APPLICATION FOR MEXICAN VISA

APPLICATION FOR MEXICAN VISA
Number:
PHOTO
(if required)
CONSULATE GENERAL OF MEXICO IN CHICAGO, ILLINOIS.
* A separate application is required for each traveler.
Please print or type this application.
I. PERSONAL DATA
1.- LAST NAME OR FAMILY NAME (exactly as it appears in passport):
2.- NAME (s) (exactly as it appears in passport):
FOR OFFICIAL USE ONLY
F.M.
No.
No. de visa
No. de etiqueta
No. de autorización SEGOB:
3.- PASSPORT NUMBER : Acreditó solvencia económica con:
Propiedades inmobiliarias:
Place of issue: SI NO
Date of issue:
Tarjeta(s) internacional(es) de crédito
SI
NO
Expiration date:
Cuenta(s) bancaria(s)
4.- CURRENT ADDRESS: SI NO
Phone:
OBSERVACIONES:
5.- CURRENT CITIZENSHIP:
6.- PLACE AND DATE OF BIRTH:
7.- SEX: FEMALE MALE
8.- MARITAL STATUS: SINGLE ( ) MARRIED ( ) WIDOWED ( ) DIVORCED ( )
II. OCCUPATION
9.- CURRENT OCCUPATION:
10.- COMPANY'S NAME:
11.- COMPANY'S ADDRESS:
PHONE:

12.- MONTHLY INCOME: 13.-YEARS EMPLOYED:
14.- OTHER INCOME (source and amount):
III. INFORMATION ABOUT YOUR TRIP
15.- CITY AND DAY OF ENTRY INTO MEXICO:
16.- PURPOSE OF YOUR TRIP TO MEXICO: TOURISM ( ) BUSINESS ( ) STUDIES ( )
RETIREMENT ( ) TRANSIT ( ) OTHER ( ) (please specify)
17.- MAIN DESTINATION AND LENGHT OF STAY IN MEXICO:
18.- IF YOU ARE VISITING MEXICO'S NORTHERN BORDER, PLEASE INDICATE THE CITIES:
PURPOSE OF YOUR VISIT:
19.- IF YOU ARE VISITING MEXICO'S SOUTHERN BORDER, PLEASE INDICATE THE CITIES:
PURPOSE OF YOUR VISIT:
20.- HAVE YOU EVER APPLIED FOR A MEXICAN VISA BEFORE? YES ( ) NO ( )
IF "YES", PLEASE PROVIDE PLACE AND DATE OF ISSUE:
PLACE OF ISSUE: DATE:
21.- DO YOU HAVE ANY VALID VISA FOR OTHER COUNTRIES? YES ( ) NO ( )
IF "YES", PLEASE PROVIDE COUNTRY, TYPE AND EXPIRATION DATE:
I declare that all information herein is true. I authorize the Mexican Government to verify it.
I am aware that the final admission into Mexico must be approved by sanitary and immigration authorities
at the port of entry, and that the issuance of a visa by a Mexican Consulate does not guarantee the
admission. I undestand that sanitary and immigration officials have the right to verify my compliance with
all legal requiremets.
Applicant's signature Date (day / month / year )

FECHA DE RECEPCION: __________________
FOR OFFICIAL USE ONLY
RECIBIO (nombre y firma)
AUTORIZO (nombre y firma)