Form 1-C "Japanese Visa Application Form"

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VISA APPLICATION FORM TO ENTER JAPAN
( Photo )
approx. 45mm x 45mm
Name in full
.
2in. x 2in.
(Surname)
.
(Given and middle name)
Different name used, if any
.
Date and place of birth
:
.
(Month)
(Day)
(Year)
(City)
(Province)
(Country)
Sex
Marital status
:
married
single
.
Nationality or citizenship
.
Former nationality, if any
.
Purpose of journey to Japan
.
Length of stay in Japan intended
.
Route of present journey: Probable date of entry
.
Port of entry into Japan
Name of ship or airline
.
( Refugee or stateless should note the title of Travel Document )
Passport
.
No.
Diplomatic, Official, Ordinary Issued at
on
.
Issuing authority
Valid until
.
Criminal record, if any
.
Home address
.
Tel.
.
Profession or occupation
.
Name and address of firm or organization to which applicant belongs
.
Tel.
.
Post or rank held at present
.
Principal former positions
.
Address of hotels or names and addresses of persons with whom applicant intends to stay
.
Dates and duration of previous stays in Japan
.
Guarantor or reference in Japan : Name
.
Address
Tel.
.
Relationship to applicant
.
Persons accompanying applicant
Name
Relationship
Birthdate
and included in his passport
I hereby declare that the statement given above is true and correct. I understand that immigration status and period of stay to be granted are
decided by the Japanese immigration authorities upon my arrival. I understand that possession of a visa does not entitle the bearer to enter Japan
upon arrival at port of entry if he or she is found inadmissible.
Date of application
.
(Month)
(Day)
(Year)
Signature of applicant
.
(FORM No.1-C) NOTICE
: Please use A-4size or letter-size paper for printing
VISA APPLICATION FORM TO ENTER JAPAN
( Photo )
approx. 45mm x 45mm
Name in full
.
2in. x 2in.
(Surname)
.
(Given and middle name)
Different name used, if any
.
Date and place of birth
:
.
(Month)
(Day)
(Year)
(City)
(Province)
(Country)
Sex
Marital status
:
married
single
.
Nationality or citizenship
.
Former nationality, if any
.
Purpose of journey to Japan
.
Length of stay in Japan intended
.
Route of present journey: Probable date of entry
.
Port of entry into Japan
Name of ship or airline
.
( Refugee or stateless should note the title of Travel Document )
Passport
.
No.
Diplomatic, Official, Ordinary Issued at
on
.
Issuing authority
Valid until
.
Criminal record, if any
.
Home address
.
Tel.
.
Profession or occupation
.
Name and address of firm or organization to which applicant belongs
.
Tel.
.
Post or rank held at present
.
Principal former positions
.
Address of hotels or names and addresses of persons with whom applicant intends to stay
.
Dates and duration of previous stays in Japan
.
Guarantor or reference in Japan : Name
.
Address
Tel.
.
Relationship to applicant
.
Persons accompanying applicant
Name
Relationship
Birthdate
and included in his passport
I hereby declare that the statement given above is true and correct. I understand that immigration status and period of stay to be granted are
decided by the Japanese immigration authorities upon my arrival. I understand that possession of a visa does not entitle the bearer to enter Japan
upon arrival at port of entry if he or she is found inadmissible.
Date of application
.
(Month)
(Day)
(Year)
Signature of applicant
.
(FORM No.1-C) NOTICE
: Please use A-4size or letter-size paper for printing