Directorate of Immigration and National Registration

DIRECTORATE OF IMMIGRATION AND NATIONAL REGISTRATION

IMMIGRATION DEPARTMENT

APPLICATION FOR ENTRY TOURIST VISA

( To be handed over to the immigration officer at the port )

1. Name in full ( in Block letters) ____TARO AOYAMA 姓名______

2. Father's Name in full ______JIRO AOYAMA 父親の名前

3. Nationality __JAPANESE 国籍 ___ 4. Sex ______MALE 性別______

5. Date of birth __31.7.1980 生年月日 _ 6. Place of Birth ____Aich , Japan 出生地______

7. Occupation _____Office worker of ABC Co Ltd 職業、勤務先も記入 ______

8. Personal description

(a) Colour of hair ____Black 髪の色 ___ (b) Height ______170 ㎝身長 ____

9. Passport

(a) Number _JA1234567 パスポート番号___ (b) Date of Issue ______12. 3. 1998 発給日 ___

(e) Date of expiry ____12. 3.2008 有効期限_

10. Present address in Japan 1-2-3 Motoyama, Chikusa-ku,Nagoya-city, Aich ,Japan 現住所 __

11. Contact Phone Numbers __052-123-4567 電話番号__e-mail address 123＠4567.ne.jp 電子メール Address in Myanmar ____○○○○Hotel ミャンマーでの滞在地（ホテル名１つでよい）

12. Purpose of entry into Myanmar ______Ｓｉｇｈｔｓｅｅｉｎｇ入国目的 ______

13. Attention for Tourists

(a) Applicant shall abide by the Laws of the Union of Myanmar and shall not interfere in the internal affairs of the Union of Myanmar.

(b) Legal action will be taken against those who violate or contravene any provision of the existing laws, rules and regulations 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.

青山太郎

パスポートと同じ手書きサイン

Date ____記入しない______Signature of applicant

( FOR OFFICE USE ONLY )

Visa No. ______記入しない______Date______記入しない______

Date __記入しない______Signature of officer in-charge

Embassy of the Union of Myanmar

Tokyo

"Myanmar Travel Info On Line" http://www.myanmarplg.com/

Tokyo Tel:+81-3-3959-9143 Fax: +81-3-3959-9140 Yangon Tel:+95-1-250 956 Fax:01-251 475