1625 k street nw suite 750 washington dc 20006 tel: 888 ... · 1625 k street nw suite 750...
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1625 K Street NW Suite 750 Washington DC 20006 Tel: 888 838 4867 ♦ Email: GEOEX@TravelDocs.com
Visa requirements shown below are for U.S. citizens. Nationals of all other countries please contact Pinnacle Travel Document Systems directly for specific requirements for your itinerary.
Visa # # Cost Late Req’d Forms Photos Per Visa Fee
Mozambique-Single 1 2 $244.00 $100.00 Mozambique-Multi 1 2 $254.00 $110.00
Zambia-Single 2 2 $169.00 $95.00 Zambia-Double 2 2 $199.00 $95.00
You will need to enclose your actual passport along with the number of completed visa application forms and photographs indicated above for each country. Please also enclose two (2) clear photocopies of the vital information page of your passport. Photographs should be recently shot passport-type color photos with a clear background approximately 2” x 2” in dimension. (Note that machine or home digital photographs are not acceptable and photographs must be different than those in your current passport.) Your passport must generally be valid for a minimum of six (6) months beyond the completion of your travel unless otherwise indicated above. Contact PTDS directly for assistance with the renewal of your U.S. passport as this can easily be done at the same time that your visas are being processed. Applications for individual countries must be received in our offices no fewer than 30 days prior to your departure from your shipping address. (Contact PTDS directly regarding deadlines for requests that include more than one country.) Documents received after the deadline will be subject to the per person late fees shown for each country. Please contact PTDS before submitting documents you expect may be received substantially after the deadline as there may be special requirements and/or additional fees associated with processing your request. It may not be possible to cancel processing of your applications once they have been submitted.
In addition to the per person combined service and consular fees shown above please include $30.00 to cover the FedEx return of your passport(s) within the continental U.S. ($30.00 for all other U.S. and Canadian addresses.) We also strongly recommend that you use FedEx or another form of traceable shipping to forward your documents to our offices.
Please note that consular fees, shipping fees and application requirements are subject to change without notice. Check or credit card payment accepted. Credit card payment subject to 3.5% surcharge.
Visas for Malawi are valid for 30 days from the date of issue. Due to the short validity of the Malawi visa your passport will be returned to you no earlier than 15 days prior to your
departure. Photographs for Zambia must be signed on the back. PLEASE NOTE THAT SOUTH AFRICA REQUIRES THAT YOU HAVE ONE SET OF FACING BLANK VISA
PAGES FOR EACH ENTRY.
Malawi-Single 2 2 $184.00 $40.00
PLEASE BE CERTAIN TO RETURN THE FOLLOWING TO: Pinnacle Travel Document Systems 1625 K Street NW Suite 750 Washington DC 20006
♦ Your actual passport (Please keep a photocopy for your records.) ♦ This completed form ♦ Two (2) photocopies of the vital information page of your current passport ♦ Total number of completed visa application forms per person indicated ♦ Total number of passport-type color photographs per person indicated
♦ Credit or debit card authorization below
PLEASE PRINT CLEARLY
Full Name (1):_____________________________ Full Name (2): _____________________________
Passport #:____________________ Exp:___/___ Passport #:____________________ Exp:___/___ Mo Y r Mo Y r
Home ________________________________ Home Tel: ________________________________
Mailing ________________________________ Work Tel: ________________________________
Address: ________________________________ Email: ____________________________________
________________________________ Date of Departure from Home: ____/____/_____ (FedEx cannot deliver to PO boxes) Mo nt h Da y Ye a r
Address ________________________________ Custom Southern Africa
For the ________________________________ Date of Tour Departure: / / Mo nt h Da y Ye a r Return of ________________________________ Date of Entry to Malawi: ___________________
Passport: ________________________________ Special Instructions:_______________________
Tel: ________________________________ _________________________________________
Please indicate below if there are known periods prior to your tour during which you will need your passport for another international tr ip or when you will not be available to sign for the return of your passport. I wil l need my passport(s) for other international travel from _____/____/_____ to _____/____/_____ Mo nt h Da y Yea r Mo nt h Da y Yea r
I wil l not be at my home and/or return shipping address from _____/____/_____ to _____/____/_____ Mo nt h Da y Yea r Mo nt h Da y Yea r
CREDIT CARD AUTHORIZATION: AMEX / V ISA / MC (please circle one)
Cardholder Name:_____________________ Signature:______________________ Bi l l ing Zip Code: _____________
Card #: ______________________________CID#______________ Expires: ____/___ Amount: US$ _________ Mo Y r F O R O F F I CE US E O NL Y
GEOEX CUSTOM S.AFRICA (ZAMB-SING90DBL120/MOZAMB-SING165MULTI-185/MALAWI105)79 FX 30 2PGS VAL6MOS DL30 DYS 40.00 3.5% TE MALAWI 30 DAYS
2017 Pinnacle Travel Document Systems
IMPORTANT NOTICE REGARDING PASSPORT PAGES & VALIDITY:
You must have at least one (1) completely blank unused visa page available in your passport for each country you are visiting that requires a visa not including the pages at the back of your passport reserved for amendments and endorsements. You should also have at least one (1) additional blank page to accommodate entry/exit stamps for those countries that do not require a visa or two sets of facing blank visa pages if entering South Africa. In addition, your passport must be valid for at least six (6) months beyond completion of your international travel. If you are a U.S. citizen and need to renew your passport Pinnacle Travel Document Systems can easily assist you with this at the same time your visas are being processed. The total additional fee for this service (including U.S. government expediting fees) is $276.00 for passport renewals and second passports. We can also assist you with expediting first time passport applications.
You will need to complete an application form and a letter of authorization for PTDS and must send your actual passport to us. Specific requirements and the necessary forms are available for download from our Internet site:
Passport Renewals
First Time Passports Second Passports
WWW.Traveldocs.com/PTDSPassports
You may also contact us via email or phone at GEOEX@PinnacleTDS.com
or 888-838-4867 and we will send you an instruction kit.
EMBASSY OF THE REPUBLIC OF ZAMBIA 2419 Massachusetts Avenue, Telephone: (202) 265-9717 NW Washington, DC 20008 Facsimile: (202) 332-0826 E-mail: embzambia@aol.com www.zambiaembassy.org
VISA APPLICATION FORM
1. Surname: 2. First Name: Middle Name:
3. Date of Birth: Place of Birth:
4. Nationality: Sex:
5. Profession: Business Telephone No. ( )
6. Nationality of Parents at time of Birth:
7. Passport No.
Date of Issue:
8. Place of Issue:
Date of Expiration:
9. If accompanied by your spouse or children, give the following particulars: (Note: Every applicant fills out an individual form) Full Name (s) Date & Place of Birth Relationship
10. Present Address: Telephone No. ( ) Email: 11. Permanent Address:
Telephone No. ( ) Email: 12. (a) Type of Visa Requested: Tourist ( ) Business ( ) Church Business ( ) Visitor ( ) Diplomatic ( )
Official ( ) Student ( ) Transit ( ) Volunteer ( ) Courtesy ( )
(b) Entry requested: Single ( ) Double ( ) Multiple (x )
(c) Date of entry into Zambia: ______________________________
(d) Length of Stay in Zambia: _____ __________________________
13. Final Destination of Journey in Zambia: Address in Zambia:
14. Expected Departure Date from Zambia: Next Destination from Zambia:
15. Duration and Particulars of any previous residence or visits in Zambia:
16. If traveling on business, please list names and addresses of persons to be visited in Zambia:
17. If visiting relatives or friends, please list names and addresses of persons to be visited in Zambia:
18. Signature of Applicant:_______________________________________________________ Date:__________________ For official use only: Date Tag # Visa fee Rush Fee Payment Visa # Receipt# Notations
Rev. 04/2006
DOE Jonathan Bonham
13 MAR 1961 Los Angeles CA USA USA Male
Engineer 987 654-0123 USA
0123456789
1 0MAY 2005
US Dept of State
09 MAY 2015
COMPLETE AS APPLICABLE
1234 Main Street Anywhere CA 98765987 654-3210 JDoe@anywhere.net
SAME AS ABOVE
PER YOUR ITINERARY
PER YOUR ITINERARY
PER YOUR ITINERARY PER YOUR ITINERARY
PER YOUR ITINERARY PER YOUR ITINERARY
COMPLETE IF APPLICABLE
LEAVE BLANK
LEAVE BLANK UNLESS APPLICABLE
PLEASE DO NOT FORGET TO SIGN & DATE BOTH YOUR APPLICATIONS
GEOEX
✔
PLEASE STAPLEONE (1) COLORPHOTO SIGNEDON THE REVERSEHERE ON BOTHCOPIES OF YOURAPPLICATION
✔
DOE JONATHAN BONHAM
MARRIED FEMALES LOS ANGELES, CA USA
13 MAR 1961 M MARRIED USA
0123456789 17 05 2005 16 05 2015 USA
ENGINEER MANAGER
ABC INTERNATIONAL INC
1234 MAIN STREET, ANYWHERE CA 98765
✔
✔
LEAVE BLANK UNLESS YOU HAVE BEEN A PAST RESIDENT OF MOZAMBIQUE
LEAVE BLANK UNLESS PAST RESIDENT
TOURISM-PREPAID TOUR
PER YOUR ITINERARY PER YOUR ITIN PER YOUR ITIN
PER YOUR ITINERARY PER YOUR ITINERARY
LEAVE BLANK LEAVE BLANK PER YOUR ITIN PER YOUR ITIN N/A
AS APPLICABLE
PLEASE DO NOT FORGET TO SIGN AND DATE YOUR APPLICATION
JOHNATHAN BONHAM DOE
MARRIED
PER YOUR ITINERARY (ADDRESS IN MALAWI)
1234 MAIN STREET
ANYWHERE, CALIFORNIA USA
MARCH 13, 1961 LOS ANGELES, CALIFORNIA USA
MALE RETIRED
987654321 FEBRUARY 12, 2010
US DEPT OF STATE FEBRUARY 11, 2020
NOT APPLICABLE NOT APPLICABLE
USA
PER YOUR ITINERARY (DATE OF ENTRY TO MALAWI)
PER YOUR ITINERARY (WHERE ARE YOU TRAVELING TO MALAWI FROM)
PER YOUR ITINERARY (WHERE ARE YOU GOING AFTER MALAWI)
PER YOUR ITINERARY (HOME ADDRESS HERE)
TOURISM
PER YOUR ITINERARY
PER YOUR ITINERARY PER YOUR ITINERARY
AIRPLANE (MEANS OF TRANSPORTATION WHEN LEAVING)
PRE-PAID TOUR
N/A
N/A (DATE YOU PREVIOUSLY TRAVELED TO MALAWI)
N/A
N/A (DATE YOU PREVIOUSLY TRAVELED TO MALAWI)
N/A
N/A
PER GEOEX PER GEOEX
NOT APPLICABLE
PLEASE DO NOT FORGET TO DATE AND SIGN YOUR APPLICATIONS.
EMBASSY OF THE REPUBLIC OF ZAMBIA 2419 Massachusetts Avenue, Telephone: (202) 265-9717 NW Washington, DC 20008 Facsimile: (202) 332-0826 E-mail: embzambia@aol.com www.zambiaembassy.org
VISA APPLICATION FORM
1. Surname:
2. First Name: Middle Name:
3. Date of Birth: Place of Birth:
4. Nationality: Sex:
5. Profession: Business Telephone No. ( )
6. Nationality of Parents at time of Birth:
7. Passport No.
Date of Issue:
8. Place of Issue:
Date of Expiration:
9. If accompanied by your spouse or children, give the following particulars: (Note: Every applicant fills out an individual form) Full Name (s) Date & Place of Birth Relationship
10. Present Address: Telephone No. ( ) Email:
11. Permanent Address:
Telephone No. ( ) Email: 12. (a) Type of Visa Requested: Tourist ( ) Business ( ) Church Business ( ) Visitor ( ) Diplomatic ( )
Official ( ) Student ( ) Transit ( ) Volunteer ( ) Courtesy ( )
(b) Entry requested: Single ( ) Double ( ) Multiple (x )
(c) Date of entry into Zambia: ______________________________ (d) Length of Stay in Zambia: _____ __________________________
13. Final Destination of Journey in Zambia:
Address in Zambia:
14. Expected Departure Date from Zambia:
Next Destination from Zambia:
15. Duration and Particulars of any previous residence or visits in Zambia:
16. If traveling on business, please list names and addresses of persons to be visited in Zambia: 17. If visiting relatives or friends, please list names and addresses of persons to be visited in Zambia: 18. Signature of Applicant:_______________________________________________________ Date:__________________ For official use only: Date Tag # Visa fee Rush Fee Payment Visa # Receipt# Notations
Rev. 04/2006
PEDIDO DE ENTRADA EM MOCAMBIQUEREQUEST FOR ENTRY VISA TO MOZAMBIQUE
RECIBO №
PREENCHER COM LETRA LEGIVEL TO BE FILLED IN LEGIBLE LETTERS
VISTO №
UMA ENTRADA Single entry
DATA DE EMISSAO
......../�..../ ��.. DUPLAS ENTRADAS Double entry
VALIDADE
MULTIPLAS ENTRADAS Multiple entries
RESERVADO AOS SERVICOS: FOR OFFICIAL USE:
��./�.../ ���
APELIDO Surname
NOME COMPLETO Full name
NOME DE SOLTEIRA Maiden name
PAIS E LOCAL DE NASCIMENTO Country and place of birth
DATA DE NASCIMENTO Date of birth
SEXO Sex
ESTADO CIVIL Marital status
NACIONALIDADE Nationality
PASSAPORTE № Passport №
DATA DE EMISSAO Date of issue ���/���/ ���.
Validade Validity ���/���/ ���.
NACIONALIDADE DO P.te P.te nationality
PROFISSAO/OCUPACAO Profession/Occupation
CARGO QUE OCUPA Position you hold
INSTITUICAO, ORGANIZACAO OU EMPRESA ONDE TRABALHA Institution, organization or firm you work ENDERECO DA RESIDENCIA PERMANENTE Address of the permanent residence ESTEVE ALGUMA VEZ EM MOCAMBIQUE ? SIM NAO Have you ever before been in Mozambique ? Yes No JA FOI RESIDENTE EM MOCAMBIQUE ? SIM NAO Have you ever been a resident in Mozambique ? Yes No PORQUE SAIU DE MOCAMBIQUE ? DATA DE SAIDA Why did you leave Mozambique ? Date of exit } ���./���../ ����. INDIQUE AS INSTUICOES E EMPRESAS A QUE ESTEVE LIGADO Mention the institutions and firms to which you were attached
O PREENCHIMENTO INCORRECTO OU INCOMPLETO IMPLICA RESPOSTA TARDIA, DEVOLUCAO
OU INDEFERIMENTO INCOMPLETE OR INCORRECT FILLING IN OF THIS FORM MAY RESULT IN DELAY DEVOLUTION
OR REJECTION
DETALHE OS MOTIVOS DA ENTRADA EM MOCAMBIQUE In detail give reasons for your entry in Mozambique TEMPO DE ESTADA EM MOCAMBIQUE Length of stay in Mozambique
DATA DE ENTRADA Date of entry ���./���./ ����
DATA DE SAIDA Date of exit ���./���./ ���
FRONTEIRA DE ENTRADA Entry border
FRONTEIRA DE SAIDA Exit border
ENDERECO DA HOSPEDAGEM EM MOCAMBIQUE � Address of residence in Mozambique
PROVINCIA Province
DISTRITO
District
CIDADE
City
AVENIDA/RUA
Avenue/street
CASA № House №
FAMILIARES/AMIGOS RESIDENTES EM MOCAMBIQUE � Relatives, friends living in Mozambique
NOME COMPLETO
Full name
NACIONALIDADE
Nationality
PARENTESCO
Relationship
ENDERECO
Address
RESERVADO AOS SELOS
Reserved for stamps
DATA ...................................................................................................................................... Date } ���./���./ ���.. ASSUNATURA DO REQUENTE OU DA ENTIDADE SOLICITANTE Signature of applicant or of the applying entity ASSINATURA RECONHECIDA POR SEMELHANCA A EXISTENTE NO ��������������������... № ��������.. EMITIDO A ........../���/ ���� EM ������������������������
RESERVADO AOS SERVICOS For official use
DATA DE RECEPCAO
........../���/ ���.
....................................................................................................................................................
ASSINATURA DO FUNCIONARIO
DATA DE ENTREGA
........../���/ ���.
GEOEX
TOURISM
PRE-PAID TOUR
GEOEX
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