Bios DEPARTMENT: HOME AFFAIRS REPUBLIC OF SOUTH AFRICA = APPLICATION FOR VISA OR TRANSIT VISA [Section 7 (1) (g) read with sections 104 and 10; Regulation 8 (1)] Failure to complete this application form in full may result In the visa being delayed or refused, Please use block letters and black ink only. PERSONAL PARTICULARS Sumame | ALaanoou' First names (in fut) Arsas Jarearn Aesoita Maiden name Previous sumame(s) YTV ]¥[v[M[M oo Date of birth ity of birth...) asaain, Country of birth... ATED. SRT. CO AAROLES, ri Gender Male Female = at = | acquired by naturalisation, state original nationality Nationality. OSSTEN, ARAB. SMI RATES, Where and when was present natonaly obtained. ; os Passpor/Travel Docunent Nib | suing autonty cia sCetc Type of document: Diplomatic/Otficial/ Ordinary Passport/Travel_| Date of expiry... /didaL Jol Document/other (Specify) Permanent residential address...LULL - hone number...) (20d 4 Pero resent at this adoross...°“t. 7? ARS (number) County of permanent residence...’ AE Period resident in that country sss meni eet ARS... B Occupation or profession... WEINESS. Tame, adorees and flophone no. of employer, unvealyrgersaion, ela. which you re aliached, or that you attend or which you represent It self-employed, state name, address, telephone no. and nature of business MILLEN Una, SLATE Ress. REAL ESTATE 1 NESS Marital status | NOVO", Maried | X | Widowed Frstvancts ot rove | re AL HAT AL ZARRON| YY Y[V[M[M]o]o paseo Nationality nn WAVE one NB: SEPARATE FORMS MUST BE COMPLETED IN RESPECT OF PERSONS OVER THE AGE OF 16 AND CHILDREN UNDER THE AGE OF 16 TRAVELLING ON THEIR OWN PASSPORTS: Particulars of children endorsed on your passpon accompanying you! Sumame First name(s) Date of bith lace of birth Diss sel - x @, = = Qo iA 7 (4), _ 7 = oo VISIT To SOUTH AFRICA Expected date of arval in the RepubleY 2OUS ET. 3B Prace of arival.... JOHAN NES BURG PUpO80 of Vt nn SIME S Duration of stay (months, weeks or days)..... ONE IETS Number of entries required ge (wiProposed residential address (physical) In the Republo, including the full name(s) of your host or hotel D PRIVE 30 Sonn Names of organisations o Name Identity document number or permanent residence permit number of South African host Indicate by means of an X whichever is applicable Have you at any time applied for a permit to settle permanently in South Africa? yes| no] Have you ever been restricted or refused entry into South Africa? yes; no} Have you ever been deported from or ordered to leave South Africa? yes] [a0] Have you ever been convicted of any crime in any country? yes] [no] X | 1s @ criminal action pending against you in ery country? yes] [no] K ‘Are you an unrehabilitated insolvent? yes| [ne Ae yu sung ram bores o ary or HIBS or coMaGoUs Geese OFAN Jyeal [no | Have you ever been judicially declared incompetent?” yes| no | ‘Are you @ member of, or adherent to an associaion or organisation advocating the pr ‘of social violerice or racial hatred or are you or have you been a member of an yes, no] ‘rganisation or association utlising ere or terror to pursue is ends? Give particulars if reply to one or more of the questions above isin the affirmative: ‘To be completed by applicants applying for visitor's permits exceeding three months: Tn the case of a spouse or dependant minor child of the holder of a permit issued in terms of section 11, 13, 14, 15, 17, 19 oF 22, submission of a marriage certificate or an unabridged birth certificate. Proof of academic sabbatical, it applicable. Proof of non-remunerative voluntary or charitable activities to be undertaken, if applicable, Proof of research to be undertaken, if applicable. rool of funds available for subsistence during period of vist. ‘To be completed by applicants applying for diplomatic, official or courtesy visas: In the case of an offical visit, submission of @ note verbal. In the case of a diplomatic placing in the Republic, proof of such placing.