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Malaysia Visa Form

This document is a visa application form from the Malaysian Immigration Department. It requests information such as the applicant's name, gender, date of birth, nationality, occupation, passport details, purpose of visit, and contact information of the sponsor in Malaysia. The applicant needs to specify the type of application as being within Malaysia or overseas, sign and date the form, and provide a 3.5cm x 5cm photograph. The form should be typed and relevant boxes should be marked with an X.

Uploaded by

Sushil Meshram
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173 views2 pages

Malaysia Visa Form

This document is a visa application form from the Malaysian Immigration Department. It requests information such as the applicant's name, gender, date of birth, nationality, occupation, passport details, purpose of visit, and contact information of the sponsor in Malaysia. The applicant needs to specify the type of application as being within Malaysia or overseas, sign and date the form, and provide a 3.5cm x 5cm photograph. The form should be typed and relevant boxes should be marked with an X.

Uploaded by

Sushil Meshram
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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JABATAN IMIGRESENMALAYSIA

BORANG PERMOHONANVISA
VISA APPLICATION FORM

*Jenis Permohonan
Type of Application

A.

Dalam Malaysia
In Malaysia

1M.47- Pin. 1/97

Seberang Laut
Oversea

Gambar
Pemohon
PhotographOf
Applicant
(3.5 em x 5.0
em)

MAKLUMAT PEMOHON
PARTTCTTTARS OF APPUCANT

1.

Nama Penuh(Huruf Besar)


Full Name (CapitalLetter)
I

2.

*Jantina
Gender

3. TempaUNegaraLahir
Place/Country of Birth

4. **Tarikh Lahir
Date of Birth

Lelaki
Male

Perempuan
Female

D
]

[
[

5. Warganegara
Nationality

hari
day

bulan
tahun
month year

6. Pekerjaan
Occupation

7. Alamat
Address

8. Taraf Perkahwinan
Marital Status

Belum Berkahwin
Single

.
D

Berkahwin
Married

B. MAKLUMAT PASPORT PERJALANAN J DOKUMENPERJALANAN


PARTTt?llTARS OF PASSPORT / TRA VRT.J)Ot?llMF.NT

10. Nombor
Number

9. Jenis Dok.umen Perjalanan


Type Of Travel Document

11. Tempatl Negara DiKeluarkan


Place/ Country Of Issue

12. **Sah
ValidSehingga
Until

[
hari
day

Borang ini hendaklah ditaip. Tandakan (x) dalam petak yimg berkenaan.
This form should be typed. Mark (x) in the appropriate box.

..

bulan tahun
month year

Format T arikh 99/99/9999

Date Format DD/MM/YYYY

c.

BUTIR-BUTIR PENGANJUR DI MALAYSIA


PARTlClTTARS OP SPONSOR IN MAlA Y.~lA

13. Nama Penuh ( Huruf Besar)


Ful Name(Capital Letter)

[
15. No Telefon
Telephone No.

14. NO.KadPengenalan
NRIC

16. Alamat
Address

Negeri
State
D. BUTIR~BUTIR PERMOHONAN
UP-TATT.OF APPUCATTnN

17. Tempoh Tinggal Yang Dicadangkan


Duration Of Proposed Stay

18. *Tujuan Perjalanan


Purposed Of Journey

Bercuti
Holiday

Transit
Transit

Urusan PerniagaaR
Business

Urusan

Rasmi

Official

Trip

Melawat Saudara Mara I Kawan


VisitingFriends / Relatives

Persidangan
Conference

Bekerja
Employment

Lain-lain (Nyatakan)
Other Specify

Belajar
Study

Tarikh
Date

Bulan
Month

Tandatangan Pemohon I Penganjur


Signature of Applicant / Sponsor

Borang ini hendaklah ditaip. Tandakan (x) dalam petak yang berkenaan.
This form should be typed. Mark (x) in the appropriate box.

..

Format Tarikh 99/99/9999


Date Format DD/MMIYYYY

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