ARMS-DIMS

Fields in red color are mandatory.
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This form is prepared for the details of Passenger Locator and Health Declaration of the passengers.
For latest travel advisory please visit www.immigration.gov.np

Mode of Arrival in Nepal By Air By Land

Arrival Date

Flight No.

1.1 First Name*

1.2 Middle Name

1.3 Last Name*

1.3 Gender

1.4 Nationality*

1.5 Date of Birth (YYYY-MM-DD)*

1.6 Passport/Citizenship No.*

Issue Date

1.7 Permanent Address:

District:

Municipality/Village

WardNo.

Town/Village

1.8 Address in Nepal*.

District

WardNo.

1.9.1 Mobile/Landline No.*

Email*

1.9.2 Full Name of Contact Person

Relation

Contact No.

From	To	Mode of Travel	Flight/ Vehicle No.	Date	Add/ Remove

3.1 Country Name*

3.2 Current City/Town/Village