ZA BI-84 Form 11 2019-2025 free printable template

BI-84 Form 11 DEPARTMENT OF HOME AFFAIRS REPUBLIC OF SOUTH AFRICA APPLICATION FOR VISA OR TRANSIT VISA Section 7 1 g read with section 10A and 10B Regulation 8 1 Failure to complete this application form in full may result in the visa being delayed or refused. Please use block letters and black ink only. PERSONAL PARTICULARS Surname First names in full Maiden name Previous surname s Y M D Date of birth City of birth Country of birth. Gender Male Female If acquired by naturalisation...state original Nationality. Where and when was present nationality obtained. Passport/Travel Document Number. Issuing authority. Type of document Diplomatic/Official/Ordinary Passport/Travel Date of expiry. Document/other specify. Permanent residential address Period resident at this address. Telephone number. code number Country of permanent residence. Occupation or profession. Name address and telephone no. of employer university organisation etc* to which you...are attached or that you attend or which you represent If self-employed state name address telephone no. and nature of business Marital status Never married Widowed Separated Divorced First name s of spouse NB SEPARATE FORMS MUST BE COMPLETED IN RESPECT OF PERSONS OVER THE AGE OF 16 AND CHILDREN UNDER THE AGE OF 16 TRAVELLING ON THEIR OWN PASSPORTS* Particulars of children endorsed on your passport accompanying you Place of birth VISIT TO SOUTH AFRICA Expected date of arrival in the Republic Y....M. D. Place of arrival. Purpose of visit. Duration of stay months weeks or days. Number of entries required Single Multiple Two Proposed residential address physical in the Republic including the full name s of your host or hotel Names of organisations or persons you will be contacting during your stay in the Republic Name Address Relationship Identity document number or permanent residence permit number of South African host. Indicate by means of an X whichever is applicable Have you at any...time applied for a permit to settle permanently in South Africa yes no Have you ever been restricted or refused entry into South Africa Is a criminal action pending against you in any country Are you an unrehabilitated insolvent Are you suffering from tuberculosis or any other infectious or contagious disease or any mental or physical deficiency Are you a member of or adherent to an association or organisation advocating the practice of social violence or racial hatred or are you or have you...been a member of an organisation or association utilizing crime or terrorism to pursue its ends Give particulars if reply to one or more of the questions above is in the affirmative To be completed by applicants applying for visitor s permits exceeding three months In the case of a spouse or dependant minor child of the holder of a permit issued in terms of section 11 13 14 15 17 19 or 22 submission of a marriage certificate or an unabridged birth certificate. Proof of academic sabbatical if...applicable. Proof of non-remunerative voluntary or charitable activities to be undertaken if applicable.