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Non-Immigrant Visas

Special Appointment Request Form

(日本語)

This form is only to be used if you have paid the visa application fee (also called the "MRV fee") by March 23 and have not scheduled a visa interview appointment.

Please fill out the form below and send the ATM receipt by fax:

Tokyo:03-3224-5151
Osaka:06-6315-5962
Naha:098-876-4243

Please note: the Embassy or consulates are unable to schedule an appointment until the faxed ATM receipt is received and the payment is confirmed. If your request is approved, we will send you an appointment letter by fax notifying you of your interview date and required documents. Please read the instructions on the letter carefully and bring the letter to your interview. Also, please make sure to submit the original payment receipt and a self-addressed LetterPack 500 along with other required documents listed on the appointment letter to your interview.

This form cannot be used for general inquiries. For general inquiries, please see here.

1.
Full name: (Last, First)
2.
Visa Category:
3.
ATM Receipt Number:
4.
Date of Receipt Issuance:
5.
Desired Interview Date:
      • 1st choice:
      • 2nd choice:
6.
Desired Location of Appointment:
  Tokyo  Osaka  Naha
7.
E-mail Address:
8.
FAX Number:
9.
Telephone Number: