🇲🇬
IMMIGRATION ACT
REPUBLIC OF MADAGASCAR
ARRIVAL/DEPARTURE FORM - Form 1
IMMIGRATION ACT : CAP 25.02
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FOR COMPLETION BY ARRIVALS AND DEPARTURES - IMMIGRATION ACT : CAP 25.02
1 Surname (Family Name)
2 Firstname(s) / Given Names
3 Sex (tick) - Male / Female
Male
Female
4 Date of Birth (day / month / year)
5 Country of Birth
6 Present Country of Residence
7 Nationality of Passport (state country)
8 Passport Number
9 Passport Expiry Date (day / month / year)
10 Number of Accompanying Children under 16 - Male / Female
11 Mode of Travel: (tick one box) Air - Flight No. / Rail / Road - Reg No. / Other - Specify
Road - Reg No.
Air - Flight No.
Rail
Other
FOR COMPLETION BY ARRIVALS ONLY
12 Address in Madagascar
13 Purpose of Entry (tick one box): Returning Resident / Prospective Resident / Employment / Seeking Employment / Visiting Friends/Relatives / Holiday/Tourist / In Transit / Diplomat / Business / Student / Other
Holiday/Tourist
Visiting Friends/Relatives
Business
Employment
Seeking Employment
Returning Resident
Prospective Resident
In Transit
Diplomat
Student
Other
14 Length of intended stay in Madagascar - days/weeks/months
Phone Number (for system)
SUBMIT & GENERATE QR CODE - Form 1 - 🇲🇬 Madagascar
Signature ___________________ Date ___________________