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Visa Extension Request Jakarta 2023

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90 views1 page

Visa Extension Request Jakarta 2023

Uploaded by

rima
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Jakarta, 22 February 2023

To :
CHIEF OF SOUTH JAKARTA IMMIGRATION OFFICE
TUTTY ALAWIYAH 207, MAMPANG PRAPATAN
JAKARTA SELATAN – 12760

Subject : Application for “Visa On Arrival” Extension

Dear Sir,
The Undersigned, here with confirm that :

Name : Francis Patrick Segaline

Place/ Date of Birth : Pennsylvania, U.S.A

Gender : Male

Nationality : United States of America

Passport Number : 653864335

Indonesian Address : Apartemen Bona Vista Tower I Unit 506

Jl. Bonavista Raya, Bona Indah, Lebak Bulus, Cilandak

Jakarta Selatan 12440

Apply for “Visa On Arrival” Extension on my name, because of


I need more time to get to know my fiancé's family and her country Indonesia.

NOT TO WORK OR FIND A JOB, during my stay in Indonesia I DO NOT WORK AND
DO NOT RECEIVE SALARY / WAGE.

Faithfully yours,

Francis Patrick Segaline

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