eTicket Dominican Republic - Application (Arrival and Departure)

Please complete all mandatory fields (marked with red asterisk *)

In this form you will complete application for both tickets Arrival and Departure

For Arrival only application form please click here

For Departure only application form please click here

Arrival

Permanent Address:*

Country of Residence:*

City:*

State (ex: New York):*

Postal code or zip code:*

Do you make stops in other countries on your way to Dominican Republic?*
Yes
No

First Name/s (exactly as they appear on your passport):*

Last Name (exactly as it appear on your passport):*

Date of Birth:*

Year:*

Month:*

Day:*

Gender:*

Place of birth:*

Is the nationality of the passport different from your place of birth?*
Yes
No

Passport Number:*

Civil Status:*

Occupation:*

Email:*

Telephone Number*
(Include + and the country code. Example +17035555678):

Are you a foreigner resident in the Dominican Republic?*
Yes
No

Where you will be staying in the Dominican Republic?*

Embarkation Port (Departure Airport):*

Disembarkation Port (Arrival Airport, for transit pick "other"):*

Airline Name/Company:*

Flight Date:*

Year:*

Month:*

Day:*

Flight Number:*

Flight Confirmation Number/PNR: (Optional)

Travel Purpose:*

Days of Staying:*

Do you plan on practicing any of the following sports during your stay?*

Customs Information

DO YOU BRING OR BRING WITH YOU OR IN YOUR LUGGAGE (S), CURRENCY VALUES OR ANOTHER PAYMENT INSTRUMENT, AN AMOUNT IN EXCESS OF USD $ 10,000.00 OR ITS EQUIVALENT IN ANOTHER ( S) TYPE (S) OF CURRENCY (S)?*

DO YOU BRING WITH YOU OR IN YOUR LUGGAGE LIVE ANIMALS, PLANTS OR FOOD PRODUCTS?*

DO YOU BRING WITH YOU OR IN YOUR BAGGAGE GOODS SUBJECT TO TAX PAYMENT?*

Departure

Embarkation Port (Departure Airport):*

Disembarkation Port (Arrival Airport):*

Airline Name/Company:*

Flight Date:*

Year:*

Month:*

Day:*

Flight Number:*

Flight Confirmation Number/PNR: (Optional)

I confirm that the answers and information in this application are true and correct to the best of my knowledge and belief. I further confirm that I have read and agree with the ''Terms & Conditions" of eticketdominicanrepublicform.com*

Application Form (Arrival and Departure)

Arrival

Customs Information

Departure