Additional Application Form for Non-Immigrant ”O –A” Visa  (Long Stay)

 

First name………………Middle name……………Family name………............................

 

Passport No…………………………………..Issued at………………………………….

 

Date of issue………………………………….Expiry date……………………………….

 

Nationality……………………………………Nationality at birth…………………………

 

Place of birth…………………………………..

 

Date of birth……………………………………Age………………………………………

 

Spouse (if applicable)…………………………..Name……………………………………

 

Present address……………………………………………………………………………..

 

……………………………………..Tel……………………………..Fax…………………

 

Occupation….............................................................Monthly income……………………..

 

Amount of saving…………………………………..(in which bank)…………………….....

 

Date of arrival in Thailand…………………………………………………………………..

 

Travel by………........... … Flight No……………………………….Port of entry…………

 

Proposed address of stay in Thailand……………………………………………………….

 

…………………………………Tel…………………………………..Fax………………..

 

Reference person in Thailand………………………………………………………………

 

………………………………….Tel………………………………….Fax………………..

 

I hereby declare that the abovementioned statements are true and accurate and that in no case

shall I engage myself in any profession or occupation during my stay in Thailand.

 

 

Signature …………………………….Name in print…………………………………..

 

Date………………………………….