DEPARTMENT OF IMMIGRATION AND EMIGRATION

APPLICATION FOR EXTENSION OF VISIT VISA

Passport No.:










Place of issue:













Day
Month
Year
Day
Month
Year
Date of issue:











Date of expiry:










Name in full:






























































Nationality:

























Occupation:

























Civil status:
Single:  

Married:  

Divorced:  

Widowed:  

Address in the country of domicile:






























































Address in Sri Lanka:






























































Day
Month
Year
Date of arrival:








Date of expiry of visa/endorsement:








Extension of visa required until:








or for


month
Exchange brought in: Type of currency:









Amount:





Amount cashed: Foreign currency:








=
 Sri Lanka Rupies:







Credit card available:
Master Card:

Visa Card:

American Express:

Day
Month
Year
Years
Months
Date of last visit to Sri Lanka, if any:








Duration:




Whether you are in possession of a return ticket ( If any to be produced).

Yes

No
Day
Month
Year
Date of flight:








Destination Airport:




























Reasons for extension:




















































































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.
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Signature of applicant
Date
Assistant Controller
Unit 6, Visit Visa