myanmarconsulateny@verizon.net CONSULATE GENERAL OF THE REPUBLIC OF THE UNION OF MYANMAR, NEW YORK. Work History for Visa Applicant 1. Name in Full (Fill in Blocks) / (First Name) PHOTO 2x2 / (Middle Name) (Last Name) 2. 3. 4. Date of Birth (dd/mm/yy) / / Place of Birth Permanent Home Address : (Include Apartment Number, Street, City, State or Province & Postal Zone) 5. Telephone Number Home : Work Description – Current : (a) Job Title : (b) Office/Section/Division (c) Describe your Duties : 6. 7. 8. Work Description – Previous : (a) Job Title : (b) Office/Section/Division (c) Describe your Duties : Work Description – Previous : (a) Job Title : (b) Office/Section/Division (c) Describe your Duties : Work : From-To (mm/yy) From-To (mm/yy) From-To (mm/yy) I hereby declare that the particulars given above are true and correct and that I will not engage in any activities irrelevant to the purpose of my entry. Signature of Applicant Date : THE REPUBLIC OF THE UNION OF MYANMAR Immigration Department REPORT OF ARRIVAL Name is directed to deliver this report to the immigration Authorities on arrival in Myanmar. Passport No. Place and Date of Issue Visa No. and Date Authority, if any Full address in Myanmar Name and Address of Reference Or Guarantor in Myanmar PHOTO ----------------------------------Signature of Passport Holder Visa Issuing Officer Date of Issue--------------------- Date of Departure from USA Date of Arrival in Myanmar Date of Expiry of Stay in Myanmar