Kingdom of Bahrain ‫ﻣﻤﻠﻜـــﺔ اﻟﺒﺤـــﺮﻳﻦ‬

Ministry of Interior ‫وزارة اﻟﺪاﺧﻠﻴـــــــــــــﺔ‬

Nationality, Passports & Residence A�airs ‫ﺷـﺆون اﻟﺠﻨﺴﻴـــﺔ واﻟﺠــﻮازات واﻹﻗﺎﻣــﺔ‬
Directorate of Visas & Residence ‫إدارة اﻟﺘﺄﺷﺮﻴات واﻹﻗﺎﻣﺔ‬

‫اﺳﺘﺎﻤرة ﻃﻠﺐ اﻟﺤﺼﻮل ﻋﲆ اﻟﺘﺄﺷﺮﻴات واﻹﻗﺎﻣﺔ‬

‫رﻗﻢ اﻟﻄﻠﺐ‬
Application Form For Visa & Residence Permit
‫رﻗﻢ اﳌﻠﻒ‬ Self Sponsorship ‫اﻟﻜﻔﺎﻟﺔ اﻟﺸﺨﺼﻴﺔ‬ Residence Permit ‫اﻹﻗﺎﻣﺔ‬ Visa ‫اﻟﺘﺄﺷﺮﻴة‬
New Issue ‫إﺻﺪار ﺟﺪﻳﺪ‬ Visit ‫زﻳﺎرة‬
Renewal ‫ﺗﺠﺪﻳﺪ‬ Work ‫ﻋﻤﻞ‬
Required ‫اﻟﺨﺪﻣﺔ‬ Service ‫ﻧﻮع‬
Extension ‫ﻤﺗﺪﻳﺪ‬ Family ‫إﻟﺘﺤﺎق‬
Service ‫اﳌﻄﻠﻮﺑﺔ‬ Type ‫اﻟﺨﺪﻣﺔ‬
Cancellation ‫إﻟﻐﺎء‬ Re - entry ‫ﻋﻮدة‬
Other ‫أﺧﺮى‬ Business ‫رﺟﺎل أﻋﺎﻤل‬

Applicant Details ‫ﺑﻴﺎﻧـﺎت ﺻﺎﺣﺐ اﻟﻄﻠﺐ‬

Full Name ‫اﻻﺳﻢ اﻟﻜﺎﻣﻞ‬

Sex ‫اﻟﺠﻨﺲ‬ C.P.R.Number ‫اﻟﺮﻗـﻢ اﻟﺸﺨﴢ‬

Female ‫أﻧﺜﻰ‬ Male ‫ذﻛﺮ‬
Place of Birth ‫ﻣﺤﻞ اﳌﻴﻼد‬ Date of Birth ‫ﺗﺎرﻳﺦ اﳌﻴﻼد‬

Place of Issue ‫ﻣﺤﻞ اﻹﺻﺪار‬ Passport Number ‫رﻗﻢ ﺟﻮاز اﻟﺴﻔﺮ‬

Valid Until ‫ﺻﺎﻟﺢ ﻟﻐﺎﻳﺔ‬ Date of Issue ‫ﺗﺎرﻳﺦ اﻹﺻﺪار‬

Occupation ‫اﳌﻬﻨﺔ‬ Nationality ‫اﻟﺠﻨﺴﻴﺔ‬

R.P. Expiry Date ‫ﺗﺎرﻳﺦ اﻧﺘﻬﺎء رﺧﺼﺔ اﻹﻗﺎﻣﺔ‬ Property Reg. No. ‫رﻗﻢ اﻟﻌﻘﺎر‬

Guarantor Details ‫ﺑﻴﺎﻧـﺎت اﻟﻀﺎﻣﻦ‬

C.P.R. / C.R.No. ‫ اﻟﺴﺠﻞ اﻟﺘﺠﺎري‬/ ‫اﻟﺮﻗـﻢ اﻟﺸﺨﴢ‬ Personal / Employer ‫ ﺻﺎﺣﺐ اﻟﻌﻤﻞ‬/ ‫اﻻﺳﻢ اﻟﺸﺨﴢ‬

Email ‫اﻟﱪﻳﺪ اﻹﻟﻜﱰوﻲﻧ‬ Mobile Number ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل‬

Address ‫اﻟﻌﻨــﻮان‬
House / Flat No Building No Road No Block No Area ‫اﳌﻨﻄﻘﺔ‬ ‫رﻗﻢ اﳌﺠﻤﻊ‬ ‫رﻗﻢ اﻟﻄﺮﻳﻖ‬ ‫ اﻟﺸﻘﺔ رﻗﻢ اﳌﺒﻨﻰ‬/‫رﻗﻢ اﳌﻨﺰل‬

Declaration of �e Guarantor ‫إﻗـﺮار وﺗﻌﻬﺪ اﻟﻀﺎﻣﻦ‬

I, the undersigned, have read all terms, conditions and documents stated in the application taken
from the Nationality, Passports and Residence A�airs website www.npra.gov.bh and agree to
follow them. All the above details are true and correct and I hold myself responsible for the good
conduct and behaviour of the person named herein. I undertake to repatriate him/her at any time
upon orders to do so by a competent authority .
‫أﻗﺮ أﻧﺎ اﳌﻮﻗﻊ أدﻧﺎه ﺑﺎﻻﻃﻼع ﻋﲆ ﻛﺎﻓﺔ اﻟﴩوط واﻷﺣﻜﺎم واﳌﺴﺘﻨﺪات اﻟﺨﺎﺻﺔ ﻟﻬﺬا اﻟﻄﻠﺐ ﰲ‬
‫ واﻟﺘﺰاﻣﻲ اﻟﺘﺎم‬www.npra.gov.bh ‫اﳌﻮﻗﻊ اﻹﻟﻜﱰوﻲﻧ اﻟﺨﺎص ﺑﺸﺆون اﻟﺠﻨﺴﻴﺔ واﻟﺠﻮازات واﻹﻗﺎﻣﺔ‬
‫ وأﺗﺤﻤﻞ ﻣﺴﺌﻮﻟﻴﺔ ﺣﺴﻦ ﺳﻠﻮك وﺗﴫف‬.‫ وأن ﺟﻤﻴﻊ اﻟﺒﻴﺎﻧﺎت اﳌﺬﻛﻮرة أﻋﻼه ﺻﺤﻴﺤﺔ وﺳﻠﻴﻤﺔ‬،‫ﺑﻬﺎ‬
.‫ ﻛﺎﻤ أﺗﻌﻬﺪ ﺑﱰﺣﻴﻠﻪ ﻣﺘﻰ ﻣﺎ ﻃﻠﺐ ﻣﻨﻲ ذﻟﻚ ﻣﻦ ﻗﺒﻞ اﻟﺴﻠﻄﺎت اﳌﺨﺘﺼﺔ‬،‫اﳌﺬﻛﻮر أﻋﻼه‬

Date ‫اﻟﺘﺎرﻳﺦ‬ Signature of Guarantor / ‫ﺗﻮﻗﻴﻊ اﻟﻀﺎﻣﻦ‬

Applicant Forwarder Details ‫ﺑﻴﺎﻧﺎت ﻣﻘﺪم اﻟﻄﻠﺐ‬

NPR - VRA - D01

C.P.R . ‫اﻟﺮﻗـﻢ اﻟﺸﺨﴢ‬ Personal / Employer ‫ ﺻﺎﺣﺐ اﻟﻌﻤﻞ‬/ ‫اﻻﺳﻢ اﻟﺸﺨﴢ‬

Applicant Forwarder Signature ‫ﺗﻮﻗﻴﻊ ﻣﻘﺪم اﻟﻄﻠﺐ‬ Mobile Number ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل‬

PLEASE MAKE SURE YOU HAVE RECEIVED A RECEIPT. .‫اﻟﺮﺟﺎء اﻟﺘﺄﻛﺪ ﻣﻦ اﺳﺘﻼم اﻟﺮﺻﻴﺪ اﻟﻨﻘﺪي‬
For More Information Please call 17399777 NPRA.GOV.BH 17399777 ‫ﳌﺰﻳﺪ ﻣﻦ اﻻﺳﺘﻔﺴﺎر اﻟﺮﺟﺎء اﻻﺗﺼﺎل ﻋﲆ اﻟﺮﻗﻢ‬
‫‪For o�cial use only‬‬ ‫ﻟﻼﺳﺘﻌﺎﻤل اﻟﺮﺳﻤﻲ ﻓﻘﻂ‬

‫اﺟﺮاءات اﻟﺘﺪﻗﻴﻖ‬
‫اﻟﻀﺎﻣﻦ اﻟﺴﺎﺑﻖ‬ ‫ﺗﺎرﻳﺦ اﳌﻐﺎدرة اﻟﺴﺎﺑﻖ‬ ‫ﺗﺎرﻳﺦ اﻟﺪﺧﻮل اﻟﺴﺎﺑﻖ‬ ‫ﻧﻮع اﻟﺘﺄﺷﺮﻴة اﻟﺴﺎﺑﻘﺔ‬

‫رﺟﺎل اﻷﻋﺎﻤل‬ ‫رﺟﺎل اﻷﻋﺎﻤل‬

‫زﻳﺎرة‬ ‫زﻳﺎرة‬
‫اﻟﻘﻄﺎع اﳌﴫﰲ‬ ‫ﻋﺪد اﳌﺨﺎﻟﻔﻦﻴ‬ ‫اﻟﻘﻄﺎع اﳌﴫﰲ‬ ‫ﻋﺪد اﳌﺘﻮاﺟﺪﻳﻦ‬
‫اﻟﻌﻤﻞ‬ ‫اﻟﻌﻤﻞ‬
‫إﻟﺘﺤﺎق‬ ‫إﻟﺘﺤﺎق‬
‫ﺳﻴﺎﺣﻴﺔ‬ ‫ﺳﻴﺎﺣﻴﺔ‬

‫اﻟﺮﻗﻢ اﻟﻮﻇﻴﻔﻲ‬ ‫اﺳﻢ اﳌﺪﻗﻖ‬

‫اﻟﺘﺎرﻳﺦ‬ ‫اﻟﺘﻮﻗﻴﻊ‬

‫إدارة اﻟﺒﺤﺚ واﳌﺘﺎﺑﻌﺔ‬ ‫إدارة اﻟﺘﺄﺷﺮﻴات واﻹﻗﺎﻣﺔ‬ ‫اﻻﻋﺘﺎﻤد اﻟﺮﺳﻤﻲ‬

‫اﻟﺘﺎرﻳﺦ‬ ‫اﻟﺘﺎرﻳﺦ‬ ‫اﻟﺘﺎرﻳﺦ‬