Form to complete to get eVisa Brazil

Please enter the name, first name (s) and passport number exactly as they appear on your passport information page.

Enter your Family (last) name as it appears in your passport in the Last name field. Last name is required to complete the application.
Enter your first name here as it appears in your passport in the First Name field. The first name is required to complete the application.
Please enter your old last name
Please choose one of the following options
Please indicate your gender. Required to complete the application.
Please indicate your marital status
Enter the email address at which you can be contacted. The email address is required to complete the request. If you don't have an e-mail address, you may provide the e-mail address of a third party (for example, a family member, friend or colleague).
Confirm here the email address you entered in the first Email field
Indicate your date of birth. Date of birth is required to complete the request.
Indicate here the town, chief town, village or hamlet where you were born. The city, town, village or hamlet where you were born is required to complete the request. If you don't know the city where you were born, type UNKNOWN.
Choose the country where you were born. Country of birth is required to complete the request.

Address

In this Line 1 Address field, enter your home address number and street. Don't include city and state in this field. Line 1 address is required to complete the application.
Enter the postal code of your city
Indicate here the city, the chief town, the village or the hamlet. The city, town, village or hamlet is required to complete the application.
Indicate your country of residence. The country is required to complete the application.
Please enter the requested information
At least one telephone number is required to complete the application. If you don't have a telephone number, you can give an alternative telephone number of a third party belonging to a contact point (for example a family member, friend or colleague). The telephone number is required to complete the application.
Enter your profession
Enter this information in numeric characters
Indicate the expected date of your trip (as a precaution a minimum of five days before your departure date, is recommended for all requests for e-visa)

Passport information

Enter your passport number as it appears on your passport. The passport number may contain numbers and/or letters (9 maximum). Make a clear distinction between the number 0 and the letter O. The passport number is required to complete the application.
Indicate the date your passport was issued, as it appears in your passport in the Date of Issue field. The date of issue of the passport is required to complete the application.
Indicate the expiry date of your passport, as it appears in your passport in the Expiry Date field. The expiry date of the passport is required to complete the application.
Choose the country of which you are a national, as it appears in your passport. The country of which you are a national is required to complete the application
Purpose of Travel
Indicate the date of birth of parent 1
Indicate parent's date of birth 2

Security Check

Documents to upload: Passport and Photo must be scanned in clear colors. The photo background should be white.

Kindly check the box
Kindly upload your scanned passport (Information page) in clear and sharp colour in one of the following formats: jpg, jpeg, gif, pdf
Kindly upload your scanned ID photo in clear colour (white background) in one of the following formats: jpg, jpeg, gif, pdf
Information required only in case of a minor's application
Kindly submit the signed authorization letter (in pdf)
The document must be in JPEG format
The supporting document may be the death certificate, single parent custody, legal document or any document that justifies why only one parent approves the Visa application. They must be in PDF format
The document must be in JPEG format
The document must be in JPEG format
You must accept our general conditions of sale to continue

General Information

Specific Information

After completing the form and validating your payment, all your details will be checked and validated.Once your application is accepted, you will quickly receive your Electronic Travel Authorization by return email allowing you to visit Brazil.