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Immigration (Prescribed Forms) Regulations

Commencement: 24 April 1984

IMMIGRATION (PRESCRIBED FORMS) REGULATIONS

Order 13 of 1984
Order 3 of 1989

ARRANGEMENT OF REGULATIONS

1. Disembarkation form
2. Deposit, bond or security form
3. Form of prohibition notice
4. Form of application for permit

5. Form of permit to enter and reside in Vanuatu
6. Form of order of removal from Vanuatu
   

SCHEDULE 1 – Arrival card
SCHEDULE 2 – Deposit, bond or security form
SCHEDULE 3 – Prohibition notice
SCHEDULE 4 – Application for a permit to enter and reside in Vanuatu
SCHEDULE 5 – Permit to enter and reside in Vanuatu
SCHEDULE 6 – Order of removal from Vanuatu

To prescribe certain forms for the purposes of the Immigration Act [Cap. 66].

1. Disembarkation form
Any person who disembarks from an overseas vessel or aircraft at any port of entry into Vanuatu shall complete and sign the form set out in Schedule 1.

2. Deposit, bond or security form
Any foreigner who enters Vanuatu, unless exempted, shall furnish the Principal Immigration Officer with a deposit, bond or other security in the form set out in Schedule 2.

3. Form of prohibition notice
(a) The Principle Immigration Officer shall prevent, with such reasonable force as may be necessary, the disembarkation of any person in respect of whom a prohibition notice has been issued.

(b) A prohibition notice shall be in the form as set out in Schedule 3.

4. Form of application for permit
An application for permit to enter and reside in Vanuatu shall be made in the form as set out in Schedule 4.

5. Form of permit to enter and reside in Vanuatu
A permit to enter and reside in Vanuatu shall be in the form as set out in Schedule 5.

6. Form of order of removal from Vanuatu
An order of removal from Vanuatu shall be in the form as set out in Schedule 6.

SCHEDULE 1

(Regulation 1)

VANUATU GOVERNMENT – IMMIGRATION
ARRIVAL CARD – CARTE DE DÉBARQUEMENT

CAREFULLY COMPLETE ONE CARD PER PERSON IN CAPITAL LETTERS
REMPLIR AVEC SOIN UNE CARTE PAR PERSONNE EN LETTRES CAPITALES

1. SURNAME (FAMILY NAME)

NOM

GIVEN NAMES

PRÉNOMS

2. PASSPORT No.

PASSEPORT No.

ISSUED AT on year

DÉLIVRÉ À le / / année.

3. NATIONALITY

NATIONALITÉ

4. SEX Male Female

SEXE Masculin Féminin

5. DATE OF BIRTH (day) (month) (year)

DATE DE NAISSANCE (jour) / (mois) / (année)

6. COUNTRY OF BIRTH

NÉ(E) A

7. OCCUPATION

PROFESSION

8. COUNTRY OF USUAL RESIDENCE
PAYS DE RESIDENCE HABITUELLE

PERMANENT ADDRESS (CITY/STATE)

DOMICILE PERMANENT (VILLE/REGION)

9. LAST PORT OF EMBARKATION

DERNIER PORT D’EMBARQUEMENT

10. SHIP/FLIGHT NO:
NO. DU VOL OU BATEAU

11. ADDRESS IN VANUATU (NAME HOTEL OR PRIVATE ADDRESS)

ADRESSE À VANUATU (HOTEL OU ADRESSE PRIVÉE)

12. PURPOSE OF TRAVEL; ANSWER A OR B BY ENTERING X IN ONE BOX ONLY

OBJET DU VOYAGE : RÉPONDRE EN A OU B EN MARQUANT UNE SEULE CASE PAR "X".

A. VISITORS ONLY (LESS THAN 4 MONTHS) B. OTHERS (4 MONTHS OR MORE)
(MOINS DE 4 MOIS) (4 MOIS OU PLUS)

TRANSIT / STOP OVER [ ] AN INTENDING RESIDENT
FUTUR RÉSIDENT [ ]
VISITING FRIENDS OR RELATIVES [ ]
VISITE AUX AMIS/PARENTS A RETURNING RESIDENT
RÉSIDENT DE RETOUR [ ]
HOLIDAY/VACATION [ ]

VACANCES

BUSINESSS/OFFICIAL/CONFERENCE
AFFAIRES/OFFICIEL [ ]

OTHER (STATE PURPOSE)
INDIQUEZ AUTRE [ ]

INTENDED LENGTH OF STAY
(NUMBER OF NIGHTS)
DURÉE PROBABLE DU SÉJOUR
(NOMBRE DE NUITS)

DATE OF ARRIVAL
DATE D’ARRIVÉE SIGNATURE

SCHEDULE 2

(Regulation 2)

Immigration Act, Cap. 66

DEPOSIT, BOND OR SECURITY FORM

This is to certify that we, the undersigned,

do hereby declare and affirm that we will stand surety for the repatriation of

to

and any other expenses incurred while awaiting repatriation, as required by the Immigration Act, Cap. 66 until released by the Principal Immigration Officer from this Bond.

Date:

Witness:

SCHEDULE 3

(Regulation 3)

Immigration Act, Cap. 66

PROHIBITION NOTICE

To the master/captain of the vessel/aircraft

I hereby notify you that is this

day of 20 prohibited from disembarking in Vanuatu.

Port Vila/Luganville
Vanuatu

20

Principal Immigration Officer

SCHEDULE 4

(Regulation 4)

Immigration Act, Cap. 66

DEMANDE DE PERMIS D'ENTREE ET DE SEJOUR AU VANUATU
APPLICATION FOR A PERMIT TO ENTER AND RESIDE IN VANUATU

à adresser aux chefs du Service de l'Immigration à Port-Vila (Vanuatu)
to be sent to the Principal Immigration Officer, Port Vila (Vanuatu)

Je soussigné (Nom et prénoms)
I, (Full Name)

demeurant à (Adresse actuelle)
of (Present Address)

Sollicite un permis d'entrée et de résidence à Vanuatu. En cas d'octroi de ce permis, je me propose d'embarquer pour Vanuatu sur le premier (navire/avion) disponible après la date du
do hereby make application for a permit to enter and reside in Vanuatu. If I obtain the required permit I intend to leave for Vanuatu on the first available ship/plane leaving after the day of 20

Renseignements me concernant:
I submit the following particulars concerning myself:

1. Nationalité:

Nationality (country of which citizen or subject):

2. Lieu et date de naissance:

Place and date of birth:

3. Lieu de naissance et nationalité des parents:

Place of birth and nationality of parents:

Père/Father:

(Lieu/place of birth) (Nationalité/Nationality)

Mère/Mother:

(Lieu/place of birth) (Nationalité/Nationality)

4. Dernier lieu de résidence permanente et durée:

Last place of permanent residence and period:

5. Précédents séjours à Vanuatu et durée, du au

Whether previously in Vanuatu. If so, when, from to

6. Avez-vous déjà été expulsé ou refoulé de Vanuatu,

Have you ever been deported from or refused entry to Vanuatu?

7. Situation matrimoniale (célibataire, marié, veuf, divorcé)

Marital state (single, married, or divorced)

8. Si vous êtes marié:

If married, state:

Nom et prénoms du conjoint

Full name of wife/husband:

SCHEDULE 5

(Regulation 5)

Immigration Act, Cap. 66

PERMIT TO ENTER AND RESIDE IN VANUATU
PERMIS D'ENTRÉE ET DE SÉJOUR AU VANUATU

M.

demeurant à
of

est autorisé à entrer et séjourner à VANUATU sous reserve de l'exécution des conditions suivantes:
is permitted to enter and reside in Vanuatu subject to compliance with the following conditions:

1. Dépot d'une somme de VT

That security in the sum of VT be deposited

ou d'un certificat de caution pour cette somme garantie par M.

or a security bond for the sum be lodged by

(Nom et Adresse)

(Name and Address)

2. Exercise de la seule profession ou occupation suivante:

That he engage only in the following occupation or profession:

3. Emploi, a l'arrivée à VANUATU, au service de:

That on arrival in VANUATU he will be employed by:

à charge pour lui de faire savoir au chef du service d'Immigration s'il vient à cesser d'occuper cet emploi.

and will report to the Principal Immigration Officer if he ceases to be so employed.

4. Le présent permit expirera le

This permit will expire on

à moins d'être renouvelé avant cette date.

unless previously renewed.

Fait à Vanuatu le

Granted in Vanuatu the day of 20

Le Titulaire Chef du Service d'Immigration

Signature of Permit Holder Principal Immigration Officer

N.B. Le Chef du Service d'immigration peut dispenser le titulaire de l'une ou de l'ensemble de ces conditions.

Note: The Principal Immigration Officer may strike out all or any of these conditions.

SCHEDULE 6

(Regulation 6)

Immigration Act, Cap. 66

ORDER OF REMOVAL FROM VANUATU

It is hereby ordered that you

(full name)

shall on the be removed from and

remain out of Vanuatu
(length of period)

Dated at Port Vila the day of 20

Minister responsible for Immigration

Table of Amendments

Sched 1 Substituted by Order 3 of 1989