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1. Your name
2. Your birth date
3. Your passport number
4. Date of issue (visa) * 
5. Date of expiration (visa) *
6. Number of times this visa will let you enter this country 
7. Number of days you can stay in this country 
8. Dates of entry  *
9. Visa Type

* Please note that dates can be formatted as DD/MM/YY or MM/DD/YY.