American Express Corporate Services

American Express Corporate Services ADVANCE REQUEST FOR VISAS UNICEF, Travel Services Section

Instructions: This request should be sent through the American Express office, Rm. 565, “WELL IN ADVANCE” of travel. The American Express Visa Section will indicate under “requirements” what documentation is required to process the necessary visas. All visa forms must be completed in full, signed by the applicant and all the instructions therein complied with.

To Be Completed by Staff Member Last day at work/office:

Travelers Name: Nationality: Date of Departure from New York:

Title & Division Ext. Secty. Name & Ext.:

Expiry date of UN Laissez-Passer Expiry date of Ntl. Passport Expiry date of G-4 Re-Entry Visa

Accompanied By Relationship Nationality

Countries for which Visas are Reason for Travel Dates Requirements Requested Official Official From: To: # of entries UNLP Ntl Visa Photos Business Rest Day / Day / PPT Forms Stop- Month Month Over

I certify that the visas requested are required for authorized official travel.

Date:______Staff Members Signature:______