UBALOZI WA JAMHURI YA MUUNGANO WA TANZANIA, RIYADH

APPLICATION FOR AN ENTRY VISA

EMBASSY OF THE UNITED REPUBLIC OF TANZANIA

P.O.Box 94320 Riyadh 11693, Saudi Arabia

WELCOME TO TANZANIA THE LAND OF KILIMANJARO AND ZANZIBAR

(Please use CAPITAL LETTERS)

1. Surnames or Family Name: ……………………………………………………………………………………...................................................................

2. First Names: …………………………………………………………………………………..........................................................................................

3. Present Nationality: …………………………......................…………......... Nationality at Birth: .......……………...............….....…………….............

4. Date of Birth: ……….............……………Place of Birth: …….............………………...........Country: ........................……....……....Sex: ................

5. Passport No.: ……..............…………….....Place Issue: ……….............…..…… ...Date of Issue: ……….......……….....Valid Until….........................

6. Profession: …………………..................... Place of Residence: ………........….............………….. Employer: ……….....…..........……….......……......

7. Full Address: P.O. Box: ……….................................……....….....… Code: …………....…....……… City: ………..............……......………………..

8. Telephone (work): …......………...….................. Residence: ….....………..............……......………….Mobile: …………………….....................……..

9. Marital Status {Single, Married, Divorce, Widowed} …………............................................................……………………………......…………………

10. Purpose of Journey: ……………….....……………...............………..........……... Proposed Date of Entry: …...............….......………….....................

11. Means of Transport {Air, Ship, Car}: ………….......….............…….........……... Duration of Proposed Stay: ……...................................................

12. Point of Entry into Tanzania: …………...............................................……….. Point of Departure into Tanzania: …........…………………….............

13. Full Address while in Tanzania: ………………..............................................................………………………………….....……………………………

Addresses of References/ Sponsors in Tanzania:

( I ) Name: ………......………………………..……...................…….…….. Address P.O. Box: ………..........................…......………….....……………..

City: ……………………………….....................................………...Tel.: ..…….............………………….Mobile: ……..............................................

(II ) Name: ……………………………………….............……… Address P.O. Box: …………………………………........................................................

City: ………………...………...………………..............................…… Tel.: ….......…...........….…………….. Mobile: ………………….....………........

Means of Subsistence During your stay in Tanzania: ……………..........................................................................…………………………………...........

Date: ……………………........................................……....... Signature of Applicant: ………...............................…………………………………….......

(1. Please Attach your Passport and letter from your Sponsor 2. Items No. 12 & 13 must not be left blank)

WARNING !!! GIVING FALSE INFORMATION CAN LEAD TO REFUSAL OF ENTRY INTO TANZANIA

FOR OFFICIAL USE ONLY VISA ISSUED: SERIAL No. ....................................................................

COMPUTER NO……………………….....…..……….……...VISA VALID FOR: ………….....................................................………WEEKS/MONTHS

VISA PAID CASH /CHEQUE NO.: …………...……...............................…......………… AMOUNT……..........................……………………………....

ERV NO.: ………………………………………………………………..............................……… DATE: ………..........……...................…………….......

UHAMIAJI REF NO.: ……………………………………………….......................................... DATE: …………………..................................…………

SIGNATURE OF ISSUING OFFICER: …………………….............................…………..…….. DATE: ………………...…....................………..............