Personal and Contact Information
Please enter name exactly as it appears on passport.
*Last Name
*First Name
Middle Name
*Email
*Mobile Number
*Date of Birth
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
*Country of Birth
Select Birth Country
United States of America
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, St. Eustatius, and Saba
Bosnia Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comores Islands
Congo
Cook Islands
Costa Rica
Cote D’Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Fiji
Finland
France
French Guiana
French Polynesia
French West Indies
Gabon
Gambia
Georgia (CIS)
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guinea Bissau
Guinea, Republic of
Guyana
Haiti
Honduras
Hong Kong SAR, China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea - North
Korea, Republic of (South)
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau, China
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
North Macedonia
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Barthélemy
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Vincent and the Grenadines
Samoa (American)
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland (Eswatini)
Sweden
Switzerland
Syria
Taiwan, China
Tajikistan
Tanzania
Thailand
The Vatican (Holy See)
Tibet
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Western Samoa
Yemen
Zambia
Zimbabwe
*City of Birth
*Gender
Select One
Male
Female
*Country of Citizenship
Select One
United States of America
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comores Islands
Congo
Cook Islands
Costa Rica
Cote D’Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark (Including Greenland)
Diplomatic Passport (Gov Business)
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Fiji
Finland
France
French Guinea
French Polynesia
French West Indies
Gabon
Gambia
Georgia (CIS)
Germany
Ghana
Greece
Grenada
Guatemala
Guinea Bissau
Guinea, Republic of
Guyana
Haiti
Honduras
Hong Kong SAR, China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of (North)
Korea, Republic of (South)
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau, China
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
North Macedonia
Norway
Official Passport (Govt Business)
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Samoa (American)
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
St. Vincent and the Grenadines
Sudan
Suriname
Swaziland (Eswatini)
Sweden
Switzerland
Syria
Taiwan, China
Tajikistan
Tanzania
Thailand
The Vatican (Holy See)
Tibet
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United Nations Laissez Passer
Uruguay
US Re-entry Permit
US Refugee Travel Document
Uzbekistan
Vanuatu
Venezuela
Vietnam
Western Samoa
Yemen
Zambia
Zimbabwe
*Passport Number
*Passport Expiration Date
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
*Country of Departure
Select Departure Country
United States of America
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, St. Eustatius, and Saba
Bosnia Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comores Islands
Congo
Cook Islands
Costa Rica
Cote D’Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Fiji
Finland
France
French Guiana
French Polynesia
French West Indies
Gabon
Gambia
Georgia (CIS)
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guinea Bissau
Guinea, Republic of
Guyana
Haiti
Honduras
Hong Kong SAR, China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea - North
Korea, Republic of (South)
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau, China
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
North Macedonia
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Barthélemy
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Vincent and the Grenadines
Samoa (American)
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland (Eswatini)
Sweden
Switzerland
Syria
Taiwan, China
Tajikistan
Tanzania
Thailand
The Vatican (Holy See)
Tibet
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Western Samoa
Yemen
Zambia
Zimbabwe
*US Departure Date
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
Details of Trip to Russia
*Number of Entries
Select One
Single
Double
*Date of Entry
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
*Date of Exit
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
*Second Date of Entry
Required for Double Entry
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
*Second Date of Exit
Required for Double Entry
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
*Cities to be visited
*Hotel Name or Cruise Ship Name
Visa Information
*Consulate where Visa will be processed
Select One
Houston
New York
Washington DC
Payment Method
For security reasons, CIBTvisas will collect payment
after you have submitted your service request.
Learn more about Processing Times and Service Fees
* I hereby give consent and/or have obtained consent for CIBTvisas to share information provided throughout this request for services with Government Authorities, Visa Application Centers, Logistics and Application Support Companies, Invitation Providers and/or Translators/Solicitors to the extent necessary for the provisioning of the requested services.
Learn More
Information shared may include sensitive information (such as race, religion and criminal history) requested by Government Authorities. Your information may need to be transferred outside the EU region to Government Authorities and Logistics and Application Support Companies in the countries for which you have requested travel documentation in order to successfully process your service request. Such countries may not have data protection laws equivalent to countries in the EU. You may withdraw your consent at any time but we will then be unable to complete the provision of the services.
More information about this consent request:
Government Authorities, Visa Application Centers or Invitation Providers may require special information such as ethnicity, race, religion, trade union membership, health related information, biometrics or information about criminal history be provided as part of the application process. When this information is requested, the questions cannot be skipped as part of the application process. CIBTvisas is required to collect this information and send to the Government Authorities in order to successfully complete the process.
Government Authorities, Visa Application Centers, Logistics and Application Support Companies, Invitation Providers and/or Translators/Solicitors are often located outside the EU region. When this is the case, it is necessary for the information to be shared outside the EU in order to successfully complete the process. Many countries outside the EU do not have equivalent data privacy laws. We will use all reasonable care to maintain the confidentiality of such information transferred.
If you withdraw consent, we will terminate any further processing of your information as soon as practicable and notify any third party to whom we have provided this information to cease any further processing. This will not result in any refund of fees paid to date.
For more information about how your data is used, please refer to our Privacy Policy