IMMIGRATION CARD
PLEASE WRITE IN BLOCK LETTERS
ARRIVAL CARD
FULL NAME (
as appears in Passport
)
SEX
MALE
FEMALE
NATIONALITY
PLACE OF BIRTH
DATE OF BIRTH (DD-MM-YYYY)
PASSPORT NUMBER
DATE OF EXPIRY (DD-MM-YYYY)
PLACE OF ISSUE
COUNTRY RESIDENCE
LAST PLACE / PORT OF EMBARKATION
FLIGHT NO./VESSEL NAME/VEHICLE REG. NO.
OCCUPATION
1. Professional
2. Management/Administration
3.Sales/Clerical/Technical
4.Student
5. Housewife
6. Military
7. Government Offical
8. Others
PURPOSE OF VISIT
1. Bussines
2. Official mission
3. Convention
4. Holiday/visiting friend/Relative
5. Student
6. Leisure
7. Others
ACCOMMODATION
1. Hotel
2. Residence of friend/Relative
3. Appartment
4. Others
INTENDED LENGTH STAY
ADDRESS IN INDONESIA
SIGNATURE
DEPARTURE CARD
FULL NAME (
as appears in Passport
)
SEX
MALE
FEMALE
PASSPORT NUMBER
PLACE OF ISSUE
DATE OF EXPIRY (DD-MM-YYYY)
IMMIDIATE DESTINATION
FLIGHT NO./VESSEL NAME/VEHICLE REG. NO.
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