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Visa No.:________________________
Type of Visa:_____________________
□ Single Entry - $65.00
□ Multiple Entries - $150.00 Affiix passport
Date of Issue:_____________________ picture here
PAYMENT SHOULD BE MADE ONLY BY BANKER’S
Charges:_________________________ DRAFT OR MONEY ORDER PAYABLE TO THE
GHANA HIGH COMMISSION
Issuing Officer:___________________
14. Any information stated on the Form and subsequently found to be incorrect may lead to visa application rejection