Embassy of Lebanon ﺳﻔﺎرة ﻟﺑﻧﺎن
In Pakistan ﻟدى ﺑﺎﻛﺳﺗﺎن
Islamabad إﺳﻼم أﺑﺎد
Visa Application
Name اﻹﺳم Surname اﻟﺷﮭرةOccupation اﻟﻣﮭﻧﺔ
Address in Pakistan: اﻟﻌﻧوان ﻓﻲ ﺑﺎﻛﺳﺗﺎن
Telephone: H: :ب Email address: اﻟﺑرﯾد اﻹﻟﻛﺗروﻧﻲ
رﻗم اﻟﮭﺎﺗف W: :ع
Married ﻣﺗزوج Name of father إﺳم اﻷب PHOTO
(White Background)
Yes No
Name & surname of mother (before marriage) اﺳم اﻷم ﻗﺑل اﻟزواج
Place of birth ﻣﻛﺎن اﻟوﻻدة Date of birth
Day اﻟﯾوم Month اﻟﺷﮭر Year اﻟﺳﻧﺔ
ﺗﺎرﯾﺦ اﻟوﻻدة
Nationality اﻟﺟﻧﺳﯾﺔ Nationality of origin اﻟﺟﻧﺳﯾﺔ اﻷﺻﻠﯾﺔ
Passport No. رﻗم اﻟﺟواز Purpose of the trip ﺳﺑب اﻟزﯾﺎرة Date of arrival in Lebanon
ﺗﺎرﯾﺦ اﻟوﺻول إﻟﻰ ﻟﺑﻧﺎن
(Family, Business, Tourism, Work, Transit, Others)
_________________
Date of Issue Day اﻟﯾوم Monthاﻟﺷﮭر Year اﻟﺳﻧﺔ Date of expiry Day اﻟﯾوم Monthاﻟﺷﮭر Year اﻟﺳﻧﺔ
ﺗﺎرﯾﺦ اﻟﺻدور ﺗﺎرﯾﺦ اﻹﻧﺗﮭﺎء
Visa duration ﻣدة اﻟﺗﺎﺷﯾرة اﻟﻣطﻠوﺑﺔ No. of entries ﻋدد اﻟﺳﻔرات
15 days ً ﯾوﻣﺎ١٥ 1 month ﺷﮭر 3 months ﺛﻼﺛﺔ أﺷﮭر 6 months ﺳﺗﺔ أﺷﮭر One واﺣدة Two ﺳﻔرﺗﯾن Multiples ﻋدة ﺳﻔرات
Address in Lebanon _________________________________________________________________ اﻟﻌﻧوان ﻓﻲ ﻟﺑﻧﺎن
Residence _______________________________________________________________________________ ﻣﻧزل
Hotel __________________________________________________________________________________ ﻓﻧدق
Tele No: ____________________________________________________________________________ رﻗم اﻟﮭﺎﺗف
I hereby declare, that the above mentioned information is correct
and I assume full responsibility for any false declaration Date: _____________________
I acknowledge that this visa is rendered invalid if any Israeli
visa or seal is stamped on my passport. Signature اﻟﺗوﻗﯾﻊ
Reserved for Embassy
Visa No. Type of Visa Date of Issue Date of Expiry within 90 days
Responsible Signature
No. of entries Duration of Stay Fees Receipt No.
17, School Road, F-6/1, Islamabad