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SRI LANKA IMMIGRATION AND EMIGRATION
APPLICATION FOR EXTENSION OF VISIT VISA
PHOTOGRAPH
Application No
NE
1. Details Of Passport
i. Passport No ii. Place of issue
iii. Date of issue
Day Month Year Day Month Year
iv. Date of expiry
2. Name in full as
Shown in passport
3. Nationality
4. Gender i. Male ii. Female
5. Date of Birth
Day Month Year
i. Place of Birth ii. Country
6. Occupation
7. Civil status i. Single ii. Married iii. Divorced iv. Widowed
8. If Married Sri Lankan
i. Full Name of Spouse
ii. Passport Number
ii. Personal ID Number
9. Address in the
Country of Domicile
10. Address in Sri Lanka
11. Contact Details
i. Telephone Number ii. Mobile
iii. Fax
iv. E-Mail
12. Date of arrival
13. Date of expiry of visa /
landing Endorsement
Day Month Year
Day Month Year
14. Extension of visa Months
Required for

15. Exchange brought in
i. Type of currency ii. Amount
iii. Amount cashed
v. Credit card available Yes No
16. Details of previous visit to Sri Lanka within immediate six months if any,
i. Date of arrivals ii. Date of departure iii. Duration
iv.
Total
17. Whether you are in possession of a return ticket Yes No
18. Reasons for extension
i. Holiday ii. Visit Relations iii. Business
iv. Other , Specify
v. Documents annexed in support to the above reason
1
2
3
4
I hereby declare that to the best of my knowledge and belief the foregoing statements are true, that I shall not engage myself in any employment
paid or unpaid , or in any business or trade on arrival or during my stay in Sri Lanka and that I shall leave Sri Lanka before the date of expiry of
the period of my authorized stay. I also undertake to notify the Controller of Immigration & Emigration, Colombo, immediately any change of
my address, while in Sri Lanka, occurs.
…………………………………………….……
Signature of applicant & Date
FOR OFFICE USE ONLY
D/A D/E Cashed RT
Remarks
Visa Fee (Rs) Tax (Rs) Penalty (Rs) Amount (Rs)
Date Processing Officer For Controller General/Controller/Deputy Controller /Assistant
Controller
NOTE,