Visa Declaration Form

VISA DECLARATION FORM

This Visa Declaration Form is made and declared on Date: by Applicant Name: and Sponsor/Representative Name: . The parties identify themselves for the purposes of this declaration as set forth below.

RECITALS

WHEREAS, Applicant seeks entry into the receiving jurisdiction for the purpose described in Section 3 below and submits this Declaration to attest to the truthfulness and completeness of the information required for visa processing; and

WHEREAS, Sponsor/Representative has agreed to support Applicant's application by providing information, sponsorship, or facilitation related to Applicant's intended stay and has authority to make statements and provide documents on Applicant's behalf; and

WHEREAS, the parties acknowledge that false statements, omissions, or material misrepresentations may result in denial of the visa, revocation of any issued visa, and administrative or criminal penalties under applicable immigration and criminal laws;

NOW, THEREFORE, in consideration of the mutual covenants contained herein and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, Applicant and Sponsor hereby declare and agree as follows:

1. DEFINITIONS

For purposes of this Declaration, the following terms shall have the meanings set forth below: "Applicant" means the individual identified as Applicant Name above; "Sponsor" means the individual or entity identified as Sponsor/Representative Name above; "Declaration" means this Visa Declaration Form and all attachments that are submitted in support of the visa application.

2. APPLICANT IDENTIFICATION

3. PURPOSE OF VISIT; TRAVEL PLANS

Applicant declares that the primary purpose of the intended entry is:

4. SUPPORTING SPONSOR INFORMATION

5. IMMIGRATION, CRIMINAL AND MEDICAL HISTORY

Has Applicant ever been refused a visa, entry, or had a visa revoked? No Yes

Has Applicant ever been convicted of a crime or subject to criminal proceedings? No Yes

6. REPRESENTATIONS AND WARRANTIES

Applicant represents and warrants that all statements made in this Declaration and in any documents submitted in support of the visa application are true, complete, and correct to the best of Applicant's knowledge and belief. Applicant understands that omission of material facts or submission of false documents may constitute fraud and render Applicant inadmissible under applicable immigration law and subject to civil or criminal penalties.

Sponsor represents that any statements made on behalf of Applicant are made with Sponsor's authority and that Sponsor will notify the relevant authorities and Applicant of any changes in Sponsor's ability or willingness to provide support.

7. CONSENT TO VERIFICATION; RELEASE

Applicant hereby authorizes the verification of any information contained herein, to include but not limited to verification with governmental agencies, educational institutions, employers, and law enforcement records. Applicant consents to release of records and information necessary to verify statements made in this Declaration. Applicant releases and holds harmless any entity that provides information in good faith in response to authorized verification requests.

8. PENALTIES; ACKNOWLEDGMENT

Applicant acknowledges that knowingly making a false statement or concealing material facts in connection with a visa application is punishable by law, including fines and imprisonment, and may result in permanent inadmissibility. Applicant further acknowledges that any visa issued may be revoked if it was obtained by means of misrepresentation.

9. NOTICES

All notices and communications required or permitted under this Declaration must be in writing and delivered to the contact information provided in this form. Notice is effective upon receipt.

10. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Declaration shall be governed by and construed in accordance with the substantive laws of the receiving jurisdiction without regard to principles of conflicts of law. This Declaration, together with any attachments and statements submitted in support of the visa application, constitutes the entire agreement between Applicant and Sponsor with respect to the subject matter herein and supersedes all prior oral or written agreements. If any provision of this Declaration is held invalid or unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect.

11. AMENDMENTS; WAIVER; COUNTERPARTS

No amendment or waiver of any provision of this Declaration shall be effective unless in a writing signed by both Applicant and Sponsor. Failure to enforce any right or provision in this Declaration shall not constitute a waiver of such right or provision. This Declaration may be executed in counterparts, and facsimile or electronic signatures shall be deemed original for all purposes.

12. ATTACHMENTS

The following documents are attached and form part of this Declaration: copy of passport data page, sponsorship letter, proof of funds, travel itinerary, and any additional supporting documents submitted with the visa application. Applicant certifies that attachments are true and correct copies of originals.

CERTIFICATION

By signing below, Applicant and Sponsor each certify under penalty of perjury that the information provided in this Visa Declaration Form and its attachments is true, correct, and complete. Each party further acknowledges receipt of a copy of this Declaration.

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