Residence Visa/Entry Permit Cancellation Form

Date

AUS ID

Name (as per the passport)

First Name Middle Name Last Name

Personal Email Mobile Number International number

Fee for Cancelation - 150 AED

Visa Cancellation Entry Permit Cancellation

Reason for Cancellation

Leaving UAE

Date of Departure Departing Airport Airline Flight Number

Please send copy of the Exit Stamp to OIS@aus.edu after you leave the UAE.

Transferring to another Sponsor

Please send copy of Change of Visa Status once it is issued to OIS@aus.edu.

Other Reason - Please Specify:

Important Notes
• Fill out this form and pay at the Cashier’s Office, Mezzanine Floor, Main Building.
• Submit the stamped form, along with a copy of your passport and copy of your Residence
Visa/Entry Permit to the Public Relations Department, Mezzanine Floor, Main Building, Office
MM19C.
• You must pay all your pending fines/loans at the concerned UAE authorities before cancelling the
Residence Visa/Entry Permit. This includes, but is not limited to, traffic fines, municipality fees and
bank loans.
Declaration
I confirm that the information given in this form is true, complete and accurate. Failing to provide
accurate information and/or not submitting the required documents after AUS cancels the residence
visa/entry permit may lead to legal action and/or denial of issuance of a UAE visa in the future.

Student’s Signature: Cashier’s Signature:

| Residence Visa/Entry Permit Cancellation Form | Office of Public Relations | March 2019