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Power of Attorney

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The information below is for the power of attorney that will be used when filing your
Visa application.

This form is valid for the Pensionado Visa, Private Income Retiree Visa,
Person of Means Visa and Forestry Investor Visa.

Please fill out this form only if you have received already the procedure,
requirements and rates from us and you are ready to start the process.

If not, please contact us.

Please complete the following information

Name:

Email:

Verify email:

Phone number:

Mailing address 1:

Mailing address 2:

City:

State/Province:

Zip code:

Country:

Citizenship:

Passport No.:

Marital status:

Applying alone or with dependants ?:

If dependants, how many and relationship ?

Applicant's Father Name:

Father's Citizenship:

Applicant's Mother Name:

Mother's Citizenship:

Comments:

Dependant's information:

Full Name:

Relationship:

Citizenship:

Passport No.:

Father's full name:

Citizenship:

Mother's full name:

Citizenship:

Comments:

If you are applying with more dependants, submit this form and
fill out the application again with the remaining information.

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