Surname

Other names

Date of Birth

Country of birth

Place of birth

Sex
 Man Woman Bisexual

Occupation

Phone number

Mobile number

Address

Enter your permanent residence address.

E-mail address

Passport number

Passport issue date

Passport expiry date

Copy of the passport (scan of copy as shown in example)

Residence address (the address of your place of stay in Azerbaijan).

Please answer this question: Have you ever visited the Nagorno-Karabakh and other regions of the Republic of Azerbaijan occupied by the Republic of Armenia since 1991 without an official permission of the Republic of Azerbaijan?
 Yes No

The information that you provide must match the information on your passport. Otherwise, your e-visa will be seemed invalid.
If it is found out that you illegally visited the Nagorno-Karabakh and other regions of the Republic of Azerbaijan occupied by the Republic of Armenia after 1991, you may not be allowed to enter the territory of the Republic of Azerbaijan regardless of whether or not you have obtained an electronic visa.