PAYMENT FORM

PAYMENT FORM
Payment Details
Name*

First NameLast Name
Date of Payment*

MonthDayYear
Date
Email*
example@example.com
Company Name
(if applicable)
Application Details*
Are you uploading reciept for*

Application FeeIssue Fee (FJ$189.15 per person)Bond Fee
FID Reference Number*
New Application or Extension*
Lodgment Application Type*
Bank Details

Enter bank details of account that was used to make payment for the application
Amount Paid (in FJD)*
Account Number*
Account Name*
Bank Name*
Narration/Payment Description entered during payment*
e.g 0670-12345
Upload Receipt*

Cancelof
Should be Empty:

Payment Details