EMBASSY OF TURKMENISTAN – CONSULAR SECTION
2-6-14, Higashi, Shibuya-ku, Tokyo 150-0011, Japan

tel: 03-5766-1150;

e-mail: embassy1@turkmenistan.or.jp

fax: 03-5766-1151;

IMPORTANT! Implementation of the following few additional steps is essential in order to process
quickly your Application. Please read instructions carefully and make changes as necessary before
submitting to the Embassy. The information provided with the forms will be reflected in your visa and any
corrections/changes afterwards may be highly time, effort and resource consuming. It may also lead tototal decline of your Application or in certain cases to deportation upon arrival and annulment of your visa.
1 Application per Applicant! Please do not fold or otherwise deteriorate the Application Form as it
will not be admitted for processing. Form must be filled in duly, without corrections, preferably typed orprinted, all fields must be answered (enter “n/a” where applicable). Recent photo of max. 6 months old
must be glued to each Application Form. No staples!!! Fees must be of exact amount in USD,
unless waived. All dates in dd/mm/yyyy format only!

PHOTO
Please glue,
do notstaple!

Do not write or mark in this area! Resmileşdirilen wizanyň:№Senesi:Bahasy:Maximum
Size 1.5 x 2 in.

Möhleti:Esasy: №Senesi:

Visa Application Form
1Surname/Last Name:

3

Any Other Name(s) used before:(e.g. before

5

Place of Birth:

7

Citizenship at Birth:

10Type of Passport:

Name, Given Name(s):2Date of Birth: (dd-mm-yyyy)

4marriage)

Current Citizenship:

6
8 Sex:

9 Family Status:(e.g. single, married, widowed, separated, divorced)

11(e.g. diplomatic; official/service; ordinary)

Other Travel Document if none in #10 isapplicable:(in accordance with 1951 Convention)

12

Passport #:14

Issuing Authority/Agency:

15

Children/Dependents included on your passport and traveling with you:
Full Name as written in Passport
Date of Birth:
Place Birth13

Valid from:to:(dd-mm-yyyy)(dd-mm-yyyy)

1
2
3
4
5

16

Type of Visa: (check all appropriate boxes)

Group:a

Diplomaticfb

Official (service)g Tourista Singlee

Number of days

cBusinessh Medicalb DoublefNumber of monthsdPrivatei

Driverc TriplegNumber of yearseTransitjOtherd Multiple

18 Date of Entry: (dd-mm-yyyy)

StudentIndividual:

17

Number of Entries and Duration of Stay:

19

Date of Exit: ( dd-mm-yyyy )Rev. – 2009, July 05

1

Page 2Your Full Name Here:____________________________________ Rev. – 2009, July 05

20 Mean(s)/Type(s) of Transportation(e.g. airplane, car, train, ferry, combination of all or some, other)21

Number of Previous Trips toTurkmenistan:

22 a

If any, provide Date(s):Current Employment: (Job Title, Position, Profession)c

Affiliation: (complete name & postal address)

dTel., Fax, E-mail, Webpage, etc.:

23 abb Employed since: ( mm-yyyy)

Permanent Residence Address in full :Tel., Fax, E-mail, Webpage, etc.:

24 Annual income (in USD)

25

Amount & Type of Funds Available for This
Trip: (cash, travelers checks, etc.)

26 Who will pay for this trip?
27

Where will you stay in Turkmenistan? (complete postal address)
Tel.

Fax:

29 His/Her Citizenship:

28 Name(s) of Host/Sponsor/Contact:
30 Additional information, if any, related to you or your trip that you think may be useful inconsideration of your application:

31

Declaration:- I confirm that all information provided in this Application Form is correct to the best of my knowledge.
- I am aware that any false statement(s) can lead to denial to enter/deportation from Turkmenistan even
if I have valid visa.
- In case of my/accompanying me person’s denial to enter/deportation from Turkmenistan, I/we haveno claim(s) to compensation.
- I am aware that any false or incomplete statement(s) will lead to denial to obtain visa in future and may
also render me liable to prosecution under the local law.
- I do realize that myself and person(s) accompanying me are to leave Turkmenistan upon expiration ofmy/our visa.
- I have read these provisions of Turkmenistan’s Foreign Visitors Act governing the entrance, stay andleave by foreign nationals and under its penalty I undertake to follow them.

32 Signature:
33 Date: ( dd-mm-yyyy)
Checklist: 1-One (1) Visa Application; 2 - Passport and copy of its front page carrying your photo; 3 - One(1)
passport
size
photogluedtotheApplication;
4–Fees;5 - Certified Letter of Invitation.

2