1625 K Street NW Suite 750 Washington DC 20006 Tel: 888 838 4867 ♦ Email: GEOEX@TravelDocs.com

Visa requirements shown below are for U.S. citizens. Nationals of all other countries please contact Pinnacle Travel Document Systems directly for specific requirements for your itinerary.

Visa # # Cost Late Req’d Forms Photos Per Visa Fee

Mozambique-Single 1 2 $244.00 $100.00 Mozambique-Multi 1 2 $254.00 $110.00

Zambia-Single 2 2 $169.00 $95.00 Zambia-Double 2 2 $199.00 $95.00

You will need to enclose your actual passport along with the number of completed visa application forms and photographs indicated above for each country. Please also enclose two (2) clear photocopies of the vital information page of your passport. Photographs should be recently shot passport-type color photos with a clear background approximately 2” x 2” in dimension. (Note that machine or home digital photographs are not acceptable and photographs must be different than those in your current passport.) Your passport must generally be valid for a minimum of six (6) months beyond the completion of your travel unless otherwise indicated above. Contact PTDS directly for assistance with the renewal of your U.S. passport as this can easily be done at the same time that your visas are being processed. Applications for individual countries must be received in our offices no fewer than 30 days prior to your departure from your shipping address. (Contact PTDS directly regarding deadlines for requests that include more than one country.) Documents received after the deadline will be subject to the per person late fees shown for each country. Please contact PTDS before submitting documents you expect may be received substantially after the deadline as there may be special requirements and/or additional fees associated with processing your request. It may not be possible to cancel processing of your applications once they have been submitted.

In addition to the per person combined service and consular fees shown above please include $30.00 to cover the FedEx return of your passport(s) within the continental U.S. ($30.00 for all other U.S. and Canadian addresses.) We also strongly recommend that you use FedEx or another form of traceable shipping to forward your documents to our offices.

Please note that consular fees, shipping fees and application requirements are subject to change without notice. Check or credit card payment accepted. Credit card payment subject to 3.5% surcharge.

Visas for Malawi are valid for 30 days from the date of issue. Due to the short validity of the Malawi visa your passport will be returned to you no earlier than 15 days prior to your

departure. Photographs for Zambia must be signed on the back. PLEASE NOTE THAT SOUTH AFRICA REQUIRES THAT YOU HAVE ONE SET OF FACING BLANK VISA

PAGES FOR EACH ENTRY.

Malawi-Single 2 2 $184.00 $40.00

PLEASE BE CERTAIN TO RETURN THE FOLLOWING TO: Pinnacle Travel Document Systems 1625 K Street NW Suite 750 Washington DC 20006

♦ Your actual passport (Please keep a photocopy for your records.) ♦ This completed form ♦ Two (2) photocopies of the vital information page of your current passport ♦ Total number of completed visa application forms per person indicated ♦ Total number of passport-type color photographs per person indicated

♦ Credit or debit card authorization below

PLEASE PRINT CLEARLY

Full Name (1):_____________________________ Full Name (2): _____________________________

Passport #:____________________ Exp:___/___ Passport #:____________________ Exp:___/___ Mo Y r Mo Y r

Home ________________________________ Home Tel: ________________________________

Mailing ________________________________ Work Tel: ________________________________

Address: ________________________________ Email: ____________________________________

________________________________ Date of Departure from Home: ____/____/_____ (FedEx cannot deliver to PO boxes) Mo nt h Da y Ye a r

Address ________________________________ Custom Southern Africa

For the ________________________________ Date of Tour Departure: / / Mo nt h Da y Ye a r Return of ________________________________ Date of Entry to Malawi: ___________________

Passport: ________________________________ Special Instructions:_______________________

Tel: ________________________________ _________________________________________

Please indicate below if there are known periods prior to your tour during which you will need your passport for another international tr ip or when you will not be available to sign for the return of your passport. I wil l need my passport(s) for other international travel from _____/____/_____ to _____/____/_____ Mo nt h Da y Yea r Mo nt h Da y Yea r

I wil l not be at my home and/or return shipping address from _____/____/_____ to _____/____/_____ Mo nt h Da y Yea r Mo nt h Da y Yea r

CREDIT CARD AUTHORIZATION: AMEX / V ISA / MC (please circle one)

Cardholder Name:_____________________ Signature:______________________ Bi l l ing Zip Code: _____________

Card #: ______________________________CID#______________ Expires: ____/___ Amount: US$ _________ Mo Y r F O R O F F I CE US E O NL Y

GEOEX CUSTOM S.AFRICA (ZAMB-SING90DBL120/MOZAMB-SING165MULTI-185/MALAWI105)79 FX 30 2PGS VAL6MOS DL30 DYS 40.00 3.5% TE MALAWI 30 DAYS

2017 Pinnacle Travel Document Systems

IMPORTANT NOTICE REGARDING PASSPORT PAGES & VALIDITY:

You must have at least one (1) completely blank unused visa page available in your passport for each country you are visiting that requires a visa not including the pages at the back of your passport reserved for amendments and endorsements. You should also have at least one (1) additional blank page to accommodate entry/exit stamps for those countries that do not require a visa or two sets of facing blank visa pages if entering South Africa. In addition, your passport must be valid for at least six (6) months beyond completion of your international travel. If you are a U.S. citizen and need to renew your passport Pinnacle Travel Document Systems can easily assist you with this at the same time your visas are being processed. The total additional fee for this service (including U.S. government expediting fees) is $276.00 for passport renewals and second passports. We can also assist you with expediting first time passport applications.

You will need to complete an application form and a letter of authorization for PTDS and must send your actual passport to us. Specific requirements and the necessary forms are available for download from our Internet site:

Passport Renewals

First Time Passports Second Passports

WWW.Traveldocs.com/PTDSPassports

You may also contact us via email or phone at GEOEX@PinnacleTDS.com

or 888-838-4867 and we will send you an instruction kit.

EMBASSY OF THE REPUBLIC OF ZAMBIA 2419 Massachusetts Avenue, Telephone: (202) 265-9717 NW Washington, DC 20008 Facsimile: (202) 332-0826 E-mail: embzambia@aol.com www.zambiaembassy.org

VISA APPLICATION FORM

1. Surname: 2. First Name: Middle Name:

3. Date of Birth: Place of Birth:

4. Nationality: Sex:

5. Profession: Business Telephone No. ( )

6. Nationality of Parents at time of Birth:

7. Passport No.

Date of Issue:

8. Place of Issue:

Date of Expiration:

9. If accompanied by your spouse or children, give the following particulars: (Note: Every applicant fills out an individual form) Full Name (s) Date & Place of Birth Relationship

10. Present Address: Telephone No. ( ) Email: 11. Permanent Address:

Telephone No. ( ) Email: 12. (a) Type of Visa Requested: Tourist ( ) Business ( ) Church Business ( ) Visitor ( ) Diplomatic ( )

Official ( ) Student ( ) Transit ( ) Volunteer ( ) Courtesy ( )

(b) Entry requested: Single ( ) Double ( ) Multiple (x )

(c) Date of entry into Zambia: ______________________________

(d) Length of Stay in Zambia: _____ __________________________

13. Final Destination of Journey in Zambia: Address in Zambia:

14. Expected Departure Date from Zambia: Next Destination from Zambia:

15. Duration and Particulars of any previous residence or visits in Zambia:

16. If traveling on business, please list names and addresses of persons to be visited in Zambia:

17. If visiting relatives or friends, please list names and addresses of persons to be visited in Zambia:

18. Signature of Applicant:_______________________________________________________ Date:__________________ For official use only: Date Tag # Visa fee Rush Fee Payment Visa # Receipt# Notations

Rev. 04/2006

DOE Jonathan Bonham

13 MAR 1961 Los Angeles CA USA USA Male

Engineer 987 654-0123 USA

0123456789

1 0MAY 2005

US Dept of State

09 MAY 2015

COMPLETE AS APPLICABLE

1234 Main Street Anywhere CA 98765987 654-3210 JDoe@anywhere.net

SAME AS ABOVE

PER YOUR ITINERARY

PER YOUR ITINERARY

PER YOUR ITINERARY PER YOUR ITINERARY

PER YOUR ITINERARY PER YOUR ITINERARY

COMPLETE IF APPLICABLE

LEAVE BLANK

LEAVE BLANK UNLESS APPLICABLE

PLEASE DO NOT FORGET TO SIGN & DATE BOTH YOUR APPLICATIONS

GEOEX

✔

PLEASE STAPLEONE (1) COLORPHOTO SIGNEDON THE REVERSEHERE ON BOTHCOPIES OF YOURAPPLICATION

✔

DOE JONATHAN BONHAM

MARRIED FEMALES LOS ANGELES, CA USA

13 MAR 1961 M MARRIED USA

0123456789 17 05 2005 16 05 2015 USA

ENGINEER MANAGER

ABC INTERNATIONAL INC

1234 MAIN STREET, ANYWHERE CA 98765

✔

✔

LEAVE BLANK UNLESS YOU HAVE BEEN A PAST RESIDENT OF MOZAMBIQUE

LEAVE BLANK UNLESS PAST RESIDENT

TOURISM-PREPAID TOUR

PER YOUR ITINERARY PER YOUR ITIN PER YOUR ITIN

PER YOUR ITINERARY PER YOUR ITINERARY

LEAVE BLANK LEAVE BLANK PER YOUR ITIN PER YOUR ITIN N/A

AS APPLICABLE

PLEASE DO NOT FORGET TO SIGN AND DATE YOUR APPLICATION

JOHNATHAN BONHAM DOE

MARRIED

PER YOUR ITINERARY (ADDRESS IN MALAWI)

1234 MAIN STREET

ANYWHERE, CALIFORNIA USA

MARCH 13, 1961 LOS ANGELES, CALIFORNIA USA

MALE RETIRED

987654321 FEBRUARY 12, 2010

US DEPT OF STATE FEBRUARY 11, 2020

NOT APPLICABLE NOT APPLICABLE

USA

PER YOUR ITINERARY (DATE OF ENTRY TO MALAWI)

PER YOUR ITINERARY (WHERE ARE YOU TRAVELING TO MALAWI FROM)

PER YOUR ITINERARY (WHERE ARE YOU GOING AFTER MALAWI)

PER YOUR ITINERARY (HOME ADDRESS HERE)

TOURISM

PER YOUR ITINERARY

PER YOUR ITINERARY PER YOUR ITINERARY

AIRPLANE (MEANS OF TRANSPORTATION WHEN LEAVING)

PRE-PAID TOUR

N/A

N/A (DATE YOU PREVIOUSLY TRAVELED TO MALAWI)

N/A

N/A (DATE YOU PREVIOUSLY TRAVELED TO MALAWI)

N/A

N/A

PER GEOEX PER GEOEX

NOT APPLICABLE

PLEASE DO NOT FORGET TO DATE AND SIGN YOUR APPLICATIONS.

EMBASSY OF THE REPUBLIC OF ZAMBIA 2419 Massachusetts Avenue, Telephone: (202) 265-9717 NW Washington, DC 20008 Facsimile: (202) 332-0826 E-mail: embzambia@aol.com www.zambiaembassy.org

VISA APPLICATION FORM

1. Surname:

2. First Name: Middle Name:

3. Date of Birth: Place of Birth:

4. Nationality: Sex:

5. Profession: Business Telephone No. ( )

6. Nationality of Parents at time of Birth:

7. Passport No.

Date of Issue:

8. Place of Issue:

Date of Expiration:

9. If accompanied by your spouse or children, give the following particulars: (Note: Every applicant fills out an individual form) Full Name (s) Date & Place of Birth Relationship

10. Present Address: Telephone No. ( ) Email:

11. Permanent Address:

Telephone No. ( ) Email: 12. (a) Type of Visa Requested: Tourist ( ) Business ( ) Church Business ( ) Visitor ( ) Diplomatic ( )

Official ( ) Student ( ) Transit ( ) Volunteer ( ) Courtesy ( )

(b) Entry requested: Single ( ) Double ( ) Multiple (x )

(c) Date of entry into Zambia: ______________________________ (d) Length of Stay in Zambia: _____ __________________________

13. Final Destination of Journey in Zambia:

Address in Zambia:

14. Expected Departure Date from Zambia:

Next Destination from Zambia:

15. Duration and Particulars of any previous residence or visits in Zambia:

16. If traveling on business, please list names and addresses of persons to be visited in Zambia: 17. If visiting relatives or friends, please list names and addresses of persons to be visited in Zambia: 18. Signature of Applicant:_______________________________________________________ Date:__________________ For official use only: Date Tag # Visa fee Rush Fee Payment Visa # Receipt# Notations

Rev. 04/2006

PEDIDO DE ENTRADA EM MOCAMBIQUEREQUEST FOR ENTRY VISA TO MOZAMBIQUE

RECIBO №

PREENCHER COM LETRA LEGIVEL TO BE FILLED IN LEGIBLE LETTERS

VISTO №

UMA ENTRADA Single entry

DATA DE EMISSAO

......../�..../ ��.. DUPLAS ENTRADAS Double entry

VALIDADE

MULTIPLAS ENTRADAS Multiple entries

RESERVADO AOS SERVICOS: FOR OFFICIAL USE:

��./�.../ ���

APELIDO Surname

NOME COMPLETO Full name

NOME DE SOLTEIRA Maiden name

PAIS E LOCAL DE NASCIMENTO Country and place of birth

DATA DE NASCIMENTO Date of birth

SEXO Sex

ESTADO CIVIL Marital status

NACIONALIDADE Nationality

PASSAPORTE № Passport №

DATA DE EMISSAO Date of issue ���/���/ ���.

Validade Validity ���/���/ ���.

NACIONALIDADE DO P.te P.te nationality

PROFISSAO/OCUPACAO Profession/Occupation

CARGO QUE OCUPA Position you hold

INSTITUICAO, ORGANIZACAO OU EMPRESA ONDE TRABALHA Institution, organization or firm you work ENDERECO DA RESIDENCIA PERMANENTE Address of the permanent residence ESTEVE ALGUMA VEZ EM MOCAMBIQUE ? SIM NAO Have you ever before been in Mozambique ? Yes No JA FOI RESIDENTE EM MOCAMBIQUE ? SIM NAO Have you ever been a resident in Mozambique ? Yes No PORQUE SAIU DE MOCAMBIQUE ? DATA DE SAIDA Why did you leave Mozambique ? Date of exit } ���./���../ ����. INDIQUE AS INSTUICOES E EMPRESAS A QUE ESTEVE LIGADO Mention the institutions and firms to which you were attached

O PREENCHIMENTO INCORRECTO OU INCOMPLETO IMPLICA RESPOSTA TARDIA, DEVOLUCAO

OU INDEFERIMENTO INCOMPLETE OR INCORRECT FILLING IN OF THIS FORM MAY RESULT IN DELAY DEVOLUTION

OR REJECTION

DETALHE OS MOTIVOS DA ENTRADA EM MOCAMBIQUE In detail give reasons for your entry in Mozambique TEMPO DE ESTADA EM MOCAMBIQUE Length of stay in Mozambique

DATA DE ENTRADA Date of entry ���./���./ ����

DATA DE SAIDA Date of exit ���./���./ ���

FRONTEIRA DE ENTRADA Entry border

FRONTEIRA DE SAIDA Exit border

ENDERECO DA HOSPEDAGEM EM MOCAMBIQUE � Address of residence in Mozambique

PROVINCIA Province

DISTRITO

District

CIDADE

City

AVENIDA/RUA

Avenue/street

CASA № House №

FAMILIARES/AMIGOS RESIDENTES EM MOCAMBIQUE � Relatives, friends living in Mozambique

NOME COMPLETO

Full name

NACIONALIDADE

Nationality

PARENTESCO

Relationship

ENDERECO

Address

RESERVADO AOS SELOS

Reserved for stamps

DATA ...................................................................................................................................... Date } ���./���./ ���.. ASSUNATURA DO REQUENTE OU DA ENTIDADE SOLICITANTE Signature of applicant or of the applying entity ASSINATURA RECONHECIDA POR SEMELHANCA A EXISTENTE NO ��������������������... № ��������.. EMITIDO A ........../���/ ���� EM ������������������������

RESERVADO AOS SERVICOS For official use

DATA DE RECEPCAO

........../���/ ���.

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

ASSINATURA DO FUNCIONARIO

DATA DE ENTREGA

........../���/ ���.

GEOEX

TOURISM

PRE-PAID TOUR

GEOEX