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U.S. 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 : Exchange rate in Rupiah payment will be given by the teller based on confirmation with U.S. Embassy. For more information regarding the amount to be paid and how to apply, please visit U.S. Embassy website (http://jakarta.usembassy.gov). 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 Menara Standard Chartered Lantai Dasar Jl. Prof. DR. Satrio No. 164 Jakarta 12930 Tel: +6221 - 57 999 000 Fax: +6221 - 5790 1272

Bandung Jl. Ir. H. Juanda No. 16 Bandung 40115 Tel: +6222 - 424 1944 Fax: +6222 - 423 3716 Call Center: +6222 - 426 0892

Jakarta - Kebon Jeruk Graha Multi Jl. Panjang No. 55 Jakarta 11530 Tel: +6221 - 5367 4775 Fax: +6221 - 5367 4746

Bandung - Pasirkaliki Paskal Hyper Square A-1 Jl. Pasirkaliki No 25 - 27 Bandung 40181 Tel: +6222 - 860 60680 Fax: +6222 - 860 60928

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 Semarang 50010 Tel: +6224 - 841 0000 Fax: +6224 - 845 1111 Call Center: +6224 - 845 0188

Jakarta - Kelapa Gading Jl. Raya Bulevar Barat Blok LC 6 No. 24 Jakarta 14240 Tel: +6221 - 4585 3385 Fax: +6221 - 4585 3370

Surabaya - Basuki Rahmat Menara Standard Chartered Bank Jl. Basuki Rahmat No. 63-65 Surabaya 60271 Tel: +6231 - 532 0311 Fax: +6231 - 535 5371 / 545 8862

Jakarta - Pluit Ruko Mega Mal, MG 33 Jl. Pluit Indah Raya Jakarta 14450 Tel: +6221 - 668 3925 Fax: +6221 - 668 3551

Surabaya - Darmo Jl. Bukit Darmo Boulevard No. 2-2A Surabaya 60226 Tel: +6231 - 732 0901 Fax: +6231 - 732 0902

Jakarta - Mangga Dua Ruko Mal Mangga Dua Blok RM No. 7 Jl. Mangga Dua Raya Jakarta 10730 Tel: +6221 - 6230 3818 Fax: +6221 - 6230 3808

Medan Jl. Imam Bonjol No. 17 Medan 20151 Tel: +6261 - 4512 000 / 453 8800 Fax: +6231 - 451 0550 Call Center: +6261 - 457 2888

Jakarta - Sunter Rukan Puri Mutiara Blok A No. 97 Sunter Agung Jakarta 14350 Tel: +6221 - 6531 0939 Fax: +6221 - 6531 0669

Denpasar Jl. Teuku Umar 2-4 / Ruko 9-12 Denpasar - Bali 80114 Tel: +62361 - 223 700 Fax: +62361 - 223 737 Call Center: +62361 - 244 888

U.S. 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 : Exchange rate in Rupiah payment will be given by the teller based on confirmation with U.S. Embassy. For more information regarding the amount to be paid and how to apply, please visit U.S. Embassy website (http://jakarta.usembassy.gov). 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 Sudirman Melawai

PermataBank Tower I, lantai Ground, Jl. Jend. Sudirman Kav. 27 12920 Jl. Melawai Raya No. 7A, Jl. Wijaya IX No.1, Kebayoran Baru 12160

021 5237899, 5237999

021 2500680

021 7201065, 7201066

021 7209833

Metro Pondok Indah

Pondok Indah Plaza II Blok B II No. 7, Jl. Metro Pondok Indah 12310

021 7504020, 7653022, 7654463, 75902511, 75902512

021 7654463

Plaza D'Best Kelapa Gading

Plaza D'Best Kelapa Gading, Lobby Utama, Kompl Plaza Kelapa Gading Inkopal Lantai I Blok B No. A-17B, Jl Raya Boulevard Barat, Kelapa Gading, Jakarta Utara 14240

021 45859370-75

021 45859375

Hayam Wuruk

PermataBank Tower III, Jl. Hayam Wuruk No.84-85 11160

021 2601006, 2601050, 6282277, 6297694

021 6296412, 6295363

Intercon Kebon Jeruk

Pertokoan Kebon Jeruk Intercon F/2-4 11630

021 5852002

021 5852002, ext.110

Sunter Royal

Ruko Royal Sunter F-1/3, Jl.Sunter Podomoro, Jakarta Utara 14350

021 651,2588; 652,2780; 6507452

021 652,2785; 651,2595

Pluit

Jl. Pluit Kencana Raya No. 41-43 14450

021 6603138

021 6603792

Atrium

Gedung Atrium, Plaza Setiabudi, Lantai 1, Jl. HR. Rasuna Said Kav.62, Jakarta Selatan 12920

021 5210541

021 5210425

Menara Thamrin

Menara Thamrin Lobby Lantai 1. Jl. MH Thamrin kav.3 10250

021 39830185, 39830188

MEDAN Zainul Arifin Medan

Jl. Zainul Arifin No. 49-51, Medan 20152

061 4158188

061 4150188

Jl. Pandanaran 14, Semarang 50241

024 8310200, 8310201

024 8310225, 8310366

Jl. Tunjungan No. 52, Surabaya 60273

031 5315500, 5311342

031 5319536

Jl. Dewi Sartika 88, Denpasar 80114

0361 261678, 261668

0361 261679

Jl. Bromo No. 20, Malang 65112

0341 361815

0341 328573

Jl. Jend. Sudirman No. 12, Makassar 90113

0411 325410, 325417, 325411

0411 314840

Ruko Megamas Blok 1 A1 No. 1, Jl. Piere Tendean Boulevard, Manado 95111

0431 879812, 879813, 879780, 879781

0431 879872

Jl. Pangeran Diponegoro no. 18, Kediri 64121

0354 672789-794

0354 672801

Jl. Trunojoyo No. 35, Jember 68131

0331 484612, 427888

0331 484614

Jl. P. Mangkubumi No. 26-28, Yogjakarta

(0274) 516666

SEMARANG Pandanaran 1 SURABAYA Tunjungan DENPASAR Dewi Sartika MALANG Bromo MAKASSAR Sudirman MANADO Ruko Megamas KEDIRI Diponegoro JEMBER Trunojoyo YOGYAKARTA Mangkubumi