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DIPLOMATIC/OFFICIAL/REGULAR VISA

EMBASSY OF THE. REPUBLIC OF LIBERIA. 5201 16th Street, NW. Washington, DC 20011. 202 723 0437 / tel 202 723 0436 / fax DIPLOMATIC/OFFICIAL/REGULAR VISA. Same Day +75$. Name (First/Middle Initial/Last). FEES Next Day + 50$. Street Address/Suite No. US CITIZENS. SINGLE: 1-3 Months US$ City/State/Zip MULTIPLE: 1 Year US$ MULTIPLE: 2 Years US$ Telephone MULTIPLE: 3 Years US$ ECOWAS CITIZENS GRATIS. Email Address ALL OTHERS. Date Of Birth SINGLE: 1-3 Months US$ MULTIPLE: 1 Year US$ Place of Birth (City/Country) MULTIPLE: 2 Years US$ ABSOLUTELY NO cash or personal cheques Nationality accepted. All fees are non-refundable. All fees are to be paid in US Dollars via money order, cashier cheque or bank draft. Make payable to: Embassy of Liberia.

Name (First/Middle Initial/Last) Street Address/Suite No. Place Issued Date Issued Expiration Date Visa Type Requested Proposed Travel Date Length of Stay Purpose of Trip If ‘Other’, please explain: Business

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