APPLICATION FOR A STUDY VISA

A study visa may be issued to a foreigner intending to study at a learning institution* in the Republic of South
Africa for longer than three (3) months.
PLEASE PRINT OUT THIS CHECKLIST AND SUBMIT IT WITH THE COMPLETE VISA APPLICATION!
Information regarding means of submitting a visa application and the processing period is available on the
Embassy website (see http://www.suedafrika.org/en/visa-sa-documents/business-hours.html).

The following documentation must be submitted by each applicant.

Please keep / submit the documentation in the order as listed below.
Original machine readable passport
Validity of no less than thirty (30) days after the foreigners intended departure from
the Republic of South Africa.
Passports must have at least two (2) blank pages for endorsements.
The passports of applicants who are not German citizens must contain a valid long
term or permanent residence visa for the Federal Republic of Germany the
original residence card / Chipkarte (accompanied by a photocopy) must be
submitted; applicants who are EU citizens must submit their original
Anmeldebescheinigung (accompanied by a photocopy).
Foreigners who hold non-machine readable passports should contact the Embassy
in Berlin (berlin.consular@dirco.gov.za) or the Consulate-General in Munich
(munich.consular@dirco.gov.za) for further information i.e. specifications of nonmachine readable passports for entry into the Republic of South Africa.
Passport photocopies
Of the passport page with the applicants personal data / photograph.
Of all previous visas for the Republic of South Africa in the passport.
Of second passport, if the applicant holds another passport.
One fully completed application form DHA-1738
Must be downloaded and printed: http://www.suedafrika.org/downloads/DHA1738.pdf.
All questions must be answered in English questions that dont apply may be
completed with n/a.
A fingerprint form is not required to be completed by applicants.
Applicants must provide an email address under Part 4 (may be written below
telephone number).
Contact person under Part 4 refers to someone in Germany.
Proposed date and place of departure for the Republic under Part 5 means the
date and place of departure from Germany.
Full details of the intended duration of stay in, and intended date of departure from
the Republic of South Africa must be completed under Part 5.
The question, Have you ever been refused entry into or deported from the
Republic under Part 7 must be completed with either yes or no, and details
provided, if the answer is yes.
One (1) biometric photograph
Should be a recent photograph, not older than 6 months.
Photographs must be taken and printed professionally photographs printed at
home would be rejected.
An official letter confirming provisional acceptance or acceptance at that learning
institution and the duration of the course
The letter must be dated and signed.
In the case of medical electives, this letter must be issued by the learning institution
/ university and not the (academic) hospital.

Mission

An undertaking by the Registrar or Principal of the learning institution to

i.
provide proof of registration of the student / learner as contemplated in
the relevant legislation within 60 days of registration; or
ii.
in the event of failure to register by the closing date, provide the
Director-General with a notification of failure to register within 7 days
of the closing date of registration;
iii.
within 30 days of de-registration, notify the Director-General that the
applicant is no longer registered with such institution; and
iv.
within 30 days of completion of studies, notify the Director-General
when the applicant has completed his or her studies or requires to
extend such period of study.
This undertaking may be added / included (copied and pasted verbatim) as part
of the above-mentioned official letter confirming provisional acceptance or
acceptance at that learning institution.
In the case of medical electives, this letter must be issued by the learning institution
/ university and not the (academic) hospital.
Proof of medical cover renewed annually for the period of study with a medical
scheme registered in terms of the Medical Schemes Act, 1998
See https://www.medicalschemes.com/MedicalSchemes.aspx for full list of
registered medical schemes in the Republic of South Africa which are accepted for
the visa application.
Proof must be submitted in the form of confirmation / insurance certificate from the
registered medical scheme in the Republic of South Africa, which includes the
applicants particulars and duration (starting and ending dates) of insurance cover
proof of payment / application for insurance is not accepted.
Medical cover by German / overseas health insurance companies is not accepted.
An undertaking by the parents or legal guardian that the learner will have medical
cover for the full duration of the period of study
The undertaking only applies to applicants who are school pupils and must be in the
form of a signed and dated letter in English.
In the case of students / applicants who are adults, such an undertaking is not
required.
In the case of a learner under the age of 18 years
i.
an unabridged birth certificate (ungekrzte Geburtsurkunde) German children and
children born in Germany may submit an international birth certificate and a
photocopy thereof;
ii.
a certified copy of the South African identity document or foreign passport with a
valid temporary residence visa of the learner's guardian in the Republic of South
Africa;
iii.
proof of physical address and contact number of the adult person residing in the
Republic of South Africa, who is acting or has accepted to act as such learner's
guardian, including a confirmatory (signed and dated) letter from that guardian; and
iv.
proof of consent (in the form of a signed and dated letter in English) for the intended
stay from both parents or, where applicable, from the parent or legal guardian who
has been issued with a court order granting full or specific parental responsibilities
and rights or legal guardianship of the learner.
(See also http://www.suedafrika.org/downloads/admission_children.doc)

!
!
!

10

11

12

13

14

Proof of sufficient financial means

Only original documentation is accepted, which shall be in the form of:
a) bank statements (Kontoauszge) of a current account (Girokonto) reflecting
the transactions of the last three (3) months the amount (balance /
Kontostand) shall not be less than the euro equivalent of R3000,00 at the
current exchange rate; applicants with online bank accounts must contact their
bank (head office) to have printed statements authenticated / stamped by the
bank;
b) cash available to the applicant e.g. savings account (Sparbuch) the amount
(balance / Kontostand) shall not be less than the euro equivalent of R3000,00
at the current exchange rate; applicants with online bank accounts must
contact their bank (head office) to have printed statements authenticated /
stamped by the bank;
c) travellers' cheques;
d) an undertaking, supported by a bank statement or salary advice, by a South
African citizen or permanent resident that he or she will be hosting the
applicant and accepting responsibility for the costs related to the maintenance
and removal of the applicant from the Republic of South Africa (a certified copy
of the hosts South African identity document or foreign passport with a valid
long term visa or permanent residence permit should also be included i.e.
submitted); or
e) in the case of learners or students, an undertaking to the learning institution for
payment of all fees and accommodation from a bursary scheme or scholarship
or parents, as the case may be in the case of the applicants parents
providing the written undertaking, it must be in the form of a signed and dated
letter in English and accompanied by certified copies of the parents passport(s)
/ identity document(s) and their bank statements reflecting the transactions
of the last three (3) months.
Photocopies of proof of sufficient financial means
Photocopies are certified and original documentation will be returned to applicants.
If no photocopies are submitted, original bank statements will not be returned to
applicants.
In the case of a foreign state accepting responsibility for the applicant in terms of a
bilateral agreement, a written undertaking from such foreign state to pay for the
departure of the applicant
As no such bilateral agreement exists between Germany and South Africa, this
requirement is not applicable to / required from German students / citizens.
An original police clearance certificate
Must be issued by the police or security authority in each country where the
applicant resided for 12 months or longer after attaining the age of 18 years, in
respect of criminal records or the character of that applicant.
Shall not be older than six months at the time of its submission.
In respect of the police clearance certificate for Germany, the normal certificate
regarding the entries over the last 5 years, which is sent to the applicants private
address, may be submitted.
If there are no entries (Keine Eintragung) on a police clearance certificate for
Germany, it does not have to be translated into English.
A medical report
The prescribed form BI-811 (see http://www.suedafrika.org/downloads/BI811_Medical%20Certificate.pdf) must be used (downloaded and printed).
The prescribed form BI-811 must be completed, signed, stamped and dated by a
registered medical practitioner (e.g. Hausarzt, Internist) with regard to the
applicant's general state of health, detailing any medical condition he or she suffers from.
Shall not be older than six months at the time of its submission.

15

A radiological report
The prescribed form BI-806 (see http://www.suedafrika.org/downloads/BI806_Radiological%20Report.pdf) must be used (downloaded and printed).
The prescribed form BI-806 must be completed, signed, stamped and dated by a
registered radiologist (Radiologe) certifying that the applicant has been examined
and that no signs of active pulmonary tuberculosis could be detected.
Shall not be older than six months at the time of its submission.
Not required in respect of children under the age of 12 years or pregnant women.
If it is unclear that the form was completed / the applicant was indeed examined (xrayed) by a registered radiologist, applicants are required to submit the radiological
findings (radiologischer Befund / Auswertung) from his or her radiologist.
16 In respect of dependent children accompanying the applicant or joining the applicant
in the Republic of South Africa, proof of parental responsibilities and rights or written
consent in the form of an affidavit from the other parent or legal guardian, as the case may
be
(See also http://www.suedafrika.org/downloads/admission_children.doc)
17 In respect of a spouse accompanying the applicant or joining the applicant in the
Republic of South Africa, a copy of a marriage certificate or proof of a permanent
homosexual or heterosexual relationship (see
http://www.suedafrika.org/downloads/Permanent_spousal_relationship.doc)
If a marriage certificate is not in English, it must be translated and certified as a
correct translation by a sworn translator; alternatively, applicants who got married in
Germany may submit an international marriage certificate.
18 A yellow fever vaccination certificate
Only required, if the foreigner travelled or intends travelling from or transiting
through a yellow fever endemic area to the Republic of South Africa.
The certificate shall not be required where that person travelled or intends travelling
in direct transit through such an area.
(See also http://www.suedafrika.org/downloads/Yellow_fever.doc)
19 Proof of payment of the applicable fee
Payment of the application fee must be made through an electronic bank transfer
(see http://www.suedafrika.org/downloads/Application_fee.doc).
A copy of the transfer / deposit slip must be submitted as proof of payment.
Payment must be made at least five working (5) days before submitting the
application.
Payment of the application fee may not be made in cash at the Embassy in Berlin
and Consulate-General in Munich!
20 A DHL envelope (ExpressEasy Prepaid National)
The envelope is required to return the applicants passport.
Applicants may not collect passports in person after the application has been
adjudicated.
The envelope is available for purchase at any post office (Deutsche Post) branch
(see http://www.dhl.de/de/express/filialservices.html#tabs-2).
Applicants must complete their details (address and phone number) under Part 2
(Empfnger) on the DHL envelope, which may be folded, if the visa application is
submitted by post.
Applicants are also advised to keep a record of the tracking number.
FOR OFFICIAL USE (Not to be completed by the applicant)

Applicants name: ......

Application accepted
!
Application not accepted
!
(Please submit this checklist,
if the application will be re-submitted)
Date:
Ref.:

VISUMSANTRAG
Sehr geehrte Damen und Herren,
wir beziehen uns auf Ihre Anfrage und mchten Ihnen mitteilen, dass auslndischen Staatsbrgern, die
keine Inhaber von Reisepssen oder Reisedokumenten, die von der sdafrikanischen Visumspflicht
befreit sind, sind, unterliegen der Visumpflicht und mssen daher bei einer sdafrikanischen
Auslandsvertretung ein Visum beantragen und einholen, bevor sie in die Republik Sdafrika reisen
(Hinweise zu den verschiedenen Visa finden Sie am Ende dieses Dokumentes). Das Visum erlaubt dem
Inhaber, die Reise zur Republik Sdafrika anzutreten und sich am Grenzbergang, z.B. an einem
internationalen Flughafen, bei einem Einreisebeamten zu melden. Die folgenden Unterlagen sind vom
Antragsteller einzureichen:

ein vollstndig (in Grobuchstaben und mit schwarzer Tinte) ausgeflltes Formular
einschlielich eines (1) Passfotos (siehe Formular BI-84);
ein Reisepass im Original mit einer Gltigkeit von mindestens dreiig (30) Tagen ber die
Ausreise aus der Republik Sdafrika hinaus und mindestens zwei (2) leeren Seiten fr
Sichtvermerke (Fremdpsse mssen eine gltige Langzeit- oder Daueraufenthaltserlaubnis fr
die Bundesrepublik Deutschland enthalten; alternativ, kann eine beglaubigte Kopie des
Aufenthaltstitels als Chipkarte eingereicht);
schriftliche Besttigung und/oder Dokumente, die den Zweck und die Dauer des Besuchs
besttigen im Falle eines Urlaubs, ist der Nachweis einer Hotelreservierung oder ein
Einladungsschreiben des Gastgebers in Sdafrika (einschlielich entweder eine Kopie des
sdafrikanischen Personalausweises oder Fremdpass mit einer gltigen Aufenthaltsgenehmigung
fr die Republik Sdafrika) beizufgen;
ein Gelbfieber-Impfschein, falls der Antragsteller aus einem Gelbfiebergebiet in die Republik
Sdafrika einreist; dieser Impfschein ist nicht erforderlich, wenn der Antragsteller in direktem
Transit durch ein solches Gebiet gereist ist;
bezglich minderjhriger Kinder, die den Antragsteller begleiten oder dem Antragsteller in
Sdafrika wieder zugefhrt werden, sind die folgenden Unterlagen einzureichen:
a) ein Nachweis ber die Vormundschaft oder das Sorgerecht im Falle eines minderjhrigen
Kindes, das einem Vormund oder einem Sorgerechts-berechtigten untersteht;
b) Zustimmung des Vormunds im Falle eines unbegleiteten Minderjhrigen;
Nachweis ber ausreichende finanzielle Mittel in Form von
a) Kontoauszgen;
b) verfgbarem Bargeld, einschlielich Reiseschecks;
c) einer Absichtserklrung des Gastgebers in Sdafrika, falls erforderlich ergnzt durch
Kontoauszge oder Gehaltsnachweise, dass er, sollte dies ntig werden, die Kosten fr den
Unterhalt und die Ausreise des Antragstellers bernimmt; und/oder
d) Stipendien im Fall von Schlern oder Studenten;
ein Nachweis ber eine gltige Rckflugreservierung falls der Aufenthalt 12 Monate nicht
berschreitet; Antragsteller die diese Bedingung nicht erfllen knnen, drfen eine Kaution von
767,- hinterlegen, die nach der endgltigen Ausreise des auslndischen Staatsbrgers oder
nach der Ausstellung einer Daueraufenthaltsgenehmigung fr den auslndischen Staatsbrger
zurckgezahlt wird;
ein datiertes und vom Antragsteller unterschriebenes Begleitschreiben, in welchem das
beabsichtigte Rckreisedatum aus der Republik Sdafrika, die Email-Adresse sowie die
Handynummer des Antragstellers aufgefhrt werden;
ein adressierter A5-Rckumschlag (versehen mit 3,50 Porto fr Einschreiben) zur Rcksendung
des mit dem Sichtvermerk versehenen Reisepasses und der Originale der persnlichen
Dokumente;
die nicht rckerstattbare Antragsgebhr von 52,-, wenn zutreffend (siehe Inhaber normaler
Reisepsse oder Reisedokumente, die der Entrichtung von sdafrikanischen Visumsgebhren
unterliegen)

Nur Antragsteller mit Wohnsitz in einem der folgenden Bundeslnder sollten ihre Antrge bei der
Botschaft der Republik Sdafrika in Berlin abgeben: Berlin, Brandenburg, Bremen, Hamburg, Hessen,
Mecklenburg-Vorpommern, Niedersachsen, Nordrhein-Westfalen, Rheinland-Pfalz, Saarland, Sachsen,
Sachsen-Anhalt, Schleswig-Holstein, Thringen.
Die Antragsgebhr und die Barhinterlegung knnen auf das folgende Konto berwiesen werden
(Antragsteller mit einem Wohnsitz in Bayern und Baden-Wrttemberg sollten keine Gebhren auf
dieses Konto berweisen siehe auch u.s. Hinweis mit Kontodaten des Sdafrikanischen
Generalkonsulat in Mnchen):
Kontoinhaber
Kontonummer
Bank
BLZ
Verwendungszweck

: Sdafrikanische Botschaft
: 261 89 24
: Commerzbank AG Berlin
: 100 400 00
: Visum; (Name des Antragstellers)

Fgen Sie bitte dem Antrag eine Kopie des berweisungsbelegs als Nachweis bei. Auerdem sollten die
Barhinterlegung, falls zutreffend, und die Antragsgebhr separat berwiesen werden. Nur Antragsteller,
die Ihren Antrag persnlich bei unserer Dienststelle einreichen, knnen die Antragsgebhr und die
Barhinterlegung in bar bezahlen. Antragsteller, die dies betrifft, sollten jedoch darauf achten, dass sie die
Betrge passend haben, da unsere Dienststelle nicht ber Wechselgeld verfgt.
Mit freundlichen Gren
Konsularabteilung
Botschaft der Republik Sdafrika
Tiergartenstrae 18
10785 Berlin
Fax: 030 22073 202
Email: berlin.consular@foreign.gov.za
Website: www.suedafrika.org

Hinweis:

Die folgenden Arten von Visa knnen ausgestellt werden:

a) Ein Besuchervisum kann einer Person ausgestellt werden, die in die Republik Sdafrika
einreisen mchte, um bei der Einreise eine Besuchergenehmigung (visitors permit) zu
erlangen:
i.
Urlaub
ii.
Geschftsreise
iii.
zum Besuch einer Tagung, einem Seminar oder Sportveranstaltung
iv.
den Verlobten oder Ehepartner zu besuchen
v.
als begleitende Ehepartner und/oder Abhngige von einem Inhaber eines
gltigen visitors permit, study permit, treaty permit, business permit, medical
treatment permit, work permit, or exchange permit
vi.
Studium von nicht lnger als drei (3) Monaten
vii.
rztliche Behandlung von nicht lnger als drei (3) Monaten
viii.
Studienjahr (sog. academic sabbatical) von nicht lnger als drei (3) Monaten
ix.
freiwilligen und gemeinntzigen Ttigkeiten von nicht lnger als drei (3) Monaten
x.
Forschung von nicht lnger als drei (3) Monaten

b) Ein offizielles Visum kann dem Inhaber eines offiziellen Passes ausgestellt werden, der
aufgrund des Diplomatic Immunities and Privileges Act, 2001 Immunitt und Privilegien in
der Republik Sdafrika geniet und beabsichtigt, im Rahmen eines offiziellen Besuches in
die Republik Sdafrika einzureisen;
c) Ein diplomatisches Visum kann dem Inhaber eines diplomatischen Passes ausgestellt
werden, der aufgrund des Diplomatic Immunities and Privileges Act, 2001 Immunitt und
Privilegien in der Republik Sdafrika geniet und beabsichtigt, im Rahmen eines offiziellen
Besuches in die Republik Sdafrika einzureisen;
d) Ein Visum fr Besucher von hohem Rang kann einer Persnlichkeit von hohem Rang und
seinen Angestellten oder bestimmten Mitgliedern seines Haushalts ausgestellt werden, die
die Erlaubnis vom Innenminister (Minister of the Department of Home Affairs) haben, in die
Republik Sdafrika einzureisen und sich dort aufzuhalten, vorausgesetzt, dass diese
auslndischen Staatsbrger nicht beabsichtigen, sich permanent in der Republik Sdafrika
aufzuhalten.
Antragsteller, die beabsichtigen in der Republik Sdafrika zu arbeiten, einschlielich
Pflichtpraktikanten, Monteuren, Journalisten und Drehteams, mssen die Erlaubnis zu arbeiten
mit dem Visumsantrag einreichen (s.
http://www.suedafrika.org/downloads/Authorisation_to_work_on_VP.pdf).
Um sicherzugehen, dass der Antragsteller die Bedingungen seiner Erlaubnis einhlt, kann der
Innenminister (Minister of the Department of Home Affairs) zustzlich zu dem Nachweis ber
finanzielle Mittel von dem Antragsteller eine Barhinterlegung verlangen.
Bei Dokumenten, die dem Antrag beigefgt sind, muss es sich um Originale oder beglaubigte
Kopien handeln, die, falls erforderlich, von einem beeidigten bersetzer ins Englische bersetzt
sind.
Ein vollstndiger Antrag kann entweder per Post an unsere Dienstelle geschickt oder persnlich
whrend der ffnungszeiten (Montag Freitag von 09:00 bis 12:00) dort abgegeben werden.
Wenn ein Visumsantrag bei Einreichung vollstndig ist, betrgt die Bearbeitungszeit 5
Arbeitstage. Daher empfehlen wir Antragstellern, vor Ausstellung des Visums keinen Flug
zu buchen; nur eine Kopie der Flugreservierung muss dem Antrag beigefgt werden.
Unsere Dienststelle darf das Visum eines Antragstellers erst drei (3) Monate vor dem geplannten
Einreisedatum in die Republik Sdafrika ausstellen; wir bitten daher den Antrag nicht vor diesem
Ausstellungszeitraum einzureichen.
Antragsteller, die in Bayern oder Baden-Wrttemberg wohnhaft sind, mssen ihre Antrge an das
sdafrikanische Generalkonsulat in Mnchen senden:
Sdafrikanisches Generalkonsulat
Sendlinger-Tor-Platz 5
80336 Mnchen
Tel: 089 23 11 63 0
Fax: 089 32 11 63 53
Email: munich.consular@foreign.gov.za

Antragsteller aus Bayern und Baden-Wrttemberg, welche ihre Antrge beim Sdafrikanischen
Generalkonsulat in Mnchen einreichen, mssen die zutreffenden Antragsgebhren und
Barhinterlegungen per Bankberweisung auf folgendes Konto einzahlen und dem Antrag eine
Kopie des berweisungsbelegs als Nachweis beilegen (bitte beachten Sie, dass das
Generalkonsulat in Mnchen keine Barzahlung oder Bankschecks akzeptiert):
Kontoinhaber
Kontonummer
Geldinstitut
Bankleitzahl (BLZ)

: Sdafrikanisches Generalkonsulat
: 356 719 900
: Commerzbank AG Mnchen
: 700 800 00

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No. 37679

GOVERNMENT GAZETTE, 22 MAY 2014

(DHA-84) Form 11

DEPARTMENT OF HOME AFFAIRS

REPUBLIC OF SOUTH AFRICA

APPLICATION FOR PORT OF ENTRY VISA OR TRANSIT VISA

[Section 7(1)(g) read with section 10A and 10B; Regulation 8(1)]
NB: A SEPARATE APPLICATION FORM MUST BE COMPLETED IN RESPECT OF
EACH ACCOMPANYING FAMILY MEMBER.
PERSONAL PARTICULARS
Surname:

First names (in full):

Maiden name:

Previous surname(s):
Y

Date of birth:

YY\M MDD

Country of birth:

Gender (write in full)

Nationality:

If acquired by naturalisation, state original

nationality:

Where and when was present nationality obtained:

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STAATSKOERANT, 22 MEI 2014

Passport/Travel Document Number:

No. 37679

Issuing authority:
Date of expiry:

Type of document:
Diplomatic/Official/Ordinary Passport/ Travel
document/other (specify)

Permanent residential address in country of normal residence

Period resident at this address:

Country of permanent residence:

Telephone number: (
Home telephone No
Cellphone No
E-mail address.

Period resident in that country:

Occupation or profession:

Name of Employer, University Organisation.

Address:

Telephone No

Fax No

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129

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No. 37679

GOVERNMENT GAZETTE, 22 MAY 2014

If self-employed, state name, address, telephone no. and nature of business:

Name of business:
Address:

Telephone No
Marital status:

Fax No.:

Never
married

Widowed

Married

Separated

Divorced

First name(s) of spouse:

Maiden name
Date and place of
marriage
Y

N/

Date of birth of
spouse:

Nationality
....

VISIT TO SOUTH AFRICA

Expected date of arrival in the Republic: YY

Place of arrival.

MM

DD.

Purpose of visit:

Duration of stay (months, weeks or days)

Number of entries required:
Single
Two
Multiple

Proposed residential address (physical) in the Republic, including the full name(s) of your host or
hotel:

Residential (physical) Address in the Republic:

Name of Host or Hotel:

Telephone of Host or Hotel:

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STAATSKOERANT, 22 MEI 2014

No. 37679

Names of Organisations or persons you will be contacting during your stay in the Republic:
Address

Name

Relationship

Identity document number or permanent residence permit number of South African host, where
applicable:

Indicate by means of an X whichever is applicable

Have you at any time applied for a permit to settle permanently in the

Yes

No

Have you ever been restricted or refused entry into the Republic?

Yes

No

Have you ever been deported from or ordered to leave the Republic?

Yes

No

Have you ever been convicted of any crime in any country?

Yes

No

Is a criminal action pending against you in any country?

Yes

No

Are you an unrehabilitated insolvent?

Yes

No

Are you suffering from tuberculosis or any other infectious or contagious

Yes

No

Have you ever been judicially declared incompetent?

Yes

No

Are you a member of, or adherent to an association or organisation

Yes

No

Republic?

disease or any mental or physical deficiency?

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GOVERNMENT GAZETTE, 22 MAY 2014

advocating the practice of social violence or racial hatred or are you or have

you been a member of an organisation or association utilizing crime or

terrorism to pursue its ends?

Give particulars if reply to any of the questions above is in the affirmative:

In the case of an official visit, submission of a Note Verbale.

In the case of a diplomat placed in the Republic, proof of placement.

To be completed only by passengers in transit to another country:

Destination after leaving the Republic:
Mode of travel to destination:

Intended date and port of departure from the Republic to that destination:

Do you hold a visa or permit for temporary or permanent residence in the country of your
destination? (Proof must be submitted)

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STAATSKOERANT, 22 MEI 2014

No. 37679

133

(surname and name of applicant) declare that

the above details provided by me are true in substance and in fact and that I fully
understand the meaning thereof;
I understand that should my port of entry visa / transit visa / visitor's visa be approved, I
would not be allowed to change my purpose of visit whilst in the Republic;
I understand that if I need to extend my stay in the Republic for whatever reason, that

such an application will only be accepted if it is submitted at least 30 days prior to the
expiry date of my current visa; and
I understand that if I depart from the Republic after the expiry date of my visa, that I
would be declared an undesirable person and that I would not qualify for a visa or
admission into the Republic for a period of at least

Signature of applicant

Date

FOR OFFICIAL USE

Approved/not approved by

Type of visa:

Reasons for decision:

on

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134

No. 37679

GOVERNMENT GAZETTE, 22 MAY 2014

DOCUMENTATION TO BE SUBMITTED IN SUPPORT OF A VISA NOT EXCEEDING A

PERIOD OF THREE MONTHS
Attached
Yes

Valid passport which expires in no less than 30 days after expiry of the
intended date of departure from the Republic
Proof of sufficient financial means
Proof of a valid return or onward ticket or purchase of ticket.

Documentation outlining the purpose and duration of the visit, or a written

invitation by the host(s) in the Republic, as the case may be.

Where the applicant is attending an activity or event, a letter from the

organisation under whose control the activity or event is taking place,
confirming such attendance and whether or not the foreigner will be
remunerated, and if remunerated, the amount of the remuneration
In respect of a dependent child accompanying the applicant to or joining the

applicant in the Republic(a) proof of consent from one or both parents or legal guardian, as the
case may be, in the form of a letter or affidavit;

(b) Where applicable, a copy of a court order granting the applicant

parental responsibilities and rights in respect of the child;
(c)

A letter from the person who is to receive the child in the Republic,

containing his or her residential address in the Republic where the child
will be residing;
(d) A copy of the identity document or valid passport and visa or permanent

residence permit of the person who is to receive the child in the

Republic; and
(e) The contact details of the parents or legal guardian.

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No

STAATSKOERANT, 22 MEI 2014

No. 37679

Attached

Yes

In respect of medical treatment for a period not exceeding three months(a) A letter from the applicant's registered medical practitioner or medical
institution within the Republic, confirming(i) that space is available at the medical institution;
(ii) the estimated costs of the treatment;
(iii) whether or not the disease or ailment is curable;
(iv) treatment schedule; and
(v) the period of intended treatment in the Republic.
Details of the person or institution responsible for the medical

(b)

expenses and hospital fees: Provided that in the case where the
applicant's medical scheme or employer is not liable for expenses
(c)
(d)
(e)

incurred, proof of financial means to cover the medical costs.

The particulars of the persons accompanying the applicant
A valid return air flight ticket, where applicable
Proof of sufficient financial means or provision for the costs indirectly
related to the treatment.

In respect of studies for a period not exceeding three months-

(a) An undertaking by the Registrar or Principal of the learning institution

to(i)

provide proof of registration of the learning institution as

contemplated in the relevant legislation, within 60 days of
registration;

(ii)

in the event of failure to register by the closing date, provide the

Director-General with a notification of failure to register within 7

(iii)

(iv)

days of the closing days of registration;

within 30 days, notify the Director-General that the applicant is no
longer registered with such institution; and
within 30 days, notify the Director-General when the applicant has
completed his or her studies or requires to extend such period of
study.

This gazette is also available free online at www.gpwonline.co.za

No

135

136

No. 37679

GOVERNMENT GAZETTE, 22 MAY 2014

Attached

Yes

No

In respect of short-term work to be undertaken in the Republic, a letter from

the employer stipulating(a)

the purpose or necessity of the work

(b)

the nature of the work;

(c)

qualification and skills required for the work;

(d)

the duration of the work;

(e)

the place of work

(f)

duration of the visit;

(g)

proof of remuneration or stipend that the foreigner will receive from the
employer; and

(h)

identity and contact details of the prospective employer or relevant

contact person from the host institution.

DOCUMENTATION TO BE SUBMITTED IN SUPPORT OF A VISITOR'S VISA APPLICATION

FOR A PERIOD EXCEEDING THREE MONTHS
Attached
No
Yes

Valid passport which expires in no less than 30 days after expiry of the
intended date of departure from the Republic
A yellow fever vaccination certificate, where applicable.
A medical report.

A radiological report.

Marriage certificate or in the case of a foreign spousal relationship, proof of

official recognition thereof issued by the authorities of the country concerned,
If available.

The affidavit where a spousal relationship to a South African citizen or

resident is applicable, as well as documentation proving cohabitation and the
extent to which the related financial responsibilities are shared by the parties
and setting out the particulars of children in the spousal relationship.
Divorce decree, where applicable.
Court order granting full or specific parental responsibilities and rights, where
applicable.
Death certificate, in respect of late spouse, where applicable.

Written consent from both parents and court order granting full parental
responsibilities and rights parent, where applicable.

This gazette is also available free online at www.gpwonline.co.za

STAATSKOERANT, 22 MEI 2014

No. 37679

137

Attached
Yes
No

Proof of legal adoption where applicable.

Legal separation order, where applicable.

Police clearance certificates in respect of applicants 18 years and older, in

respect of all countries where person resided one year or longer since having
attained the age of 18.
A yellow fever vaccination certificate, where applicable.
Proof of academic sabbatical, where applicable.

Proof of voluntary or charitable activities to be undertaken, where applicable

Proof of research to be undertaken, where applicable

In respect of an application by a person who is the spouse or dependent child

of the holder of a visa issued in terms of section 11, 13, 14, 15, 17, 18, 19, 20

or 22 of the Act, a certified copy of such holder's visa and a written

undertaking of financial responsibility for the applicant.

In respect a teacher at an international school, a contract of employment

signed by the employer and the applicant and a written undertaking of
financial responsibility for the applicant.
In respect of a person involved in the production of a film or advertisement in

the Republic, documentation confirming such production and the duration

thereof.

In respect of a foreign journalist seconded to the Republic by a foreign news

agency, documentation confirming such secondment and the duration thereof.
In respect of a visiting professor or lecturer, an invitation from the host in the
Republic.
In

respect of artists who wish to write, paint or sculpt, documentation

confirming the activity to be undertaken and the duration thereof.

In respect of a person involved in the entertainment industry who would be
travelling through the Republic to perform, confirmation thereof by the host in
the Republic
In respect of a tour leader or host of a tour, a contract of employment signed

by the employer and the applicant and a written undertaking of financial

responsibility for the applicant.

This gazette is also available free online at www.gpwonline.co.za

BI-811

G.P.-S. 017-0194

DEPARTMENT: HOME AFFAIRS

REPUBLIC OF SOUTH AFRICA

MEDICAL CERTIFICATE
CONDITIONS OF A RECURRENT NATURE
Although the person(s) may be generally in a good state of health at the time of the examination, it would
be appreciated if the medical officer / practitioner could furnish details of any disease, condition or defect
the person(s) has / have suffered and which might recur.
I hereby certify that I have examined the following person(s):
1. ...........................................................................

5. .............................................................................

2. ...........................................................................

6. .............................................................................

3. ...........................................................................

7. .............................................................................

4. ...........................................................................

8. .............................................................................

and find him / her / them

(a) not mentally disordered* or physically defective in any way;
(b) not suffering from leprosy, veneral disease, trachoma, or other infections or contagious
(b condition;
(c) generally in a good state of health;
except for the following defects observed:
(Please type or print)

Name of person(s)

Details regarding the disorder, disease or disability, the seriousness thereof and
the treatment, if any, prescribed/recommended

.............................................................

...............................................................................................................

.............................................................

...............................................................................................................

.............................................................

...............................................................................................................

.............................................................

...............................................................................................................

.............................................................

...............................................................................................................

.............................................................

...............................................................................................................

Official stamp and address of medical officer/

practitioner/hospital
................................................................
Signature of medical officer / practitioner

...........................................................................................
...........................................................................................

Date ........................................................
Int. code
290299
300
301
303304
308
310315
320349

...........................................................................................

* Mentally disordered includes the following:

All psychoses.
Neuroses.
Personality disorders.
Addictions.
Behaviour disturbances of childhood.
All forms of mental retardation.
Epilepsy and all other forms of degeneration of the central nervous system.

BI-806

G.P.-S. 017-0044

DEPARTMENT: HOME AFFAIRS

REPUBLIC OF SOUTH AFRICA

RADIOLOGICAL REPORT

Note:
(1) A radiological report of the chest is required in respect of every prospective immigrant
12 years of age and over.
(2) The radiologist must insert the names of the prospective immigrants examined by him in
the space provided for that purpose on the form. Unused spaces must be crossed out.
(3) A separate report is required in respect of every applicant suffering or suspected to be
suffering from tuberculosis.

I hereby certify that I have radiologically examined the chest(s) of the following person(s)
and that I could find no signs of active pulmonary tuberculosis.

Name

(1) ...................................................................................................................................................
(2) ...................................................................................................................................................
(3) ...................................................................................................................................................
(4) ...................................................................................................................................................
(5) ...................................................................................................................................................
(6) ...................................................................................................................................................

........................................................
Radiologist

Official stamp and address of Radiologist/Hospital:

Date ................................................

...........................................................................................
...........................................................................................
...........................................................................................