DEMANDE DE VISA VISA APPLICATION (veuillez remplir très lisiblement) (please fill in legibly)

Name: First names: Visa №:………………………………….. Nom Prénoms

Date of birth: Place of birth: Né le, à

Nationality original: Nationalité d’origine

current: actuelle

Marital status: Children (number): Situation de famille Enfants (nombre)

Current residence (exact address): Résidence actuelle (adresse exacte)

Phone number: landline / fixe: Numero de téléphone mobile/ portable:

Email:

Profession / profession:

Employed by / employé chez:

Date of entry to Djibouti / Date d’entrée à Djibouti:

Duration of the visa requested: Days Durée du Visa sollicité jours

Transit to: with a stopover of days Transit à destination de avec un arrêt de jours

Type of visa applied for / Nature du Visa sollicité:

Official Business Tourist family visit Officiel business touriste visite familiale

Detailed reasons for the trip: Motifs détaillés du voyage

Have you ever been in the Republic of Djibouti for more yes/oui Specify on which date: than three months without interruption? no/non Précisez à quelle date Avez-vous déjà habité en République de Djibouti pendant plus de trois mois sans interruption?

If it is a business trip, provide the name and full address (s) of the business owner you wish to meet. / Indiquez avec précision es noms et adresses complète des commerçants ou industriels que vous désirez rencontrer s’il s’agit d’un voyage d’affaires :

RÉPUBLIQUE DE DJIBOUTI REPUBLIC OF DJIBOUTI MINISTÈRE DES AFFAIRES ÉTRANGERES ET MINISTRY OF FOREIGN AFFAIRS AND DE LA COOPERATION INTERNATIONALE INTERNATIONAL COOPERATION AMBASSADE DE DJIBOUTI AU PRÈS DE LA EMBASSY OF THE REPUBLIC OF DJIBOUTI RÉPUBLIQUE FÉDERAL D’ALLEMAGNE À BERLIN IN THE GERMAN FEDERAL REPUBLIC IN BERLIN

Passport number / Passport № :

Date of issue / Délivré le :

Issuing authority / Par :

Valid until / Valable jusqu’au :

ID card number / Carte d’identité №:

Date of issue / Délivrée le :

Issuing authority / Par :

Valid until / Valable jusqu’à :

…………………..….......................................................

Photo

Are you travelling alone or together with family members? yes / oui Voyagez-vous seul ou avec des membres de votre famille? no / non

If yes, provide their names and first names: Si oui, indiquez leurs noms et prénoms

Family ties in Djibouti (complete addresse) / Attaches familiales en République de Djibouti (exactes adress):

Place of entry into the Republic of Djibouti: Indication précise de lieu d’entrée en République de Djibouti

Place of departure from the Republic of Djibouti: Indication précise de lieu de sortie de République de Djibouti

Your exact address(s) during your stay in the Republic of Djibouti: Indication de vos adresses exactes en République de Djibouti pendant que vous y séjournerez

Do you intend to set up a trading company or an industrial company in the Republic of Djibouti? Comptez-vous installer en République de Djibouti un commerce ou une industrie?

Approval of both guardians or parents

We agree that a visa is issued to our child and confirm that we are the guardians on the basis of the documents and signatures we have provided. L’AUTORISATION DES REPERSENTANTS LEGAUX POUR MINEUR NON EMANCIPÉ

Nous autorisons l’établissement d’un visa en faveur du mineur et déclarons sur l’honneur avoir le plein exercice de la puissance paternelle à l’égard de cet enfant: Documents / Preuves::

In / à , the / le Signature / signature ..................................................................... I agree not to accept any paid or au pair job During my stay in the Republic of Djibouti, not to seek to settle there permanently and to leave the territory of Djibouti at the expiry of the visa which will be granted to me eventually. Je m’engage à n’accepter aucun emploi rémunéré ou au pair Durant mon séjour en République de Djibouti, à ne pas chercher à m’y installer définitivement et á quitter le territoire djiboutien à l’expiration du visa qui me sera éventuellement accordé. My signature is binding and makes me the subject of criminal prosecution and / or expulsion in case of false statements, which will result in the refusal of a visa in the future. Ma signature engage ma responsabilité et m’expose, en sus de poursuites prévues par la loi en cas de fausse déclaration, à me voir refuser tout visa pour l’avenir.

In / à , the / le Signature / signature .....................................................................

Avis du chef de mission : ……………………………………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………………………………..,

Embassy of the Republic of Djibouti, Kurfürstenstrasse 84, D-10787 Berlin, Tel.: +30-26390157, secretary@djibouti-embassy.de (Visa Section)

Cadre réservé à l’administration

Nom : …………….…………….…………….………………..Prénom :…………………………………………………….

Numéro du visa …………….…………….…………….…….Numéro du passeport……………………………………...

Nature du visa : …………….…………….…………………..Date de délivrance : …………….…………….…………..

Date d’expiration : …………….…………….………………..Nombre d’entrées autorisées : …………….…………….

Durée de chaque séjour: …………….………………….

Additional information for the visa application for the Republic of Djibouti (Updated October 10 2019) 1. For all travelers:

Every traveler from Germany to the Republic of Djibouti receives his visa from the Djiboutian Embassy in Berlin. The visa is no longer issued at the

airport in Djibouti. The processing of a visa application takes a maximum of four working days, but usually a visa is issued within 24 hours.

A complete visa application consists of the following documents:

• two passport photos

• two completed application forms!

• Your passport with a validity of at least 6 months

• a confirmation of your accommodation (Hotel booking or „lettre d'hébergement“, see section 5.)

• a confirmation of your return flight (e.g. copy of the plane ticket)

• Please indicate the purpose of your journey, the place of your entry, and in case of transit, your final destination (see application form).

The fees for visas are as follows:

• 10 € for a visa with a duration of 1-14 days;

• 20 € for a visa with the duration of 15 - 90 days.

Please transfer the fee to the account of the Embassy of the Republic of Djibouti at Deutsche Bank:

Account number: 4391009, BLZ: 10070000 or IBAN: DE65 100 700 000 439100900, BIC: DEUT DE BBXXX,

Purpose of use: v i sa fees .

As an applicant, you do not have to appear in person at the embassy, but you can send us your visa application by registered mail. For the return

please transfer additionally the postage for the return! Please inform yourself on our website about the height of the postage within Germany and/or to

Austria, Poland and the Czech Republic.

enclose a stamped envelope (by registered mail) with your address. We also ask you to use a dust jacket for your passport.

2. Holder of service passports:

For a business trip with a service passport, the visa is free of charge. Diplomats, business travelers or transfer passengers need a verbal note for the

visa.

3. Entry visa for minors: Minors traveling alone require an attached notarized permit from both parents for the visa. When traveling with one parent, the notarized permission

of the second parent is required.

4. Entrepreneurs and business travelers:

As a business traveler, please enclose with your visa application a signed letter regarding your mission, an invitation from your business partner and

the confirmation of a hotel reservation or other accommodation.

5. Holder of a "Passport for refugees": As the holder of a travel document for refugees, please attach a letter of invitation, a so-called "lettre d'hébergement", which was issued by the

"District de Djibouti" to your visa application. Your family or friends in Djibouti, you will stay with have to apply in time for this letter of invitation. In the

invitation letter, your name and passport number must be written exactly and exactly as in your "Travel document for refugees". With this

information, the letter of invitation is issued in Djibouti.

Thank you for your interest in the Republic of Djibouti.

With best wishes,

the Visa-Section of the Embassy of the Republic of Djibouti

OBLIGATION OF ENTRY REQUIREMENTS

For the entry from Germany to Djibouti

Since November 2020 new entry regulations apply for entry into the Republic of Djibouti. From now on, entry

is only possible with a negative PCR test not older than 72 hours, which you must present to your airline

before departure.

I hereby confirm that I have read and understood the content of the obligation:

First Name, Name ______________________________

Passport number ______________________________

Date, signature ______________________________

Unité – Egalité – Paix

Embassy of the Republic of Djibouti

in Germany

Ambassade de la République de Djibouti

en Allemagne