(Full Name) ------------------------------------

(Full Name) ------------------------------------

Male/Female) ------------------------------------
(Date of Birth) ------------------------------------
Place of Birth) ------------------------------------
(Height) ------------------------------------
(Weight) ------------------------------------
(Colour of Hair) ------------------------------------
Colour of Eyes) ------------------------------------
(Visible Mark) ------------------------------------
(Occupation) ------------------------------------
) ------------------------------------
(During stay in Myanmar)
) (Present) ------------------------------------
(Present Address) ------------------------------------
------------------------------------
(Previous Address in Myanmar)
(Religion) ------------------------------------
------------------------------------
------------------------------------
------------------------------------
- ------------------------------------
------------------------------------
(National and Date of
Naturalization)
------------------------------------
------------------------------------
National of Foreign Registration
Card No.)
 2
------------------------------------
------------------------------------
(Previous Passport N0., Issue date and ------------------------------------
Issue Authority)
------------------------------------
------------------------------------
(Present Passport No., Issue Date and
Issue Authority)
------------------------------------
------------------------------------
(Date of Expiry of Present Passport)
------------------------------------
(Date of Departure from Myanmar)
------------------------------------
------------------------------------
(Purpose of re-entry into Myanmar)
------------------------------------
------------------------------------
(Name, Address, National Registration No.
And Relationship of guarantor in Myanmar)
------------------------------------
- ------------------------------------
------------------------------------
(Whether funds for air ticket to Myanmar
Deposited in Bank. If so name of Bank,
amount , and proof of deposit)
------------------------------------
------------------------------------
------------------------------------
------------------------------------
------------------------------------
(Whether income tax paid to Myanmar
Government during abroad)
 3
- ------------------------------------
(Whether convicted of any crime)
------------------------------------
- ------------------------------------
------------------------------------
(Name of Political, Social or cultural ------------------------------------
Organization of which applicant is a member
Of or had any connection)
------------------------------------
(Education qualification)

(Education in Myanmar- Name of School,

College, University attended, Name of employee if any)

Period
From) (School,University) (Location) (Grade)
(To)

(Education Abroad-Name of School, College, University attended, Name of employee if
any)

Period
From) (School,University) (Location) (Grade)
(To)
 4

(Countries resided/employments after departure from Myanmar)

Period
From) (Company/Organization) (Location)
(To)

) (Name of
Father and Fathers sibling)

Name Sex Nationality Occupation Address Remarks

 5

) (Name of
Mother and Mothers sibling)

Name Rela Sex Nationality Occupation Address Remarks

(Name of Applicants siblings)

Name Sex Nationality Occupation Address Remarks

 6
(Wife / Husband)

Name Sex Nationality Occupation Address Remarks

)
(Name of Wifes/ Husbands Father and Fathers sibling)

Name Sex Nationality Occupation Address Remarks

 7

)
(Name of Wifes/ Husbands Mother and Mothers sibling)

Name Sex Nationality Occupation Address Remarks

(Name of Children and their spouses)

Name Sex Nationality Occupation Address Remarks

 8

(Relatives residing abroad)

Name Sex Nationality Occupation Address Remarks

( I understand that any false or misleading statement made by me or any other material
and facts willfully concealed by me may subject me to criminal prosecution.)

--------------------------------- -------------------------------
(Date) (Applicants Signature)