Fillable Smart Visa Extension

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Smart Visa Extension

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BOI SV-EX-02-02 13/05/2020 Page 1 of 7
APPLICATION
FOR SMART VISA EXTENSION
Part A : Personal Information
1.Full English name as in passport
First name
Middle name
Last name
2.Current Nationality / Nationality at birth, if
different
3.Date of birth (dd-mm-yyyy)
4.Place of birth (city, province/state, country)
5.Sex
Male Female
6.Marital status
Single Married Divorced Other (Please specify)
7.Passport number
8.Date of issue (dd-mm-yyyy)
9.Valid until (dd-mm-yyyy)
10.Home address
11.Home/mobile phone number
12.E-mail address
13.Spouse
Date of birth (dd-mm-yyyy)
Nationality
Occupation
14.Children
15. Current Visa
Smart “T” Smart “I” Smart “E” Smart “S” Smart “O”
16.Valid until (dd-mm-yyyy)
17. Job position and job description
18.Name of contact person in Thailand
Relationship with the applicant
E-mail address
Mobile phone number
Part B : Targeted industries
1. For Smart Visa holder T, I and E, please choose the targeted industries most relevant to your company’s activities
☐ Next-Generation Automotive
☐ Automation and Robotics
☐ Smart Electronics
☐ Aviation and Logistics
☐ Affluent, Medical and Wellness Tourism
☐ Biofuels and Biochemicals
☐ Agriculture and Biotechnology
☐ Digital
☐ Food for the Future
☐ Medical Hub
☐ Human Resource Development in Science and Technology
☐ Environmental Management and Renewable Energy
☐ Alternative Dispute Resolution
M
M
M
M
BOI SV-EX-02-02 13/05/2020 Page 2 of 7
2. For Smart Visa holder S, please choose the startup sectors/ targeted industries /startup stage most relevant to your activities
Startup Sectors
Targeted Industries
Startup Stage
☐ HealthTech
☐ Next-Generation Automotive
☐ Idea
☐ TravelTech
☐ Smart Electronics
☐ Prototype
☐ FinTech
☐ Affluent, Medical and Wellness Tourism
☐ Launched
☐ Business/ ServicesTech
☐ Agriculture and Biotechnology
☐ Scale up
☐ IndustryTech
☐ Food for the Future
☐ PropertyTech/ UrbanTech
☐ Automation and Robotics
☐ GovTech/ EdTech
☐ Aviation and Logistics
☐ LifestyleTech
☐ Biofuels and Biochemicals
☐ AgriTech/ FoodTech
☐ Digital
☐ Other (please specify)
☐ Medical Hub
☐ Human Resource Development in Science and Technology
☐ Environmental Management and Renewable Energy
Please select the type of visa you wish to apply (only one answer is possible)
☐ Smart T
Please complete Part C
☐ Smart T (Government sponsor / higher
education institutions / specialized
institutions / Alternative Dispute
Resolution)
Please complete Part D
☐ Smart I
Please complete Part C, F and
Form A
☐ Smart E
Please complete Part C
☐ Smart S ( 2-year visa)
Please complete Part C
☐ Smart S (6-month visa)
Please complete Part E
☐ Smart O
Please complete Part G
Part C : Company and employment information
1. Company name
2. Company registration number
3. Address
4. Office number
5. Company website or e-mail address
6. Business or products or services description
7. Major products or services
Sale revenue (Approximate in Baht)
BOI SV-EX-02-02 13/05/2020 Page 3 of 7
8. Manufacturing/Service Process
Please provide a process diagram that explains the manufacturing/service process (additional documents can be attached).
Process Diagram
Explanation
9. Acquisition of core technology
Import
Procurement/Sourcing in Thailand
Developed by own company
10. Objective of technology employment
To apply to the production process or service provision To significantly increase the value of products or services
Please explain
11. Contract term
Years Months Period (dd-mm-yyyy to dd-mm-yyyy) Other (Please specify)
12. Average income per month* (Baht)
Salary (Baht per month)
Other items of income (Please specify)
13. The applicant’s involvement in company
Employee Director % of Shares Other (Please specify)
Part D : Data of the employer or sponsor in Thailand
1. Organization name
2. Address
3. Phone number
4. Type of Organization Government agency Educational institution Arbitration center/institute
5. A reference person’s name
A reference person’s position
E-mail address
Mobile phone number
p
p
p
p
p
BOI SV-EX-02-02 13/05/2020 Page 4 of 7
Part E : Business progress
1.Business progress in the last 6 months
2.Company registration progress
1. Having reserved the company name.*
2. Having registered the memorandum of association*
3. Having hold a statutory meeting
4. Having registered a company
* Prerequisite for visa extension
Part F : Private investment
1. Please select all types of your investment.
Direct investment in technology-based business in Thailand.
Investment through a venture capital company which has invested technology-based business in Thailand .
Direct investment in a startup or an incubation or accelerator business in Thailand.
2. List of companies in which the applicant has invested.
Company name
Value of shares (Baht)
Amount of convertible debt
(Baht)
The same company as the last
Smart Visa application
Yes No
Yes No
Yes No
Yes No
Yes No
3. Total value of shares owned by the applicant (Baht)
Note : In case the applicant has not invested in the same company as the last Smart Visa application, please fill
in FORM A attached.
Part G : Smart O
1. Please specify the name of Smart Visa “ T”, “E”, “I” or “S” holder or applicant whom you will accompany
First name
Middle name
Last name
2. Type of his/her Smart Visa
Smart “T” Smart “I” Smart “E” Smart “S”
3. Relationship with the main Smart Visa holder/applicant.
spouse child
Details of Smart “O” applicant’s work or study in Thailand (Please fill in this part only in the case where
applicant is working or studying in Thailand.)
4. Name of company or education institution in Thailand
5. Job position or current education level
6. Work address or education institution address
7. Phone number
8. E-mail address
9. A reference person’s name
A reference person’s job title
E-mail address
Mobile phone number
BOI SV-EX-02-02 13/05/2020 Page 5 of 7
I hereby certify that the information and the evidence provided is true and complete in all respects. If there are
any false statements which are considered perjury, I agree to be subjected to any applicable legal prosecution.
BOI SV-EX-02-02 13/05/2020 Page 6 of 7
FORM A
The data provided herewith is crucial in helping us identify whether your companies are qualified as
companies using technology in manufacturing or delivering services and being in the targeted industries.
Company Profile
1. Company name in Thailand
2. Registration date (dd-mm-yyyy)
3. Registered number
4. Address
5. Office number
6. Company website or e-mail address
7. Business / products or services description
8. Major products or services
Sale revenue (Approximate in Baht)
Annual sale revenue in total
9. Amount of share (Baht)
10. Value per share (Baht)
11. Shares owned by applicant (Baht)
12. Please choose the targeted industries most relevant to your company’s activities
☐ Next-Generation Automotive
☐ Automation and Robotics
☐ Smart Electronics
☐ Aviation and Logistics
☐ Affluent, Medical and Wellness Tourism
☐ Biofuels and Biochemicals
☐ Agriculture and Biotechnology
☐ Digital
☐ Food for the Future
☐ Medical Hub
☐ Human Resource Development in Science and Technology
☐ Environmental Management and Renewable Energy
13. Manufacturing/Service Process
Please provide a process diagram that explains the manufacturing/service process
Process Diagram
Explanation
BOI SV-EX-02-02 13/05/2020 Page 7 of 7
14. Please select the core technology used in the production process or services provision
1.
3D Printing Technology Rapid Prototyping/ Additive
Manufacturing
29.
MSTQ Technology (Metrology, Standardization Testing
Quality Assurance)
2.
Absorption Technology
30.
Human Computer interaction Technology
3.
Advanced Bioprocessing Technology
31.
Internet of Things Technology
4.
Advanced Catalyst Technology
32.
Materials Characterization Technology
5.
Advanced Food Processing Technology
33.
Advanced Membrane Technology
6.
Advanced Materials Process
34.
Genetic Engineering Technology
7.
Artificial Intelligence Technology
35.
Nano-encapsulation Technology
8.
Automation Technology
36.
Advanced Nanofiber Technology
9.
Big Data Technology
37.
Nanomaterials Syntheses Technology
10.
Bio-Analytical Technology
38.
Nanostructure Fabrication Technology
11.
Bio-based Material Technology
39.
Natural Language Processing Technology
12.
Biodegradable Materials Technology
40.
Omics Technology
13.
Bioinformatics
41.
Photonics & Optical Technology
14.
Biomaterial/ Biomedical Materials Technology
42.
Pre-Clinical & Clinical Testing Technology
15.
Blockchain Technology
43.
Printed Electronics and Organic Electronics Technology
16.
Cell Culture and Tissue Engineering Technology
44.
Robotics Technology
17.
Clean Technology
45.
Sensor Technology
18.
Cloud Computing Technology
46.
Smart grid
19.
Composite Materials Technology
47.
Software Testing Technology
20.
Cyber/ IT Security Technology
48.
Solar Cell (Photovoltaic Technology)
21.
Data Analytics Technology
49.
Surface Coating/ Surface Engineering Technology
22.
Digital Engineering and Manufacturing Technology
50.
Thermal Solar Technology
23.
Drug Delivery System
51.
Unmanned Aerial Vehicle Technology
24.
Electric Vehicle Technology
52.
Virtual &Augmented Reality Technology
25.
Embedded Technology
53.
Waste Treatment Technology
26.
Energy Storage Technology
54.
Wearable Technology
27.
Functional Materials Technology
55.
Wind Energy Technology
28.
Gene and Molecular Technology
56.
Other (please specify)
15. Acquisition of core technology
Import
Procurement/Sourcing in Thailand
Developed by own company
Please explain
16. Objective in using technology
To apply to the production process or services provision To significantly increase the value of products or services
Please explain
BOI SV-EX-02-03 13/05/2020
SUPPORTING DOCUMENTS SUBMITTED
T
I
E
S
(6M)
S
(2Y)
O
1.
Completed application form for smart visa extension
2.
Copy of valid passport (first page and all pages with Thai visa stamps)
EVIDENCE OF EMPLOYMENT AND CORPORATE
3.
Evidence of employment contract or service contract with entity in Thailand (and a
letter signed by an authorized person) which include details of employment e.g.
position, length of employment (the remaining period of employment contract must
be at least 1 year), income or evidence of working for a government agency
∆
4.
Shareholders list in Thailand (not more than 3 months old) or/and transfer slip
5.
Company profile or annual report
6.
Evidence of payment of annual income tax with receipt or salary slip (Ex: Por Ngor
Dor 1 of latest three months and Por Ngor Dor 91 of the previous year)
7.
Latest audited corporate’s annual financial statement or financial report
∆
8.
Foreign Business License or Foreign Business Certificate
*In case of a foreign majority company in restricted business activities under the
Foreign Business Act
∆
ADDITIONAL INFORMATION
9.
Financial evidence showing a deposit of no less than 600,000 Baht or equivalent in
a bank account which has been held for at least 3 months.
*In the case of a smart S visa holder being accompanied by spouses and children, an
additional amount of fixed saving of at least 180,000 Baht per person or
equivalence is required.
∆
10.
Health insurance policy covering entire course of stay in Thailand, with coverage
for hospitalization treatment of no less than 500,000 Baht
(For Smart “S” applicants and Smart “O” accompanying Smart “S” only)
∆
11.
Proof of reservation of company's name
12.
Registered memorandum of association
13.
The most up-to-date pitch deck
14.
Evidence of family relationship (i.e. marriage certificate, birth certificate)
Note: Certificate of incorporation, memorandum of association in Thailand, may be
requested on a case-by-case basis.
∆
∆
∆
∆
∆
∆
Mandatory ∆ If applicable
I confirm that I have read the guidance and there are no other documents to submit. For document are not in
English, I have provided a certified translation.
I hereby authorize One Stop Service Center for Visa and Work Permit and related govenmental institutions to share
this information provided among the agencies involved in this qualification endorsement process.
I understand that a decision may be made on my application based on these documents only.
I understand that I may be contacted or requested for additional documents or information from government offices
or its representative.
* All processes may take approximately 30 working days to process providing that you are able to provide all complete
documents at the start, so please allow considerable time to begin the process before your immigration stamp expires.
For Official Use Only
Registered Number: Received Date: Due date:
Previous Application no. Submission Officer’s Name Signature
Required documents for Smart visa extension
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Completed 16 July 2020

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