Hey Rick – C1 Bali Visa Application

This service is for the Indonesian C1 Tourist Visa, valid for 60 days for tourism purposes only.

INSTRUCTIONS: Please follow the below instructions carefully.

1 - Please complete all questions below.

2 - If you are applying for more than 1 person, we will request the photos of the other passengers passports and "selfies" once this application has been received. You will receive a SMS from us requesting this information.

3 - If travelling in a group, the below form only needs to be completed by the LEAD PASSENGER of your group

Notes for you

1 - This visa takes a minimum of 5 business days to be processed.

2 - Any additional items will be completed within 3 days of your arrival date.

(Includes - Health Declaration, Customs Declaration, Bali Tourism Tax)

3 - Once completed, you will receive a link to a secure storage drive that will contain all your documents.

4 - If you have be convicted of a criminal offence, your application will be denied by immigration, no refund will be provided.

For urgent visa help outside these hours, please email us: [email protected]

Full Name (as shown on passport) *

Phone Number *

Email Address *

Nationality *

Date of birth *

Passport Number *

Passport Expiry Date *

Mothers full name

Arrival Date in Bali *

Flight Number + Airline *

Port of Entry *

Ngurah Rai - Bali International Airport (Denpasar)

Jakarta

Accommodation Name in Bali *

Accommodation Address in Bali *

Please use Google map address Example - Jl. Werkudara, Legian, Kec. Kuta, Kabupaten Badung, Bali 80361, Indonesia

Upload a copy of your return flight ticket

Upload photos for all passengers: PDF or image. Max 10 MB.

Upload your Passport Photo Page

Upload photos for all passengers: PDF or image. Max 10 MB.

Upload a Passport-Style Photo

Upload photos for all passengers: PDF or image. Max 10 MB.

. Please use a white background with face clearly visable. Example is given below.

Bank Statement / proof of funds

Bank statement of the last 3 months with applicants name

Minimum of USD $2,000 required in the bank

Would you like to add any of these optional services? Note the below options do not impact the speed of processing by Indonesian Immigration.

All Indonesia Customs Declaration - +$10 AUD pp

Bali Tourist Tax (IDR 150,000 / approx. $15 AUD) - +$5 AUD pp

All Indonesia Declaration Information

This section is to be completed if you would like us to complete your All Indonesian Declaration.

Are you currently experiencing any of the following?

Fever

Cough

Difficulty breathing

None of the above

Countries of origin departure, transit and other countries that you visited within 21 days before departure to Indonesia

Are you carrying any animals, fish, plants, and/or their processed products?

Yes

Number of bags travelling with you

Consent checkbox I confirm the information is accurate and I give Hey Rick permission to apply for my Indonesian visa on my behalf. *

I consent

I understand my data will be deleted within 7 days of completion.

I understand my application will not be processed until payment is received. *

I understand

I understand that this is a paid concierge service and does not include the visa fees or other costs unless specified in my payment selection. *

I understand

I understand that Rick’s Team will provide a Stripe payment link via email and WhatsApp. My visa application will not be submitted until payment is received. *

I understand

By completing this form and application for Hey Rick Visa, I agree to the Terms & Conditions listed at www.heyrick.com.au/terms *

I agree