APEX-WEB-INNOVATIONS

New Application

Please fill in the details below. Fields marked with * are required.

Date *

Admin *

Status *

Country *

Agent Name

Full Name *

Letters & spaces only (min 3 chars)

Passport Number *

Apply Date

Result Date

(Complete Step 1 first)

Cost *

LKR

Sell Amount *

LKR

Advance Payment 1

LKR

Select Bank:

BOC HNB

Advance Payment 2

LKR

Select Bank:

BOC HNB

Total Advance

Profit

Balance Due

Mark Payment as Completed

Check this if the full payment has been settled.