Nationals from all countries are required to fill out the Pre Visa Form below: Submission No. Please enter particulars as printed in your passport document NAME SURNAME DATE OF BIRTH PLACE OF BIRTH FATHER'S NAME CURRENT NATIONALITY PREVIOUS NATIONALITY PASSPORT No. DATE OF ISSUE PLACE OF ISSUE EXPIRY DATE OCCUPATION PLACE VISA TO BE ISSUED (where there is an Iranian Consulate) DURATION OF STAY IN IRAN DATE OF ARRIVAL DATE OF DEPARTURE PREVIOUS DATE OF ENTRY TO IRAN PORT OF ENTRY PORT OF DEPARTURE PLACES TO BE VISITED (other than Tehran and Shiraz)