My friend has a 12-month marriage extension, but needs to leave the country for medical care. He worries the stay will be past the end of his 12-month extension. Is there something he can do to avoid "starting from scratch" by getting a non-I visa overseas?

One simple solution might be to get a new 12-month extension now, but Immigration told him that was not possible until the last month of the 12 month period. Any other solution?

How close is he to that last month? Immigration often can allow limited extra time for valid reasons. But if not he will have to start anew but it is basically the same regardless the only thing lost is the 3 year to apply for PR status - but most people never fully qualify or take advantage of that anyhow.

If your friend does not return to extend his Extension of Stay before its expiry date, he will have to go through the same procedure as when he applied the first time.

Immigration generally allows renewals to take place only as early as two weeks before the expiration date. However we have seen cases done a month early if it can be shown that the applicant is leaving Thailand. The plane ticket must be presented in such a case.

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I am not sure where that two week comes from but Immigration allows 30 days as normal from every report I have seen and I always do about 3 week early myself with no such requirement for a reason. Over 30 days normally is what requires a valid reason.