APPLICATION FOR PERMANENT RESIDENCE PERMIT [Section 5A of the Immigration Act]
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1 APPLICATION FOR PERMANENT RESIDENCE PERMIT [Section 5A of the Immigration Act] APPLICATION FORM FOR INVESTOR / SELF-EMPLOYED / PROFESSIONAL SECTION 1: PERSONAL DETAILS OF APPLICANT 1.1 Surname 1.2 First Names 1.3 Maiden Name (If any) 1.4 Any Previous Name 1.5 Gender: Male Female 1.6 Marital Status: Single Married Divorced Other 1.7 Date of birth 1.8 Place of birth 1.9 Present Nationality 1.10 Any other nationality held 1.11 Date acquired 1.12 Passport No Issuing country 1.16 Occupation Permit or Residence Permit No Date of issue 1.15 Date of expiry 1.17 Date of issue 1.18 Date of expiry 1.19 Residential address in your country of origin or last residence outside Mauritius 1.20 Residential address in Mauritius address:
2 SECTION 2 DETAILS OF EMPLOYER/BUSINESS 2.1 Business/ Company name: 2.2 Business/ Company address: address 2.6 Company Incorporation No. 2.7 Business Registration No. SECTION 3 DETAILS OF ACCOMPANYING SPOUSE AND DEPENDENTS (IF ANY) 3.1. Full name:. Relation: Passport No.:.. Date of issue:. Date of expiry: 3.2. Full name:. Relation: Passport No.:.. Date of issue:. Date of expiry: Full name:. Relation:. Passport No.:.. Date of issue:. Date of expiry: 3.4. Full name:.. Relation: Passport No.:... Date of issue:. Date of expiry: Full name:..relation: Passport No:.. Date of issue:. Date of expiry:. 2
3 SECTION 4 - SUPPORTING DOCUMENTS CHECKLIST Please tick ( ) the relevant boxes to show which documents have been submitted along with your application. You should provide original and one copy of each document. Photocopy of bio-data page of passport (The passport must have a minimum validity period of six months. The original passport should be produced while submitting the application. It will be retuned when the application is accepted) Four recent identical colour passport size photographs (not older than three months) Original Occupation, Work and/or Residence Permit (will be returned after verification) Certificate of Income/turnover from the Mauritius Revenue Authority to cover annual turnover or income for the last 3 consecutive years Certificate from a medical practitioner in Mauritius that you are not suffering from any infectious or contagious disease A sworn affidavit to the effect that the applicant has not been convicted in his country of origin or residence of any criminal offence for the past 10 years covering the last 10 years. Application fee of MUR 1,000 payable by crossed cheque drawn to the order of Government of Mauritius. SECTION 5 - DECLARATION I declare that all the information given in this application form as well as in the attached documents is true and correct. I understand that making a false statement may lead to prosecution and cancellation of my Permanent Residence Permit. Full name of applicant: Signature of Applicant:... Date: 3
4 APPLICATION FOR PERMANENT RESIDENCE PERMIT [Section 5A of the Immigration Act] APPLICATION FORM FOR RETIRED NON-CITIZEN SECTION 1: PERSONAL DETAILS OF APPLICANT 1.1 Surname 1.2 First Names 1.3 Maiden Name (If any) 1.4 Any Previous Name 1.5 Gender: Male Female 1.6 Marital Status: Single Married Divorced Other 1.7 Date of birth 1.8 Place of birth 1.9 Present Nationality 1.10 Any other nationality held 1.11 Date acquired 1.12 Passport No Date of issue 1.13 Issuing country 1.15 Date of expiry 1.17 Date of issue 1.16 Residence Permit No Date of expiry 1.19 Residential address in your country of origin or last residence outside Mauritius 1.20 Residential address in Mauritius address:
5 SECTION 2 DETAILS OF ACCOMPANYING SPOUSE AND DEPENDENTS (IF ANY) 2.1. Full name:. Relation: Passport No.:.. Date of issue:. Date of expiry: 2.2. Full name:. Relation: Passport No.:.. Date of issue:. Date of expiry: Full name:. Relation:. Passport No.:.. Date of issue:. Date of expiry: 2.4. Full name:.. Relation: Passport No.:... Date of issue:. Date of expiry: Full name:..relation: Passport No..:.. Date of issue:. Date of expiry:... 2
6 SECTION 3 - SUPPORTING DOCUMENTS CHECKLIST Please tick ( ) the relevant boxes to show which documents have been submitted along with your application. You should provide original and one copy of each document. Photocopy of bio-data page of passport (The passport must have a minimum validity period of six months. The original passport should be produced while submitting the application. It will be retuned when the application is accepted) Marriage Certificate (for accompanying spouse only) Four recent identical colour passport size photographs (not older than three months) Original Residence Permit to be returned after verification. (Not applicable to accompanying spouse and dependents) Certificate from a medical practitioner in Mauritius that you are not suffering from any infectious or contagious disease A sworn affidavit to the effect that the applicant has not been convicted in his country of origin or residence of any criminal offence for the past 10 years covering the last 10 years. Certificate from your bank attesting that you have transferred a minimum of USD 40,000 or its equivalent in convertible currency annually to Mauritius during the last 3 years. (Not applicable to accompanying spouse and dependents). Application fee of MUR 1,000 payable by crossed cheque drawn to the order of Government of Mauritius. SECTION 4 - DECLARATION I declare that all the information given in this application form as well as in the attached documents is true and correct. understand that making a false statement may lead to prosecution and cancellation of my Permanent Residence Permit. I Full name of applicant: Signature of Applicant:... Date: 3
7 APPLICATION FOR PERMANENT RESIDENCE PERMIT [Section 5A of the Immigration Act] SECTION 1: PERSONAL DETAILS OF APPLICANT 1.1 Surname APPLICATION FORM FOR SPOUSE AND DEPENDENTS 1.2 First Names 1.3 Maiden Name (If any) 1.4 Any Previous Name 1.5 Gender: Male Female 1.6 Marital Status: Single Married Divorced Other 1.7 Date of birth 1.8 Place of birth 1.9 Present Nationality 1.10 Any other nationality held 1.11 Date acquired 1.12 Passport No Date of issue 1.13 Issuing country 1.15 Date of expiry 1.17 Date of issue 1.16 Residence Permit No Date of expiry 1.19 Residential address in your country of origin or last residence outside Mauritius 1.20 Residential address in Mauritius address:
8 SECTION 2 DETAILS OF SPOUSE/PARENT/NEXT-OF-KIN HOLDING THE OCCUPATION/WORK/ 2.1 Surname RESIDENCE PERMIT 2.2 First names 2.3 Relation to Holder of Permit 2.4 Holder of Occupation/Work/ Residence Permit No. 2.5 Date of issue 2.6 Date of expiry address 2.10 Company Incorporation No Business Registration No. SECTION 3 - SUPPORTING DOCUMENTS CHECKLIST Please tick ( ) the relevant boxes to show which documents have been submitted along with your application. You should provide original and one copy of each document. Photocopy of bio-data page of passport (The passport must have a minimum validity period of six months. The original passport should be produced while submitting the application. It will be retuned when the application is accepted) Marriage Certificate (if applicable) Four recent identical colour passport size photographs (not older than three months) Your original Residence Permit to be returned after verification Original Occupation Permit, Work and/or Residence Permit of your spouse or the person on whom you depend Certificate from a medical practitioner in Mauritius that you are not suffering from any infectious or contagious disease A sworn affidavit to the effect that the applicant has not been convicted in his country of origin or residence of any criminal offence for the past 10 years covering the last 10 years. Children under 18 years are exempted from this requirement Application fee of MUR 1,000 payable by crossed cheque drawn to the order of Government of Mauritius. SECTION 4 - DECLARATION I declare that all the information given in this application form as well as in the attached documents is true and correct. I understand that making a false statement may lead to prosecution and cancellation of my Permanent Residence Permit. Full name of applicant: Signature of Applicant:... Date: 2
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