1. Macao Special Administrative Region of the Peoples Republic of China Visa Application Form ; Please complete the form with block letters and put a in the appropriate box; delete where inappropriate.Application No: ________________________ 1. 1. Personal Particulars Surname Photo Given NamePlease affix a recent 1.5-inch full face white backgroundMale Female Chinese Name Sex color photo here (//) Alias or Names Used Before Date of Birth (dd/mm/yy)______/______/_______(/) Place of Birth (Country & Province/City) Type of DocumentOfficial PassportOrdinary PassportOthers________________________________________________________ Nationality_____________________________________________________ Place of Issue____________________________________________________ (//)(//) Document No.___________________________Date of Issue (dd/mm/yy)______/______/_______Date of Expiry (dd/mm/yy)______/______/______ Present Address Contact Telephone No.Occupation ()/() Email Address (if any) Name and Address of Employer/Organization (if any) ()____________________________________________________ Fax No. (if any) ____________________________________________________ / / Any valid entry visa of another country/regionNo Yes Please state the name of the country/region /() // / Any valid/permanent residence visa/permit of anotherNoYes Please state the name of the country/region country/region (including current place of domicile)

2. 2. . Information of Visit Purpose of Visit/ Leisure/Family VisitEmployment Stay as Relative of Non-resident Worker / () Investment/Business Visit Study (at higher institutes in Macao) Residence on Dependant Basis / Official Visit Religious or Academic Exchange/TrainingOthers_________________________________ /() Particulars of Relative/Contact Person in Macao (if any) Name_________________________________________________________Telephone No._________________________________________________ Nationality________________________________________________________Occupation____________________________________________________ _____________________________________ _____________________________________ / _______________ AddressMacao Residence Document HeldType _____________________________________________No. _______________________ _____________________________________________ 3 1 14 Type of Macao Visa Proposed Valid for single journey of 14 days within 3 months to Apply Proposed Date of Entry 3 2 14 Valid for double journeys within 3 months, 14 days of stay per journey 14 _________/_________/_________ Valid for multiple journeys within 6 months, 14 days of stay per journey Other Issues to Declare 3. 3. / (/) 3. Particulars of Accompanying Spouse/Children Included in Applicants Passport(Separate application form is required for any accompanying spouse/children traveling on independent passport) (//) Full NamePlace of Birth Date of Birth (dd/mm/yy)Sex MF ______/______/______ MF ______/______/______ MF ______/______/______ MF ______/______/______4. (/) 4. Previous Records (including the accompanying spouse/children included in applicants passport) 4.1 4.5 Ever been refused a visa for entry to MacaoNo Yes If any of the answers in 4.1 to 4.4 is Yes, please specify 4.2 Ever been refused entry to Macao No Yes 4.3 Ever been deported from MacaoNo Yes 4.4 Any criminal record in Macao or other places No Yes 4.5 Ever visited Macao No Yes The information given in this application is complete and correct (//) : Date (dd/mm/yy)_____________/______________/_______________Applicants Signature____________________________________________ Representative() I (name) ________________________________________________ make this application on behalf of the applicant and my personal particulars are stated in the letter of authorization. (//) Date (dd/mm/yy)_____________/______________/_______________Representative Signature__________________________________________ 4. () Necessary documents to be submitted by applicant (The original document should be presented for verification if a photocopy is submitted)(A) / Bio data page and used pages of passport/travel document(B) () Document of financial status (e.g.bank statement, deposit in savings account, tax payment receipt, employment certificate, etc.)(C) () Document of transportation to Macao and accommodation arrangement (e.g.round-trip air ticket and hotel room reservation receipts)(D) Document to prove the purpose of visit, e.g. - - Leisure visit Tour receipt, itinerary, etc. Employment Employment approval document of Macao authorities - / - Family visit - Residence document of family in MacaoResidence on dependant basis Macao ID card of family, document of kinship, etc. - - Study Admission document of a higher institute in Macao Stay as relative of Non-resident worker Approval document of Macao authorities to stayin Macao(E) () Pages carrying important information in a travel document previously used to come to Macao (if any)(F) /() Valid entry visa or residence visa/permit of other countries or regions (if any). For Official Use CommentsInstructions