STRANDED MM2H VISA HOLDER
Please fill in questions below
Full Name *
Date of Birth
MM
/
DD
/
YYYY
Gender
Clear selection
Old Passport No. *
New Passport No. *
Nationality *
Stranded Country *
Email Address *
House in Malaysia (State/Area)*
MM2H Pass Expiry Date *
MM
/
DD
/
YYYY
MM2H Reference No. (BVP/MM2H/XXXX/XXXX/) (BVP/SHP/XXXX/XXXX) *
Date of Last Exit From Malaysia
MM
/
DD
/
YYYY
The entry restrictions include travelers who are citizens of holders of long-term passes of the countries listed below, who are residing or traveling from these countries. Are you currently a citizens of holders of long-term pass, residing or travelling from these countries? Please select. *
Reasons to enter Malaysia *
If others, state the reason below
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