US Embassy Visa Fee Payment Through Standard Chartered Bank

Step 1 :

• Fill in the date. • Fill in the applicant’s Passport number. • Fill in the applicant’s name (as shown in the Passport). If the name is longer than the available space, truncate the name and just fill in the available space. • Fill in the payer’s contact number (could be applicant’s and/or payer’s contact number).

Step 2 :

The teller will confirm the Rupiah value of USD 131 based on the exchange rate provided by the U.S. Embassy for this purpose. After that, the teller will write down the total amount in Rupiah.

Step 3 :

Please check whether all information is accurate on the deposit slip. Then give it back to the teller.

Step 4:

The teller will validate all information and will sign and print out the validated transaction on the deposit slip.

Step 5 :

Please keep this deposit slip carefully and put it together with all other documents for your visa application. The original deposit slip will be your valid evidence that the visa fee has been paid.

Standard Chartered Bank participating branches for U.S. Embassy Visa payment are as follows:

Jakarta - Satrio - Kelapa Gading Menara Standard Chartered Jl. Raya Bulevar Barat Lantai Dasar Blok LC 6 No. 24 Jl. Prof. DR. Satrio No. 164 Jakarta 14240 Jakarta 12930 Tel: +6221 - 4585 3385 Tel: +6221 - 57 999 000 Fax: +6221 - 4585 3370 Fax: +6221 - 5790 1272 Jakarta - Pluit Jakarta - Kebon Jeruk Ruko Mega Mal, MG 33 Graha Multi Jl. Pluit Indah Raya Jl. Panjang No. 55 Jakarta 14450 Jakarta 11530 Tel: +6221 - 668 3925 Tel: +6221 - 5367 4775 Fax: +6221 - 668 3551 Fax: +6221 - 5367 4746

Jakarta - Pondok Indah Pondok Indah Plaza V Jl. Marga Guna Raya Blok C No.1 Jakarta Selatan 12310 Tel: +6221 - 726 4755 Fax: +6221 - 726 4757

Semarang Jl. A. Yani 155A Menara Standard Chartered Bank Semarang 50010 Jl. No. 63-65 Tel: +6224 - 841 0000 Surabaya 60271 Fax: +6224 - 845 1111 Tel: +6231 - 532 0311 Call Center: +6224 - 845 0188 Fax: +6231 - 535 5371 / 545 8862

Medan Denpasar Jl. Imam Bonjol No. 17 Jl. 2-4 / Ruko 9-12 Medan 20151 Denpasar - Bali 80114 Tel: +6261 - 4512 000 / 453 8800 Tel: +62361 - 223 700 Fax: +6261 - 451 0550 Fax: +62361 - 223 737 Call Center: +6261 - 457 2888 Call Center: +62361 - 244 888

US Embassy Visa Fee Payment Through Permata Bank

Step 1 :

• Fill in the date. • Fill in the applicant’s passport number. • Fill in the applicant’s name (as shown in the passport). If the name is longer than the available space, truncate the name and just fill in the available space. • Fill in the payer’s contact number (could be applicant’s and/or payer’s contact number).

Step 2 :

The teller will confirm the Rupiah value of USD 131 based on the exchange rate provided by the U.S. Embassy for this purpose. After that, the teller will write down the total amount in Rupiah.

Step 3 :

The teller will input all of the information and then will print a white receipt for you to check for correct information. The white printed out receipt will look like this:

Step 4:

Please check whether all information is accurate on the white printed out receipt and the colored deposit slip. Please sign the receipt and give it back to the teller.

Step 5 :

Teller will validate all information then will sign and print out the validated transaction on the white receipt.

Step 6 :

The Permata Bank teller will only sign the white printed out receipt. Please keep this white receipt and the colored deposit slip carefully and put it together with all other documents for your visa application. The original white receipt and colored deposit slip will be your valid evidence that your visa fee has been paid.

Pramata Bank participating branches for U.S. Embassy Visa payment are as follows:

Lokasi Alamat Telepon Fax

JAKARTA

PermataBank Tower I, lantai 021 5237899, Ground, Jl. Jend. Sudirman Kav. 27 021 2500680 5237999 12920 Jl. Melawai Raya No. 7A, Jl. Wijaya 021 7201065, Melawai 021 7209833 IX No.1, Kebayoran Baru 12160 7201066 021 7504020, Metro Pondok Pondok Indah Plaza II Blok B II No. 7653022, 7654463, 021 7654463 Indah 7, Jl. Metro Pondok Indah 12310 75902511, 75902512 Plaza D'Best Kelapa Gading, Lobby Utama, Kompl Plaza Kelapa Gading Plaza D'Best 021 Inkopal Lantai I Blok B No. A-17B, 021 45859370-75 Kelapa Gading 45859375 Jl Raya Boulevard Barat, Kelapa Gading, Jakarta Utara 14240 021 2601006, PermataBank Tower III, Jl. Hayam 021 6296412, Hayam Wuruk 2601050, 6282277, Wuruk No.84-85 11160 6295363 6297694

Intercon Kebon Pertokoan Kebon Jeruk Intercon 021 5852002, 021 5852002 Jeruk F/2-4 11630 ext.110

021 Ruko Royal Sunter F-1/3, Jl.Sunter 021 651,2588; Sunter Royal 652,2785; Podomoro, Jakarta Utara 14350 652,2780; 6507452 651,2595

Jl. Pluit Kencana Raya No. 41-43 Pluit 021 6603138 021 6603792 14450 Gedung Atrium, Plaza Setiabudi, Atrium Lantai 1, Jl. HR. 021 5210541 021 5210425 Kav.62, Jakarta Selatan 12920 Menara Thamrin Lobby Lantai 1. Jl. 021 39830185, Menara Thamrin MH Thamrin kav.3 10250 39830188 MEDAN

Zainul Arifin Jl. No. 49-51, Medan 061 4158188 061 4150188 Medan 20152

SEMARANG

Jl. Pandanaran 14, Semarang 024 8310200, 024 8310225, Pandanaran 1 50241 8310201 8310366

SURABAYA

Jl. Tunjungan No. 52, Surabaya 031 5315500, Tunjungan 031 5319536 60273 5311342

DENPASAR Jl. 88, Denpasar 0361 261678, Dewi Sartika 0361 261679 80114 261668 MALANG Bromo Jl. Bromo No. 20, Malang 65112 0341 361815 0341 328573 MAKASSAR

Jl. Jend. Sudirman No. 12, 0411 325410, Sudirman 0411 314840 Makassar 90113 325417, 325411 MANADO Ruko Megamas Blok 1 A1 No. 1, Jl. 0431 879812, Ruko Megamas Piere Tendean Boulevard, Manado 879813, 879780, 0431 879872 95111 879781 KEDIRI

Jl. Pangeran no. 18, Diponegoro 0354 672789-794 0354 672801 Kediri 64121 JEMBER 0331 484612, Trunojoyo Jl. Trunojoyo No. 35, Jember 68131 0331 484614 427888

YOGYAKARTA

Jl. P. Mangkubumi No. 26-28, Mangkubumi (0274) 516666 Yogjakarta