SRI LANKA IMMIGRATION AND EMIGRATION

PHOTOGRAPH
APPLICATION FOR EXTENSION OF VISIT VISA

Application No
NE
1. Details Of Passport
i. Passport No ii. Place of issue

Day Month Year Day Month Year

iii. Date of issue iv. Date of expiry

2. Name in full as
Shown in passport

3. Nationality

4. Gender i. Male ii. Female

Day Month Year

5. Date of Birth

i. Place of Birth ii. Country

6. Occupation

7. Civil status i. Single ii. Married iii. Divorced iv. Widowed

8. If Married Sri Lankan

i. Full Name of Spouse

ii. Passport Number ii. Personal ID Number

9. Address in the
Country of Domicile

10. Address in Sri Lanka

11. Contact Details

i. Telephone Number ii. Mobile
iii. Fax

iv. E-Mail

Day Month Year

12. Date of arrival

Day Month Year

13. Date of expiry of visa /
landing Endorsement

14. Extension of visa Months

Required for
15. Exchange brought in
i. Type of currency ii. Amount

iii. Amount cashed

v. Credit card available Yes No

16. Details of previous visit to Sri Lanka within immediate six months if any,
i. Date of arrivals ii. Date of departure iii. Duration

iv. Total

17. Whether you are in possession of a return ticket Yes No

18. Reasons for extension

i. Holiday ii. Visit Relations iii. Business

iv. Other , Specify

v. Documents annexed in support to the above reason

1
2
3
4
I hereby declare that to the best of my knowledge and belief the foregoing statements are true, that I shall not engage myself in any employment
paid or unpaid , or in any business or trade on arrival or during my stay in Sri Lanka and that I shall leave Sri Lanka before the date of expiry of
the period of my authorized stay. I also undertake to notify the Controller of Immigration & Emigration, Colombo, immediately any change of
my address, while in Sri Lanka, occurs.

…………………………………………….……
Signature of applicant & Date

FOR OFFICE USE ONLY

D/A D/E Cashed RT
Remarks

Visa Fee (Rs) Tax (Rs) Penalty (Rs) Amount (Rs)

Date Processing Officer For Controller General/Controller/Deputy Controller /Assistant

Controller

NOTE,