2 11572493 Evisa en

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MINISTRY OF LAW AND HUMAN RIGHTS OF THE REPUBLIC OF INDONESIA

DIRECTORATE GENERAL OF IMMIGRATION

B211A
Jakarta, 11/05/2023

Dear,
IRINA WOLFE
DANU HOME STAY, UBUD

We would like to inform you that your visa application has been approved, with the following data:
(This document contains the approval of your visa application, with the following data)
A. VISA DATA
ID/ Application Number : 170436124230186
Visa Type : VISIT
Purpose of Visit : TOURISM
Visa Registration Number : 2A12IM29121MX
eVisa Number : EVX0146855LN
Visa must be used by : 11/08/2023
Length of Stay in Indonesia : 60 DAY

B. APPLICANT DATA
Gender : FEMALE
Place of Birth : USSR
Date of Birth : 28/11/1981
Nationality : RUSSIA
Passport Type : PASPOR
Passport Number : 767080981
Place of Issue : 64003
Passport Expiry Date : 25/03/2032
Address in Indonesia : DANU HOME STAY, UBUD

INFORMATION:
1. Foreign Nationals are required to present the same Travel Document used for the E-Visa application
Immigration Inspectors at Immigration Check Points / Inspections;
2. Foreign Nationals are subject to all Indonesian Laws and health protocols which is being enforced;
3. Stay Permit Extension may be done at a local Immigration Office, nearest to place of residence, when
applicable;
4. Holders of an electronic temporary stay visa (eVisa) with a visa number ending in 'LN' are required to report
to the nearest immigration office within 30 (thirty) days from the date of entry to Indonesia to obtain a
Temporary Stay Permit (ITAS);
5. Holders of an electronic temporary stay visa (eVisa) with a visa number ending in 'DN' are required to
report to the nearest immigration office within 7 (seven) days from the date of visa issuance to obtain a
Temporary Stay Permit (ITAS);
6. For more information, please visit www.imigrasi.go.id.

H.R. Rasuna Said Blok X 6 Kav. 8, Kuningan, South Jakarta . Call Centre 021-1500116

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