7 full names and addresses of Hotels/places/finriends or Relatives to be visited in Kenya (Physical address) Telephone/cell no mail s. Dates and Duration of previous visas to Kenya g, will you be returning to your country of Residence/Domicile? no Have you been previously denied entry into xenya? tves state when and reason given 11 Have you ever been convicted of any offence under any system of law? yes give offence and penalty? (insert name) understand that if any ot the particulars fumished above are found to be incorrect or if any relevant information is found to be withheld or suppressed, the visa is liable to be cancelled. nature of applicant) Date NOTE: (a) Incomplete applications will be rejected (b) The possession of a vsa is not the final authority to enter the Republic of Kenya (c) Engaging in any form of business or employment without a requisite permit or pass is an offence. FOR ofFICIAL USE