Indonesia Dependent (Spouse) Visa | Mix Married Application Form

DEPENDENT (SPOUSE) VISA - KITAS FORM

Fill in the form below to apply Telex (visa approval) For your Spouse Visa.
Also, we will be happy to meet you in our offices located in Bali.

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Applicant Details

Full Name*

Gender*

Place Of Birth*

Day*

Month*

Year*

Phone No.*

Email *

Address In Original Country*

Address In Indonesia*

Referrals

Type Of Travel Document*

Travel document No.*

Valid Until*

Date of Issued*

Place of Issued*

Nationalities*

Scan Passport Detail*

Scan Passport Cover*

Bank Statement*

Insurance

Indonesian Sponsor Details

Full Name

Address In Indonesia

ID Card No. / KTP No.

Family Certificate No. / Kartu Keluarga (KK) No.

Relation With The Applicant

ID Card / KTP

Family Certificate / Kartu Keluarga

Married Certificate / Akta Nikah

Bank Statement

Statement Latter

To whom it may concern

I hereby declare that all data and documents that I have provided are genuine and
correct. I am following the law in Indonesia and will take full responsibility for
any wrong information I provide.
I will take full responsibility for my personal Financial needs and any criminal
activities I perform within Indonesia.

Agreed *

Yes, I Agree

Applicants Document Required

When do you wish to travel to Bali / Indonesia*

Where do you wish to apply and collect the visa

Representative Of Indonesia Embassy*

This field should be left blank

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PT. Putra Nadi Wibawa
Service : Bali Visas

Head Office (Bali)
Jln. Raya Kerobokan, No.70
Kuta Utara, Badung, Bali.
Badung, Bali, Indonesia 80361

Phone : +62-361-934-8198
Mobile : +62-81-999-081-069

Indonesia Dependent (Spouse) Visa | Mix Married Application Form

DEPENDENT (SPOUSE) VISA - KITAS FORM

Applicant Details

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