South Africa 84 Application Visa Form – Fill Out and Use This PDF

G.P.-S. 017-0042

BI-84

REPUBLIC OF SOUTH AFRICA

DEPARTMENT OF HOME AFFAIRS

APPLICATION FOR A VISA

IMPORTANT

INSTRUCTIONS AND INFORMATION

(Please read carefully)

PURPOSE OF A VISA

A visa only enables the holder to proceed to a port of entry before or on the expiry date of the visa, where the holder must comply with the applicable law, regulations and the following entry requirements of the Republic of South Africa. No fixed travel arrangements must be made prior to the issuing of the visa and ten (10) days must be allowed for the processing thereof.

ENTRY REQUIREMENTS

❑A valid and acceptable passport / travel document good for a sufficient period to cover the intended stay.

❑A valid visa, if required.

❑Sufficient funds.

❑A return / onward ticket.

❑Yellow fever certificates are required if the journey starts or entails passing through the yellow fever belt of Africa or South America.

WHERE TO APPLY FOR A VISA

❑At the nearest South African diplomatic or consular representative.

❑Only applicants in countries where South Africa is not represented may apply to the Director-General: Home Affairs, Private Bag X114, Pretoria, 0001, through their hosts in the RSA, the airline, shipping company or travel agency arranging the applicant’s visit to the Republic.

❑Holders of official or diplomatic passports resident in countries where the RSA is not represented must forward their applications to the Director-General: Foreign Affairs, Private Bag X152, Pretoria, 0001.

❑Visas CANNOT be applied for at South African ports of entry.

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WHAT TO SUBMIT

❑Passports must accompany the applications when submitted at a South African diplomatic or consular representative.

❑If the application is lodged from a country where the RSA is not represented, copies of the relevant pages of the passport must accompany the application.

❑If a business visa is applied for, a letter of invitation from the South African company to be visited must accompany the application, as well as a letter from the company which the applicant represents.

FEES

Nationals of certain countries are subject to visa fees. Fees are levied per application and are not refundable should the application be refused.

MULTIPLE ENTRY VISAS

Visitors to South Africa travelling to neighbouring states such as Botswana, Lesotho, Swaziland or Zimbabwe must ensure that they are in possession of visas valid for those countries, if required. If they intend returning to South Africa, visas for the RSA valid for more than one entry is required for which an itinerary and a motivated request must be submitted with the application. Regular visitors to the RSA must also motivate their requests for multiple entry visas in a separate letter.

PERSONS IN TRANSIT

Persons applying for transit visas must submit proof that they will be admitted to their destinations and they must be in possession of onward / return tickets.

DURATION AND PURPOSE OF STAY

The period of residence in South Africa is not determined by the visa but by the temporary residence permit which is issued on arrival at the port of entry. Applicants must ensure that they request the full duration of their intended visit as extensions are subject to additional fees. Applicants must ensure that they apply for the correct visa / permit as the purpose of stay may not be changed once in the RSA.

(This page must be detached and retained by the applicant)

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	BI-84
REPUBLIC OF SOUTH AFRICA	Home Affairs Reference No.
DEPARTMENT OF HOME AFFAIRS	.......................................................

VISA APPLICATION

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

8.	Nationality	9. If acquired by naturalisation state original nationality
	and where and when present nationality was obtained
10.	Details of passport (a) Number	(b) Issuing authority
	(c) Date of expiry	(d) Type of document
11.	Present address
12.	Period resident at this address	13. Telephone number
14.	Country of permanent residence	15. Period resident in that country

16.Occupation/Profession ............................................................................................................................................................................

17.Name and address of employer, university, organisation etc. to which you are attached, attend or which you represent:

................................................................................................................................................................................................................

18.If self-employed, state name and nature of business:

................................................................................................................................................................................................................

20.Full names of husband/wife

(whether he/she accompanies you or not)

21.	Maiden name of wife
		Y Y Y Y M M D D
22.	Birth date of spouse																	23. His/her nationality
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.
24.	Particulars of children accompanying you and endorsed on your passport
	Surname														First names												Date of birth								Place of birth
(1)		....................................................................																								..................................								................................
(2)		....................................................................																								..................................								................................
(3)		....................................................................																								..................................								................................
(4)		....................................................................																								..................................								................................

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VISIT TO SOUTH AFRICA

25.	Expected date of arrival	............................................. 26. Port of arrival
27.	Purpose of visit
28.	Duration of stay (months, weeks or days)
29.	Proposed residential address (not P.O. Box number) in RSA, including the full names of your host or hotel:
	................................................................................................................................................................................................................
30.	Names of organisations/persons you will be contacting during your stay in the RSA:
	Name	Address	Relationship
	......................................................	....................................................................................	.....................................................
	......................................................	....................................................................................	.....................................................
	......................................................	....................................................................................	.....................................................

31.	Identity document number/immigration permit number of South African host
Indicate by means of an X whichever is applicable
32.	Have you at any time applied for a permit to settle permanently in South Africa?
		YES			NO
33.	Have you ever been restricted or refused entry into South Africa?	YES			NO
34.	Have you ever been deported from or ordered to leave South Africa?	YES			NO
35.	Have you ever been convicted of any crime in any country?
		YES			NO
36.	Is a criminal or civil enquiry pending against you or any of your dependents in any country?	YES			NO
37.	Are you suffering from tuberculosis or any other infectious or contagious diseases or any mental or	YES			NO
	physical deficiency?
38.	Give particulars if reply to one or more of questions 32 to 37 is in the affirmative

................................................................................................................................................................................................................

TO BE COMPLETED IF OBJECT OF VISIT IS MEDICAL TREATMENT

39.A doctor’s certificate confirming the necessity for treatment in the RSA, the nature of ailments and the dates of appointments with a South African doctor must be submitted.

(a)Name, address and telephone number of doctor/hospital/clinic you will visit in the RSA .............................................................

........................................................................................................................................................................................................

(b)Who is responsible for the medical expenses and hospital fees? Submit proof if paid by yourself/your medical scheme/employer

........................................................................................................................................................................................................

TO BE COMPLETED ONLY BY PASSENGERS IN TRANSIT TO A FOREIGN COUNTRY

40.Destination after leaving the RSA...........................................................................................................................................................

41.Mode of travel to destination...................................................................................................................................................................

42.Intended date and port of departure from the RSA to that destination...................................................................................................

43.Do you hold a visa/permit for temporary or permanent residence in the country of your destination? (Proof must be submitted)

................................................................................................................................................................................................................

I SOLEMNLY DECLARE THAT THE ABOVE PARTICULARS GIVEN BY ME ARE TRUE IN SUBSTANCE AND IN FACT AND THAT I FULLY UNDERSTAND THE MEANING THEREOF. I FURTHER DECLARE THAT I DO NOT CONTEMPLATE EMPLOYMENT OR STUDY OR RESIDENCE IN SOUTH AFRICA.

....................................................................	.......................................................................................
Date	Signature of applicant

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