Paying INZ Visa Fee, VAC Service Fee and Return Courier Fees ‘To pay your Visa Application Center (VAC) fee and return courier charge by credit card, you must complete and sign this form. Please fill out this form electronically and sign manually. Do not leave any blank space Please note: TTS (TT Visa Services, nc) iso commercial company in partnership with immigration New Zeolond (IN2). All fees ‘including the visa application fee, the service fee ond the courier fees are non-refundable. By signing this document, you ‘expressly agree to the Terms and Conditions listed on p.2 ofthis form ond as described on our website, including Limitations of Liability. Applicant Details Please note: Physical address for return of passports MUST have city, state, zip code and country. ‘plicant wr O Ms. or. Tile O Ms, Miss D other. ‘Applicant Surname: VEGA DUENAS ‘Applicant Given Name(s): KHALIL NASSIB Applicant Date of Birth 15/02/1988 (OD/ana/vrr?): Physical address for return of passports KHALIL NASSIB VEGA DUENAS ‘Addressee Name: and other original documents submitted with your Street: URBANIZACION LARAPA GRANDE MANZANA F-5 LOTE 15 visa application form {no P.O, box city: CUSCO state: CUSCO ‘addresses are allowed): country: PERU Zip code: 08006 Contact Telephone number | 51953753060 CELL PHONE Please include country code* | 51 84650596 LANDLINE PHONE area code + local number: Email address: | k_alil88@hotmail.com Payment Details: see int Note below (All amounts in US Dollar NZ Visa Application Visitor Visa Work Visa Category: Student Visa 0 Other T_INZ Visa fee (if you paid online. Please put PAID) PAID 1 VAC Service fee (For Paper Applications) $38 VAC Service fee (Online Applications) Application number (only A-XXXXXX format): A-1859588 2 Return =uptotwo [C1 $30 O $55 (2) passports per envelope {Continental Us) _| (Canada) B seo (Allother Locations) Maikin Courier fee[s)- (Optional) Service available in the US Only. (A labei can be provided by email for drop off at Courier) QO $30 (Continental Us) Total charges (to be charged to your credit card) _| $89 MBIE-MAKO-18597561