ulaire de demande de visa rempli en anglais au stylo bille noir • Réservation Billet d'avion A/R
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REPUBLIC OF SOl1'Oi AFRICA
APPLICATION FOR A VISA
IHSl'RUCTlOHS AND INFORIlATlON
(PIlIaII rud C8NfUIIy)IMPORTANT
A visa only enables the holder to proceed to a port of entry where helshe must comply with the Iaw 8I1d regula
tions govemlng the admission of persons to the Republic of South Africa. The hokler will be requir9d to setlafy
the immigration offIcer that good for s .ulliciont pariod to cover his/her intended stay and contaln a valld visa, where required, for entry, and8$ far as certain criminal offonON are çonoemed. hae
sufficient funds to support hlm·lhers&lf in the RSA and is in possession of a retumlonward tIekêt. The Immi
gration officer may require the lemporary visitar to make a cash deposlt if he/she cannat comply with Any of the foregoing requirements. be produced ta the immigration officer at the port of arrivai ln the RepubUc as tac..slmlles/photocopies are not acceptable. AIr1ine officiais are obJlged 10 lnsist on passengers produdng the
requlred visas before boarding.HOW TO APPLY
te complete th8 visa application faon fully and ln detall may result in the i&$lJ$ of the visa beinS dalayed or refu..d.{cl Passports must accompany the applications. However Iwo passport-type photographs as weil as certified
copies of the relevant pages of the passport must acx:ompany the application if the passpof1ls not included
and the application is Iodged from a country where the RSA Is not represented. The reverse side of the
photographs musl bear the applicant's signature. full namas and date of birth.WHERE TO APPLY
HomeAffairs. Private Bag X114, Pretoria, 0001 through their hosts in the RSA. Applications may al50 he transmit·
lad through the airline, shipping company or travel agency arrang!ng the appllcant's vlsit to the Republic. At
least 14 days must be allowed for the processing of visas. Holders of official or diplomatie passports or lais
HZ passer resident in oounlries where the ASA ls not represented must forward thelr appUcations to the
Direetor-General: Foreign Affairs, Private Bag
Xt52, Pretoria, 0001 (Protocot directorate).
be attached te your application.BI-84E
FEESNationals of certain oountr1es are 9Ubject to visa tees. PJease enquire with YOUT nearest South Afr1canIHome
Affairs representative. Fees are levied per application and not per visa.PASSPORTS
Please note
that sorne travel documents are not acceptable for fravel ta South Afrfca. Ali documents other thannational passports must be specified at question 10 (d) and oer1ified copies of the relevant pages attached ta
yeur application.HEALTlt REQUIREMENTS
Yel\oW Fever. Immunlsa1lon Is a requirement if the joumey starts or entais passlng through the yellow fever bell
of Africa or South America. Yellow fever certificates are vaUd for 8 pertod Dt 10 years beglnnlng tO days alter
the date of immunisation or, in the case of re-immunisation wlthln 8Uth period of 10 years, from date of that
munisation.PERSONS IN
TRANSIT
Persons applying for transit visas must 9ubmit proof that they will be admltted to thelr destinations and they must
be in possession of onwardlretum tickets.EUPLOYMENT OR STUDY
If employment or study is contemplated, a worit or study pennit must be obtained before entry Into South Afrlca.
Special conditions must
be met before permits are îssued.BUSINESS
A foreign visttor requlres special pennission from the Director-General: Horne Affairs if he/sOO intends to estab
lieh or condud a business in South Africa.SOJOURN IN SOUTH AFRICA
This lB net govemed by the visa but by the temporaJ'y residence permit which is issued on .anival at the South
Afl1c8n
port of entry. If an extension of stay is reQuired beyond the expiry date of the pennit, application must be
made at the nearesl offlce of the Department of Home Affairs.NEIGHBOURING STATES
VlSitors
to South Africa travelling ta neighbouring states such as Botswana, Lesotho, Swaziland or Zimbabwe must ensurathal they are in possession of visas valid for those countries. if requlred. If they intend retuming 10
South Africa visas for the ASA vaUd for more than one entry is required. (ThIs page must be dfltBched and rstained by the appticant)B1-84E
Home Malta Rererenoe No.
REPUBUC OF 90UTH AFRICA
VISA APPLICATION
FaUu,. tG complebl thl, QDIlcetton form kt full mIIY .-ult ln the vIA belng "'iIYtJCI or relueed.·Pt.... UN block""" and bIMk lM. on.,.
PERSONAL PARTlCULARS
1.Sumame
1111111111111111111111111111111111
MakI",namo 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
YYYYMMDD
4.6. Country of b1rth "' ..
7,",1_ D 1Fom""'D
N8tiorwJity 9. If acqulmd by natundislltion ataI8 original naüonaIlty and whefe and when pr988nt nalion&lity wu oblained .10. D8IaII. DI' pusport Nuntler... lssulng authority
(d) Type of document14. Country 01 permanent res!dance 15. Period resident in that country
16. OOCupelionlProfeasion
and addnôsa of employer. university. organisation elc.lo wtOOtl VOu are atlached, attend or which you reprvunt
18. state name and nature 01 business:
to pobNcallons, radio. televlslon or films, gNe detalls; l""""'mo""'" D 1Mo"''' D 1W_,O< D 1-·..•D 1.-.... D21 r:::...":"" 1
".Maklennomeofwlfe 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 IJYYYYMMDD
=dlIte of spouB 24. HIllIher natlonallty .. NB.-&EPARATE FORMS MUST BE COMPLETED IN RESPECT OF PERSONS OVER THE AGE Of 18 AND CHILDREN UNDERTHE AGE
OF 18 TRAVELLING ON THEIR OWN PASSPORTS.
25. PattIcuIars of chiIdren acoompanyng yeu and endoraed on yeu.-pasaport
SUmame First Mmes Date ofbifth PlBceof ....
(1) (4)Vl8IT 10 8OUT'H APIlICA
2$, dais tA antval " ' 27. Port of arrtv8l ..
26. Purpoee tlf VIaft .' , , ' _ .
tmonths. weeks or daya)30. State thearnooot of futlds avallable for viait 10 RSA , ,
31. Proposed rMIdentiaI addresa (no PO Box numbel) ln RSA, /nC:Ildng the fuN MJII88 of your ho8t or hoteI
32. Nam8t of orgaRsatlon&lpel1lOns yeu will be \Xlfl1ading &.Iring your stay in the ASA
vIsIt to the RSA 34. Reference number on prevlDLJS vIilla315. VIsa obt.ained al
lndtcaIe by of an X wtllche\w' Iti appIlcete101,1 l' 1ll1)' lime appIIed for 8 permit ta setlllI permanently !Il South AfJ1ca7
37. Have you ..-er been restrlcted or tefusud entrY ln\!) Souttl Atrica7
Have you ,vetr been depOlIed from or ordered ta \elMl South Afrioe? you sulll!lrin9 ftoot tuben:::ulOeia or etYi otner in!eCtKxJa or oontaQlou& d:seues or any mental or ....."'" doftcIency? particurars If reply to one or l'l'IOIe of questtons 36 10 41 " in fle affirmatIVe43, oertIficate cordlrmlng the necessIIy for tnlatmerlt ln the ASA, the nature Of alimenta and the d8t_ of appointmf1nt9 with a
South African doetor muai be submiltfld
lb)'Who Îs for 1he mediclll expenaes and hoepilallees? Submil proo' if paid by 'fOlJrsetI'yoIIr medIcaI sc:hemefernpfoy TOSECOMPL&Tl.DOHLl'DVPUSENGI!RSlMTRANSIT10A FOREIGNCOUNTRY 45.47.