Orderform for Online Visa Application for the Russian Federation Page 1 of 7 1 Visa details If you formerly had USSR or Russian citizenship, please indicate when and why you lost it: (please attach a copy of your denaturalization certificate) Type of visa: Tourist Private visit Business Official visit Work Study Transit Temporary Residing Refugee Science / Cultural / Sports / Religion Purpose of visit (in detail): Number of entries: 1x 2x multiple Date of entry in Russia: Date of departure from Russia: Please note: The date of entry and departure must exactly correspond to the date of entry and departure in the provided invitation / visa support letter (tourist voucher)! 2 Personal details Family (last) name (as in passport): First and middle names (all, as in passport): Birth name / pseudonym (if any): Sex: female male Place of birth: (as in passport) If you were born in Russia, please indicate when and which country you emigrated to: Marital status: married single (never married) divorced separated widowed Spouse s full name (if divorced or separated, please indicate maiden name if applicable): Spouse s date of birth: Spouse s place of birth: (as in passport) Spouse s current address: Spouse s nationality: Will your partner be travelling with you?
Page 2 of 7 3 Passport details Type of passport: diplomatic official ordinary (tourist) other (please specify) Passport No.: Issued by: Valid until: 4 Visit details Name & address of the Russian institution or organization to be visited?: for business visitors: name of the host organization & city Number of invitation & TIN-Organization (= INN-Tax-No. of the Russian Institution/Company/Organisation) (only for business visa) Please attach a copy or original of your invitation! Name & address of the Russian host tourist company (only for tourists): Reference No. of the Russian host tourist company (only for tourists): Confirmation No. of the Russian host tourist company (only for tourists): Please attach a copy of your visa support letter! Name, Surname and address of host (only for private visits): Please attach your original invitation! Birthday of host (only for private visits): Please attach your original invitation! Itinerary: (please indicate all places of visit): Do you have National insurance Number? Details: Details of health insurance valid in Russia (please specify insurance company & No. of insurance certificate) Who will pay for your trip to and stay in Russia? Independently Company: Name of organization: Others Individual: Name, Surname Do you plan to stay anywhere (hotel, individual) during your stay in Russia? If yes, please indicate: Hotel: Hotel name: Phone: Address: Individual: Name, Phone: Address:
Page 3 of 7 5 Additional Information: Have you ever changed your surname, name (s)? Previous surname, names: Date of change: Reason of change: Do you hold or have you ever held any other nationality or nationalities? issuing authority: Date of expiry: Have you ever been arrested or convicted of any offence? Have you ever been refused entry Russia on arrival? Reason? Information about refusals of visas to Russia or any other country? Reason? Have you ever been deported or removed from Russia or any other country? Reason? Have you completed this application form personally? Application form has been filled out by Name: Current adress: Passport Number: Contact telephone number: Date of expiry: Issuing authority:
Page 4 of 7 6 Additional Information: Information about employment in organizations (governmental or non-governmental) of the following categories: armed forces, government or municipal administration authorities, judicial authorities, lawenforcement authorities, private security companies. Have you ever worked at any of such organizations? Name of organization: Position: Date to: Have you ever been involved in armed conflicts, either as a member of the military service or a victim? Conflict name: Date to: Have you ever been suspected of any war crimes or crimes against humanity? Have you ever been a member of an organization recognized as terrorist organization? Have you ever by any means publicly expressed views that justify or glorify terrorist or extremist activities? Have you ever by any means publicly declared for dismantling the constitutional system or territorial integrity of the Russian Federation? Have you ever been charged with criminal or administrative offence (including traffic violation) in Russia or in any other country? Have you ever broken migration laws and regulations of Russia or of any other country? Have you ever been afflicted with a communicable disease of public health significance or a dangerous physical or mental disorder? Have you ever been a drug abuser or an addict? Have you ever used drugs or have been a drug addict? Level of Russian language skills Do not speak Fluent Can have a simple conversation Understand, but do not speak well Read and translate with a dictionary Have you ever visited other countries in the past ten years?
Page 5 of 7 7 Additional Informations: Have you visited Russia in the last 10 years? Is it your first passport? please indicate the last three passports Issuing Authority: Date of Expiry: in my possession lost stolen spoiled Ran out of free pages expired Issuing Authority: Date of Expiry: in my possession lost stolen spoiled Ran out of free pages expired Issuing Authority: Date of Expiry: in my possession lost stolen spoiled Ran out of free pages expired Information about your father Date of Birth: Place of Birth: Did your parent die? When and Information about your mother Date of Birth: Place of Birth: Did your parent die? When and Your Permanent residential address Street and No.: Post Code: City: Phone No.:
Page 6 of 7 8 Current/latest place of work: Type of job: emply not working selfemployed retired Company name: Company address: Company telephone No.: Position: Company e-mail: Date of joining: Date of dismissal: 9 Information about your financial situation: Your overall monthly income from all sources: Do you have any other sources of income including relatives and friends? Do you have any bank accounts, securities, stocks, other private property, including those in Russia? Name of bank or organization: Total amount of money you are planning to spend for this trip/ stay/ visit to Russia: How much of this amount are you planning to spend on accommodation and food? 10 Family details: Do you currently have relatives in Russia? Relation degree: Address: Contact telephone number: Will you accompany any children? Place of birth: Your relationship to the child? Your relationship to the parents of the child? Does the child have a passport? Issuing authority: Date of expiry:
Page 7 of 7 11 Family details: Do you have children? Place of birth: Relationship to you? Son Daughter Does the child have a passport? Issuing authority: Date of expiry: Will your child be travelling with you?, in my passport, according to their own passport Do your child reside at a different address than your current address? current address of child: Have you ever been issued a temporary residence permit (TRP) in Russia? What authority was TRP issued by? When? Are you planning to apply for a permanent residence permit (PRP) in Russia? When was your PRP issued The reason it was issued? Do you have a social network account? Name of social network Place / Date Signature applicant