Downloaded from www.immigration.gov.pg PNG Immigration & Citizenship Service Authority APPLICATION FOR ENTRY PERMIT INSTRUCTION OFFICE USE ONLY
Signature (for minors, signature of parental authority/legal guardian): 28. Entry permit for the final country of destination, where applicable
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sanitary / plumbing permit date of application date issued ... grease trap bar sink ... deep well & pump set septic vault/imhoff tank street canal
DUMB WAITER PUMPS COMPRESSED AIR, VACUUM, PNEUMATIC TUBES, CONVEYORS AND/OR MONORAILS FUNICULAR Box 2 (To be accomplished by the Design Professional) (Signed and Sealed over Printed Name) Date Issued SUPERVISOR / IN-CHARGE OF MECHANICAL WORKS Validit
Form Imm 22
FEDERAL REPUBLIC OF NIGERIA
APPLICATION FORM FOR VISA/ENTRY PERMIT
This form must be completed in full. Your application may be rejected for wrong and misleading information. ( A separate form for personal History is no longer required.) 1.
Middle name b. Marital Status
c. Full name and address of spouse
4b. Previous Nationality
Date of Birth(day/month/year)
5b. Place of Birth
Telephone No. 7a.
State what branches of the Armed Forces of your country you have served in or are serving in
Colour of Hair
Colour of eyes
Visible Identification marks
Date of issue
Date of expiry
Place of issue
Purpose of journey(please give full details)
Number of entries required.
Intended duration of stay
Proposed date of travel(day/month/year)
Mode of travel to Nigeria
If on transit, what is your destination?
Have you got entry visa to your country of destination?
Indicate how much money is available for your trip
If your reason for journey to Nigeria is for employment, state:
Name of Employers
Post to be occupied
Give a full description of job
Persons joining spouses, parents or relatives, should give full particulars of the employment of parents or spouse in Nigeria including the address where they reside.
How long has/have your spouse/parents been living in Nigeria.
Your Intended address in Nigeria (NOT P.O. Box)
Have you ever applied for a Nigerian visa before? Yes
Where did you apply for the visa?
Indicate whether visa was granted or rejected
Give reason if visa was rejected
Have you ever visited Nigeria?
If yes, was it for:
State the Period of those visits and the Address at which you stayed From
i. ii. iii. 29.
How long have you lived in the country where you are applying for visa/entry permit?
Have you ever: a)
Been infected by any contagious diseased (e.g. Tuberculosis) or suffered serious mental illness?
Been arrested or convicted for any offence or crime even though subject of pardon, arrested or other such legal action?
Been involved in narcotic activities?
If so, from which country?
Sought to obtain a visa by misrepresentation or fraud?
Tested positive to HIV AIDS? If yes, please state status
Give a list of the countries you have lived in for more than a year during the last five years: Country
Which countries have you visited during the last twelve(12) months: Country
I understand that I will be required to comply with the Immigration/Alien and other laws governing entry of Immigrants into the country for which I now apply for visa/Entry Permit.