Application – Malaysia Digital Arrival Card

"*" indicates required fields

Step 1 of 5 - Personal Details

Personal Details

Full Name*

First Name Last Name

Sex*

Male

Female

Date of Birth*

Country of Citizenship*

Mobile / Cell Phone Number*

Email Address*

Enter Email Confirm Email

Primary contact method. Please double check it is correct.

Passport & Travel Details

Provide details of the passport that you will use to travel. Enter these details exactly as they appear in your passport.

Country of Passport*

Passport Number*

Be careful with letter “O” and number “0”; and letter “I” and number “1”.

Issue Date*

Expiry Date*

Last Port of Embarkation*

Please enter the last country that you departed from to reach Malaysia.

Type of Transport*

Flight / Vessel / Transportation Number*

Intended Date of Entry*

Please indicate the date you will enter the country.

Accommodation in Malaysia*

If you do not have a temporary address in Malaysia because it is a transit/day trip, please provide the address of the port of entry that you will be arriving at.

Address of Accommodation*

State of Accommodation*

City of Accommodation*

Postcode of Accommodation

Intended Date of Exit*

Please indicate the date you intend to leave the country.

Billing Details

Billing Name*

First Name Last Name

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Payment

Malyasia DAC Application*

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Personal Details

Passport & Travel Details

Declaration of Applicant

Billing Details

Payment