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Visa Application Statement Letter For All Foreign Citizens

This document is a visa application statement letter for all foreign citizens declaring: 1) They have obtained a health certificate from Singapore stating they are free from Covid-19. 2) They consent to being quarantined by Indonesian authorities if advised by the government and will pay expenses. 3) They will be monitored by health authorities during any quarantine or self-isolation according to regulations. 4) They have health or travel insurance to cover any medical expenses from Covid-19 while in Indonesia.

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Fika Je
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428 views1 page

Visa Application Statement Letter For All Foreign Citizens

This document is a visa application statement letter for all foreign citizens declaring: 1) They have obtained a health certificate from Singapore stating they are free from Covid-19. 2) They consent to being quarantined by Indonesian authorities if advised by the government and will pay expenses. 3) They will be monitored by health authorities during any quarantine or self-isolation according to regulations. 4) They have health or travel insurance to cover any medical expenses from Covid-19 while in Indonesia.

Uploaded by

Fika Je
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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VISA APPLICATION STATEMENT LETTER FOR ALL FOREIGN CITIZENS

I the undersigned,
Name :
Sex :
Place and date of birth :
Nationality :
Passport Number :

Expiry date :

Hereby declare that:

1. I have obtained health certificate issued by health authority in Singapore, stating that
I am free from Covid-19;
2. I am fully consent to be quarantined conducted by the Indonesian Authority whenever
advised by the Indonesian Government at my own expenses at the quarantine facilities
or health service facilities appointed by the Indonesian authority should the PCR test
result shows positive at the point of entry upon arrival or shows any symptoms of
Covid-19 according to the health protocol and Indonesian laws and regulations.
3. I am willingly monitored by the health authority during the quarantine period or self -
isolation according to health protocol and Indonesian laws and regulations.
4. I am in possession of health insurance/ travel insurance which covers all the medical
expenses, and willingly pay the medical expenses at my own expenses should I am
contacted by COVID 19 virus while in Indonesia

This statement is made truthfully and to be used accordingly.

Singapore, ……………….. 2020

( )

*This statement letter is in accordance with the Minister of Law and Human Rights Regulation no 26
year 2020 and the Director General of Immigration Circulation Letter No IMI-1555.GR.01.01 Year
2020

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