THE CONSULATE OF THE UNITED REPUBLIC OF …

1 THE CONSULATE OF THE UNITED REPUBLIC OF tanzania western australia Suite 182, Level 6, 580 Hay Street, PERTH, WA 6000 Email: Telephone: (08) 9221 0033 Facsimile: (08) 9221 0133 (For Consular use only) 1. Surname or Family Name .. 2. Given 3. Former or Maiden Name (if different from above) .. 4. Date and Place of Sex .. 5. 6. Countries in which you have resided in since 7. Names, date and place of birth for minor children accompanying you .. 8. Present No (..) .. 9. Permanent address (if different from above) .. 10. Date of previous visits to tanzania (if any).. 11. Occupation ..Employer ..Position 12. Reason for journey ..Duration of stay .. (If Business, state whether for meetings, site visit etc) 13. Expected date and place of arrival .. Date Place Passport of Date of Onward/Return (Not applicable to Australian nationals and Australian permanent residents) of photo FOR CONSULAR USE ONLY Issued On _____ Payment _____ GGR _____ Signature _____ SUMMARY OF VISA REQUIREMENTS - Application form duly filled in and signed; - Valid passport (not photocopy); - Two recent passport photos; - Copy of travel or flight itinerary; - AUD95 visa fee, payable by cash (correct denomination only), money order or bank cheque payable to CONSULATE of tanzania ; and - Return self-addressed, Registered or Express Post envelope (suitable in size to No.)

2 Of applications), unless collecting in person. photo