U.S. Embassy Visa Fee Payments Through Standard Chartered and Permata Banks You can pay your nonimmigrant visa application fee with cash at any Standard Chartered Bank or Permata Bank. Before going to the bank, you must print the applicable U.S. visa application deposit slip which available from this link : http://www.ustraveldocs.com/id/id-niv-paymentinfo.asp. Make sure that you print out the correct deposit slip based on the visa class that you choose and please bring it with you when you go to Standard Chartered or Permata Bank to pay your fee. USA VISA FEE DEPOSIT SLIP Bank Copy Date: mm/dd/yyyy Amount: xxxxxxx IDR Expiration Date: mm/dd/yyyy IMPORTANT: The visa fee is dependent on the visa class for which you intend to apply. Verify the visa class before downloading this visa fee deposit slip. Visa fees are non-refundable and must be paid in Local Currency. Visa fees are non-transferrable and cannot be assigned to other applicant. Instructions: 1. This visa fee deposit slip must be used to make payment at the bank on or before the expiration date noted above. 2. A separate visa fee deposit slip is required for each applicant (i.e. one applicant, one receipt). No bulk or group payments are allowed from this visa fee deposit slip. 3. Provide the bank copy to a bank teller at the time of payment. 4. Pay the exact amount mentioned in this visa fee deposit slip at the bank branch.
Customer Copy Date: mm/dd/yyyy Amount: xxxxxxx IDR Expiration Date: mm/dd/yyyy Instructions: 1. Please keep this copy for your records. Standard Chartered Bank
Step 1: Fill in the applicant s name (as shown in the Passport). If the name is longer than the available space, truncate the name and just fill in the available space. Fill in the applicant s Passport number. Fill in the Visa Fee based on the amount that you have to pay that listed in the deposit slip you printed out. Sign the receipt and write down your name on the Payer s signature column. Step 2: Please check whether all information is accurate on the deposit slip. Then give it to the teller. Step 3: The teller will validate all information and will sign and print out the validated transaction on the deposit slip. Step 4: Please keep this deposit slip carefully and put it together with all other documents for your visa application. The original deposit slip will be your valid evidence that the visa fee has been paid. Standard Chartered Bank participating branches for U.S. Embassy Visa payment are as follows: City Branch Address Bandung Bandung Denpasar - Bali Juanda Pasir Kaliki Teuku Umar Head Office Jl. Ir.H.Juanda No.16 Bandung 40115 Paskal Hyper Square Blok A No.01 Jl. Pasir Kaliki No.25-27 Bandung 40181 Gedung Standard Chartered Bank Jl. Teuku Umar 2-4 / Ruko 9-12 Denpasar - Bali 80114 Menara Standard Chartered Lantai Dasar Jl. Prof DR Satrio No.164 12930
Medan Semarang Kebon Jeruk Kelapa Gading Mangga Dua Pantai Indah Kapuk (PIK) Pluit Pondok Indah Puri Sunter Tanah Abang Tomang Imam Bonjol Ahmad Yani Basuki Rahmat Graha Multi Jl. Panjang No.55 11530 Jl. Raya Bulevar Barat Blok LC No.24 14240 Ruko Mal Mangga Dua Blok RM No.7 Jl. Mangga Dua Raya 10730 Ruko Cordoba Blok E no 1 Jl. Marina Raya - Bukit Golf Mediterania Pantai Indah Kapuk 14460 Pluit Village MG 33 Jl. Pluit Indah Raya 14450 Pondok Indah Plaza V Jl. Marga Guna Raya Blok C No.1 12310 Rukan Grand Puri Niaga Jl. Puri Kencana Blok K6 No. 2A Kembangan Selatan Barat 11610 Rukan Puri Mutiara Blok A Kav No.97 Sunter Agung 14350 The Boulevard, Ground Floor Jl. Fachrudin Raya No. 5 Pusat 10250 Griya Sinta Jl. Tomang Raya no.39 Barat 11440 Jl. Imam Bonjol No.17 Medan 20151 Jl. A.Yani No.155 A Semarang 50010 Menara Standard Chartered Bank Jl. Basuki Rahmat No.63-65 60271
Tangerang Darmo Manyar Bumi Serpong Damai (BSD) Bukit Darmo Boulevard No. 2-2A 60226 Jl. Manyar Kertoarjo 67 60116 Ruko Golden Boulevard Blok F no 7 Jln Pahlawan Seribu, BSD City Tangerang 15322 Permata Bank
Step 1: Fill in the applicant s name (as shown in the passport). If the name is longer than the available space, truncate the name and just fill in the available space. Fill in the applicant s passport number. Fill in the Visa Fee based on the amount that you have to pay that listed in the deposit slip you printed out. Sign the receipt and write down your name on the Payer s signature column. Step 2: The teller will input all of the information and then will print a white receipt for you to check for correct information. The white printed out receipt will look like this:
Step 3: Teller will validate all information then will sign and print out the validated transaction on the white receipt. Step 4: The Permata Bank teller will only sign the white printed out receipt. Please keep this white receipt and the colored deposit slip carefully and put it together with all other documents for your visa application. The original white receipt and colored deposit slip will be your valid evidence that your visa fee has been paid. Permata Bank participating branches for U.S. Embassy Visa payment are as follows: City Branch Address Denpasar Denpasar Dewi Sartika Ubud Atrium Hayam Wuruk Kebon Jeruk Intercon Kelapa Gading Square Melawai Menara Cakrawala Pluit Jalan Dewi Sartika Kav. 88 Jl. Fachrudin Raya No. 5 Denpasar 80114 Galleria Menara Ubud No. 7 Jalan Raya Ubud Denpasar 80114 Gedung Atrium Plaza Setiabudi Lantai 1 Jl. HR Rasuna Said Kav. 62 12920 Jalan Hayam Wuruk 84-85 11160 Pertokoan Kebon Jeruk Intercon Blok F No. 2-3 11630 Ruko Italian Walk Blok D No. 29 dan D.30, Jl. Boulevard Barat Utara 14240 Jalan Melawai Raya No. 7A Jl. Wijaya IX No. 1 Kebayoran Baru 12160 Menara Cakrawala Jl. M. H. Thamrin No. 9 Pusat 10340 Jalan Pluit Kencana Raya No. 41-43 14450
Jember Kediri Makassar Malang Manado Medan Pondok Indah Sudirman Tower Sunter Royal Trunojoyo Kediri Sudirman Bromo Basuki Rahmat Zainul Arifin Pondok Indah Plaza Blok II Jl. Metro Pondok Indah Blok II BA No.7 12310 Jalan Jend. Sudirman Kav. 27 12920 Ruko Royal Sunter F1-3 Jl. Sunter Podomoro 14350 Jalan Trunojoyo No. 35 Jember 68131 Jalan Diponegoro No. 18 Kediri 64121 Jalan Jend. Sudirman No. 12 Makassar 90113 Jalan Bromo No. 20 Malang 65112 Ruko Megamas Blok 1 A1 Jalan Piere Tendean Boulevard Manado 95111 Jalan KH Zainul Arifin No. 49-51 Medan 20152 Semarang Pandanaran 1 Jalan Pandanaran No. 14 Semarang 50241 Yogyakarta Darmo Park HR Muchammad Panglima Sudirman Tunjungan Mangkubumi Jalan Mayjend. Sungkono Komp Pertokoan Darmo Park I Blok 2/3 60225 Pertokoan Golden Palace A.25 Jalan HR Mohammad No.373-383 60189 Jalan Panglima Sudirman No. 54-58 60271 Jalan Tunjungan No. 52 60273 Jalan Pangeran Mangkubumi No. 26-28 Yogyakarta 55232