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Application Information
Visa Information
Reference No.
: 2270426B1112735
Payment Receipt No.
: XC7540842
Visa No.
: Z1A9451472
Valid From
: 27/04/2026
Valid Until
: 25/07/2026
Visa Code
: VOA

Personal Information
ELISABETH SELDEN
FEMALE
New York USA
28/10/1960
3104902361
Passport (or other travel document) Information
Passport
A80388806
AMERIKA SERIKAT
05/11/2035
AMERIKA SERIKAT
Residence Information
HOTEL
JL. RAYA KEDEWATAN, KEDEWATAN, KECAMATAN UBUD, KABUPATEN GIANYAR, BALI, INDONESIA
BALI
KAB. GIANYAR
UBUD
UBUD
80571


Passport (or other travel document) Information
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Passport Valid for at Least 6 MonthsShow File

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Payment Information
Type of Visa B1
IDR
3FE360NA0N1MND97
27/04/2026
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