Denpasar, March 2018

To : Embassy Of Australia
Visa Section
In – Jakarta

To Whom It May Concern

Dear Sir / Madam

With this letter I would like to inform you that I am the undersigned ,

Name : Nama suami

Occupation : Pekerjaan
KTP No :

Certify my wife

Name : Nama istri

Passport No :
Occupation : Pekerjaan istri (diisi Housewife/Ibu Rumah Tangga)

is planning to have trip to Australia on 11 – 15 May 2018 for Holiday and I have given a permission to
her.

I acknowledge and guarantee that she will not seek any employment or permanent stay in your
country and will return to Indonesia soon after her holiday trip is completed.

All kinds of expenses during the trip of above purpose are fully covered by Kasih Ibu Hospital.
Kindly grant her necessary entry visa to enter your country.

Your kind assistance will be very highly appreciated.

Best regards

Tanda tangan di atas meterai Rp. 6000

NAMA SUAMI