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TO BE ANSWERED BY TRANSIT APPLICANTS ONLY21. Do you have a visa Yes No , Residence permit Yes No , Permit of staying Yes NoTem vistoSim Não Autorização de residénciaAutorização de permanéncia22. Country of destination 23. Date of departure from Angola (dd/mm/yy):Pais de destinoData da saida de Angola, to enter to the final country.para entrar no pais de dastino24. Itinerary 25. Time of permanenceltenrãrioTempo de permanénciaTO BE ANSWERED BY WORK APPLICANTS ONLY.26. Contract organ:27. Position you will occupy:Organismo a contactarPosição a ocupar28. Address:Endereço29. Date of initiation of contract: 30. Caution date on:Data do inicio do contratoData da cauçãoTO BE ANSWERED BY RESIDENT PERMIT APPLICANTS ONLY.32. Reason to seek residence:Razão pela qual quer residir em Angola33. Have you lived in Angola before? Yes No Place where you lived in AngolaJã viveu em Angola?Sim Não Lugar aonde residiu em Angola34.AddressEndereço31. Amount of caution: Payable to SMEValor d a cauçãoA pagar ao SME35. Will you reside with your family?: Yes No Wife Husband Father Mother Number of childrenVai residir oom a sua farnilia'?Sim Não Esposa Marido Pai Mãe Número de Shos36.Do you want to live temporally or definitively ? Means of subsistenceVai viver temporariamenteou definiltivamente Meios de subsistinciaREMARKS: The Consular Section of the Embassy of Angola has full authority to evaluate and request more documents than those submitted byapplicant The latter is hereby informed that submitting the aforementioned documents does not guarantee automatic approval for issuance of the visa.It is advisable to apply for the visa at least two weeks prior to your prospective departure date.I declare that the information given in this application is correct to the best of my knowledge and belief.The person that will travel to Angola on transit or ordinary visas are not allowed to work or perform any payableactivity.SignedObs/Comment:FOR OFFICIAL USE ONLY:DatePagou: Cheque Nr. Despacho da Direcção de Emigração e Fronteiras de AngolaN r. do Visto ..Data:Mediante TELEX, FAX nºParecer dos Serviços Consulares;O Encarregado para os Assuntos ConsularesAnexado ao processo , de / /O Director NacionalPage 6 of 7
VISA & PASSPORT SUBMISSION SHEETCall us for assistance -TRAVELER INFORMATION:My company's CIBT account number is:Date passport must be back in your possession: / /mm dd yyyyDate of next international trip: / /mm dd yyyyGreen Card Holder: Yes: No:Name:LastFirstE-Mail:Contact Name:RETURN DOCUMENTS TO THIS ADDRESS:Phone:Fax:Name:Company:Street: City: State: Zip:NO PO BOXESTelephone Number:I Authorize Delivery w/o Signature: Name (print)The address listed above is: Residential: Business:Signature:SERVICES REQUESTED:Select the type of service you request by placing a check mark in the appropriate box for each service you are ordering.Passport: First time: Renew: Pages:2nd Passport:If within 12months ofdate of issueExtend Validity:Information Change:Visas:Tourist:Business:Transit:Number of Entries:Country #1:Country #2:Country #3:I understand that any visa request that is needed in seven business days or less OR any passport request that is needed in tenbusiness days or less will be assessed a rush or emergency surchargePAYMENT METHOD FOR APPLICABLE FEES:American Express: Diners Club: MasterCard: Visa: Discover: Money Order: Check: #I hereby authorize CIBT to charge the cost of its professional visa and passport services to the following credit card. I agree to pay this amount to my credit cardcompany.Name on Card:Card Number:CIBT CHICAGO180 North Stetson Ave, Suite 3170,Chicago, IL 60601CIBT HOUSTONTwo Greenway Plaza, Suite 275,Houston, TX 77046Expiration Date:mm/yyCIBT LOS ANGELES6300 Wilshire Bvd, Suite 1520,Los Angeles, CA 90048Signature:CIBT MIAMI169 East Flagler St., Suite 1438,Miami, FL 33131CIBT NEW YORK60 East 42nd Street, Suite 1250,New York, NY 10165CIBT SAN FRANCISCO625 Market Street, Suite 1010,San Francisco, CA 94105CIBT WASHINGTON, DC2233 Wisconsin Ave, Suite 215,Washington, DC 20007FOR CIBT ONLY:Itinerary #:Date Received:Via:Missing/Inadequate Docs: PPT / APP / PHO / BCL / Other:Agent:Original Documents Included:PPT Cover / GC / I-94 / Nat Cert / INS Docs / TIX / BC / MC / DC / VACC CertDate Returned:Via:FDX / UPS / DHLAccount #: Invoiced by: Waived Signature Release: Yes / NoPayment Received: Credit Card Check/Money Order #: Amount:Code:Page 7 of 7
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