Visa Request Travel History Personal Data Documents Review Payment
Thank you for completing the online application form. Please take the time to review all of the information you have entered for completeness and accuracy. Failure to provide accurate information may result in delays in
processing, or the rejection of your application. Once you are satisfied with your application, you can submit the form and proceed to enter payment details. Please note that once submitted, the application details
CANNOT be changed. Also note that applications will not be processed by the Antigua & Barbuda Immigration Department until all required fees have been submitted.
Fee Information Travel and Visa History
Amount to be paid (USD): $300 I have previously been in Antigua & Barbuda NO
When did you arrive? Duration of stay (in days)
Name Information
Surname RAHMANI Gender MALE I have previously been issued an Antigua & Barbuda visa NO
First and middle names RASEKH Other surnames When was it issued? Where was it issued? Visa type -
Contact Information I have previously been refused an Antigua & Barbuda visa NO
Primary phone Email address Home / Mailing address WAZIR AKBAR KHAN DIS When was it refused? Where was it refused? Visa type -
+93794146456 Rras59182@gmail.com 10TH KABUL AFGHANISTAN
I have had an Antigua & Barbuda visa that has been cancelled or revoked NO
Other phone
Someone has previously filed an Antigua & Barbuda visa petition for me NO
Birth Information
Visa Information
Date of birth 06/12/1995 Country AFGHANISTAN Nationality AFGHAN
Visa type ENTRY EVISA - VISITOR Entry type MULTIPLE ENTRY
City PANJSHER State / Province PANJSHER
Intended Arrival Date 31/05/2023 Purpose of Trip VACATION
Spousal Information Duration of Stay (in days) 30
Intended Address in Antigua & Barbuda VALLEY
Marital status SINGLE Spouse's full name Spouse's date of birth What financial means will be held on arrival CHURCH 1427 JOHNSONS POINT ANTIGUA BARBUDA
for support during your stay MY SELF
Occupation Information Contact information of the person in Antigua & Barbuda who you are here to see
Present occupation CEO OF BLUE LINE TRAVEL AGENCY Full name Primary phone
Address - Present employer or school
Name - Present employer or school Email address Other phone
Passport Information I Intend to Work in Antigua & Barbuda NO
Passport number Issuing country Expiration date Name of Employer Address of Employer
Issuance date 21/09/2022
P00157225 AFGHANISTAN 21/09/2032
City - Place of State/Province - Place of Country - Place of issuance I Plan to Attend School in Antigua & Barbuda NO
issuance KABUL issuance KABUL AFGHANISTAN Name of School Address of School
Supporting Documents Request Expedited Processing YES
Document Type File Name
Photograph Family in Antigua & Barbuda
LETTER OF EMPLOYMENT Blank american visa.jpeg
No Family in Antigua & Barbuda
PASSPORT Unknown.jpeg
POLICE RECORD PHOTO-2022-10-27-13-14-26 2.jpg
PROOF OF ACCOMMODATION PAK VISA.pdf
PROOF OF FUNDS UNHCR_UPR25_TJK_E_Main.pdf
TRAVEL ITINERARY PHOTO-2022-10-27-13-14-26.jpg
Application Preparation
This application is being prepared by another person on my behalf NO
Full Name Address
Relationship to Applicant
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