Embassy of Uruguay
Tokyo
1. First name (Given name): 2. Surname (Family name):
3. Nationality: Gender: M F
4. Place of birth: City: Country:
5. Date of birth: Occupation:
6. Address:
7. Marital Status: Spouse name:
8. Email:
9. Travel documentation:
(Example: Normal Passport A123456) Please attach a copy
TYPE: Number: Date of issue:
Issued by: Expiration date:
10. Do you need a multiple entry visa?
Yes No
11. Reason for necessity of multiple entry visa:
12. For foreigners in Japan, type of qualification of stay:
(Example: permanent resident, or tourist, etc.)
Please fill in this form in English and preferably digitally.
Afterwards send it via mail, fax or courier.
This form must be accompanied by one of the “B” forms (B1, B2 or B3).
Diplomatic and Official Passports holders only need to send “A” forms.
Embassy of the Oriental Republic of Uruguay
