Saudi Visa Request Form

TODAYS DATE ______________________ DATE OF TRAVEL (NEEDED) ________________

TRAVELERS NAME _______________________________ NATIONALITY __________ PHONE # _________________
DELIVERY ADDRESS___________________________________________________________________________________
TRAVELERS COMPANY NAME ___________________/ ASSISTANT____________________ PHONE#____________________

PROJECT # (Business Travelers Only) ____________COST # (Business Travelers Only) ___________

E-Mail ______________________________________________________

DISCLAIMER
Sams Passport and Visa Services will not be held liable for any events beyond our control that will delay the
issuance of the applicants visa due to a consulate delay or overnight shipping delay by a third party. Sams service
fees, nor the consular fees; will not be refunded in the event that the visa is approved, denied or delayed. Please
keep in mind, when dealing with foreign government, notification of changes and protocol may change at little or no
notice.
Please sign here if you have fully read and accepted the terms of the disclaimer and are ready to process your visa
application.
Applicants Signature

_____________________________________

VISA SERVICES - Each application total will include an additional charge of $35 for online application and electronic fund
processing through the Saudi Processing Service.
VISA TYPE REQUIRED:

EMPLOYMENT

NUMBER OF ENTRIES REQUIRED: SINGLE

DOUBLE

MULTIPLE

Processing time for Employment Visas will take and extra 5 working days due to the diploma verification process
VISA SERVICE TYPE: REGULAR

RUSH

Sams Service Fee - for Business Visas & Family Visit

$95.00 Regular Svs - 7 to 10 working days
$125.00 Rush Svs - 5 working days
$175.00 Emergency 3 working days

EMERGENCY

VISA FEES

$115.00 Resident Visa + $35.00 Online Application Fee = $150.00

Sam's Service Fee - for Resident Visas - Employment Visas - Temporary Work - Work Visit Visa
$150.00 - Regular - 7 to 10 working days
$200.00 - Rush - 5 working days
$250.00 - Emergency 3 working days

6223 Richmond Avenue Suite #100 Houston TX 77057 Tel - 713-784-5501 Fax 713-784 -5588

RETURN POSTAGE FedEx Overnight

Standard Delivery = $20.00

Priority Delivery = $25.00

First Overnight = $65.00

Saturday Delivery = $40.00

Total Payment = Sams Service Fee + Saudi Visa Fee + Return Postage

METHOD OF PAYMENT
TYPE OF CARD___________________ CARD #_________________________________________
BILLING ZIP _______________

EXP DATE_____________

CVV#________________ (The last three numbers on the back of card).

NAME ON CREDIT CARD___________________________SIGNATURE_______________________

(OF CARD HOLDER)
CHECK # ______________________________
MONEY ORDER___________________________
TO BE COMPLETED BY SAMS PASSPORT & VISA SERVICE
DATE RECEIVED _____________________ RECEIVING METHOD ___________________
DATE OF RELEASE ____________________ SHIPPING METHOD ___________________

6223 Richmond Avenue Suite #100 Houston TX 77057 Tel - 713-784-5501 Fax 713-784 -5588