Travel Application
Page Content
ARRIVAL DECLARATION FOR BRUNEI CITIZENS AND PERMANENT RESIDENTS
Jenis Perjalanan:
*
Travel Type:
--Please Select--
Education
Civil servant in service training (returning on Government-sponsored passage)
Civil servant in-service training (returning on Self-sponsored passage)
Official government duty (returning on Government-sponsored passage)
Official government duty (returning on Self-sponsored passage)
Government sponsored medical treatment
Border checkpoint day return
Others
Nama (seperti tertera dalam Pasport):
*
Name (as appears in passport):
Tarikh Lahir:
*
Date of Birth:
Date
Nombor Pasport:
*
Passport number:
Tarikh mansuh Pasport:
*
Date of passport expiry:
Date
Tarikh Pasport dikeluarkan:
*
Date of Passport Issuance:
Date
Nombor IC (bagi yang berumur 12 tahun ke atas):
IC Number (above 12 years old):
Alamat rumah di Negara Brunei Darussalam:
*
Home Address in Brunei Darussalam:
Alamat E-mel:
*
Email Address:
Tarikh ketibaan di Negara Brunei Darussalam:
*
Date of Arrival in Brunei Darussalam:
Date
Jenis Pengangkutan :
*
Mode of Travel:
--Please Select--
Air
Land
Sea
Nombor Pengangkutan yang digunakan (seperti no. penerbangan) (jika ada):
*
Inbound Flight Route / Vessel / Vehicle Registration No:
Kategori Perjalanan :
*
Travel Category:
--Please Select--
Government (Kerajaan)
Private Sector (Swasta) / Personal
Hotel penginapan bagi tujuan pengasingan diri:
*
Declared hotel accommodation for purposes of self-isolation :
--Please Select--
Al-Afiah Hotel
Badiah
Brunei Hotel
Capital Residence
D’Anggerek
Garden Sentral
Grand City Hotel
Higher Hotel
Keoja Hotel
Lanes Hotel
Mulia Hotel
Other Agreed Arrangements
Parkview Hotel
Plaza Sutera Biru
Radisson Hotel
The Rizqun International Hotel
Roomz Hotel
Star Lodge
Swiss Hotel
Tat Place
The Centrepoint Hotel
The Corner House
The Empire Brunei
The Times Hotel
Traders Inn
V-Plaza Hotel
Nota: Hotel penginapan hendaklah ditempah sebelum tarikh ketibaan di Negara Brunei Darussalam. Penjamin/Pemohon hendaklah menghubungi hotel-hotel bagi mendapatkan kadar terkini dan membuat tempahan penginapan. Adalah dinasihatkan untuk membuat tempahan selama 6 hari minima. Tempoh pengasingan diri adalah diantara 2 ke 14 hari tertakluk kepada penilaian risiko kesihatan setelah tiba di Negara Brunei Darussalam.
Note: Hotel accommodation must be reserved before intended date of arrival in Brunei Darussalam. Sponsor/Applicant are required to contact hotels directly to seek information on respective prevailing hotel rates and to proceed with making reservations. It is advised to make a booking of a minimum 6 days. Period of isolation may be 2-14 days depending on health risk assessment upon arrival.
Negara terakhir tempat berlepas:
*
Last Country of Disembarkation:
--Please Select--
AFGHANISTAN
ALAND ISLANDS
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BONAIRE
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, THE DEMOCRATIC REPUBLIC OF THE
COOK ISLANDS
COSTA RICA
COTE D'IVOIRE
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUERNSEY
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HOLY SEE (VATICAN CITY STATE)
HONDURAS
HONG KONG Special Administrative Region, China
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN, ISLAMIC REPUBLIC OF
IRAQ
IRELAND
ISLE OF MAN
ISRAEL
ITALY
JAMAICA
JAPAN
JERSEY
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF
KOREA, REPUBLIC OF
KUWAIT
KYRGYZSTAN
LAO PEOPLE'S DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO Special Administrative Region, China
MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FEDERATED STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT BARTHELEMY
SAINT HELENA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT MARTIN
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA
SEYCHELLES
SIERRA LEONE
SINGAPORE
SINT MAARTEN (DUTCH PART)
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SPAIN
SRI LANKA
STATELESS
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
TANZANIA, UNITED REPUBLIC OF
THAILAND
TIMOR-LESTE
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES MINOR OUTLYING ISLANDS
UNITED STATES OF AMERICA
URUGUAY
UZBEKISTAN
VANUATU
VENEZUELA, BOLIVARIAN REPUBLIC OF
VIETNAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
ZAMBIA
ZIMBABWE
Negara-negara yang telah dikunjungi dalam tempoh 14 hari sebelum tarikh ketibaan di Negara Brunei Darussalam termasuk transit:
*
Countries visited during 14 days prior to arrival in Brunei Darussalam including transit:
Tujuan perjalanan semasa berada di luar Negara Brunei Darussalam:
*
Purpose of Travel Outside Brunei Darussalam:
Tujuan untuk masuk ke Negara Brunei Darussalam:
*
Purpose of Travel to Brunei Darussalam:
Telah memperolehi keputusan ujian COVID-19 PCR sebelum berlepas
*
Obtained pre-departure COVID-19 PCR Test Result:
Yes
No
Nota: Jika keputusan ujian COVID-19 telah diperolehi, adalah dikehendaki untuk menunjukkannya kepada pihak-pihak berkuasa setelah tiba di Negara Brunei Darussalam.
Note: If a COVID-19 Test result has been obtained, you are required to present this to authorities upon arrival in Brunei Darussalam.
EMPLOYING AGENCY
(if relevant)
Nama wakil organisasi / majikan untuk dihubungi:
Agency's individual contact name:
Nota: Hanya diperlukan bagi mereka yang telah membuat perjalanan keluar Negara Brunei Darussalam di atas urusan rasmi / pertugasan.
Note: Only applicable to those who had travelled outside Brunei Darussalam on official or duty travel.
Nombor telefon (bimbit):
Phone Number (mobile):
Nota: Wakil hendaklah dapat dihubungi pada setiap masa.
Note: Contact person must be available to be called at all times.
Alamat e-mel:
E-Mail Address:
Saya mengaku bahawa maklumat-maklumat yang terkandung didalam permohonan ini adalah benar dan betul.
(I hereby declare that the information provided is true and correct.)