ࡱ> egdU Mbjbjnn 8baa >>>>>RRRR|4R-eee,,,,,,,$J/2\,u>e|eee,>>L-***e>>,*e,***Pvc)*j*,b-0-*\2*4\2**&\2>*ee*eeeee,,*eee-eeee\2eeeeeeeee B :  T KHAI  NGH CP TH THC, GIA HN TM TR (1) APPLICATION FORM FOR VISA ISSUANCE, STAY EXTENSION Dng cho ngi nc ngoi ang tm tr  Vit Nam For temporary residence foreigners in Viet Nam I- Ngi  ngh The applicant: 1- H tn (ch in hoa):................................................................................................................. Full name (in capital letters) 2- Gii tnh: Nam N 3- Sinh ngy.......thng.......nm.......... Sex Male Female Date of birth (Day, Month, Year) 4- Quc tch gc: ..........................5- Quc tch hin nay:......................... Nationality at birth Current nationality 6- Ngh nghip/chc v: .............................................................................. Occupation/position 7- H chiu/giy t c gi tr i li quc t s: .........................loi (2): ..................... Passport or International Travel Document number Type C quan cp: ................................... c gi tr n ngy:........./............./..................... Issuing authority: Expiry date (Day, Month, Year) 8- Nhp cnh Vit Nam ngy:......./....../........ qua ca khu: & ........................ Date of the latest entry into Viet Nam (Day, Month, Year) via entry port Mc ch nhp cnh: .............................................................................................................. Purpose of entry 9- c php tm tr n ngy: ......../........../................ Permitted to remain until (Day, Month, Year) - a ch tm tr ti Vit Nam: ............................................................................................ Temporary residential address in Viet Nam - in thoi lin h/Email .................................................................................................... Contact telephone number/Email II- C quan/t chc hoc thn nhn  Vit Nam mi, bo lnh: Hosting organisation/ family relative in Viet Nam 1- Tn c quan, t chc Name of hosting organisation: & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & ....... a ch Address ......................................................................................................................... in thoi lin h/Email Contact telephone number/Email ................................................. 2- Thn nhn bo lnh (H tn): .............................................................................................. Hosting family relative (full name) Sinh ngy.......thng.......nm.............. Date of birth (Day, Month, Year) Giy chng minh nhn dn/h chiu/th thng tr/th tm tr s: ......................... Identity Card/Passport/Permanent/ Temporary Resident Card Number Cp ngy: ....................c quan cp: ..................................................................................... Issuing date Issuing authority Quan h vi ngiv~J L R T z     & Ÿʑznf[fT hJz6]hgSh$eCJaJh$eCJaJh8h$e5CJaJh8h$e56]hXh$e5CJaJh$e5CJaJhQ8*h$e6] h$e6]h'Zh$e6 h$e]hIRh$e6 h456 h$e6h$e hQ8*h$ehIRh$eCJaJhIRh$e5CJ\aJ h$e5\hq3h$eCJaJL  B d  p > [$\$gd$e  [$\$gd$e  F[$\$gd$e yu[$\$gd$e [$\$gd$e$a$gd$e$a$gd$egd$e$a$gd$e& @ B F    " b d  F H n p r t >VfﹲЫuiahsh$e6hf)h$e5CJaJh0h$eCJaJ h$e6hh$e6h$eCJaJhf)h$eCJaJh$e hQ8*h$e hch$e h3Qh$ehch$e6] h$e]hlh$e]h$eCJ]aJ+jhQ nhQ nCJU]aJmHnHu h$e6]hIRh$e6]#>hFNP $ a$gd$e $ a$gd$e$a$gd$e[$\$`gd$e  [$\$gd$e  B[$\$gd$e gd0 [$\$gd$efhjn2<>VrbdɽɣrcQEɲɲh0B*CJaJph#h)gdh$e6B*CJ]aJphh$e6B*CJ]aJphh!g6B*CJ]aJph h!g6 h$e6huh$e6h0B*phh1!B*phh)gdh$eB*CJaJphhuh$eB*phh$eB*CJaJphhuh$eB*CJaJphh$eB*CJaJphh39h$eCJ]aJh$eCJ]aJ h!Nh$eLNHXþ~zqeqe]X]X]XeXNhQ8*h$e6] h$e]h[h$e]h[h$eCJ]aJh$eCJ]aJh$eh$eCJaJh$eh$eB*CJaJphh$e6B*CJ]aJph#h)gdh$e6B*CJ]aJphhuh$e6 h06h0h$eB*CJaJphhuh$eB*phhTj{h$eB*phhTj{h$eB*CJaJphh$eB*phX`x0 "$DF(ؽ។ytogogogohh$e6 h$e6 hYM6hh$eCJaJh /Rh$e]hTpCJaJh /Rh$eCJaJh$eCJaJhzh$eCJ]aJ h1!] h$e]h3Qh$e]h[h$eCJ]aJ h#Zh$eh$eCJ]aJh$ehch$e6]hQ8*h$e6] h$e6]&(< JLT P $&24>@Bx|Ķ~sskbVhZh$eCJ]aJh$eCJ]aJh8h$e5h8h$e56]h8hJz56]hJz56]h$e56]h 056]h3Qh$e6]h3Qh$eCJaJh3Qh$e5CJ\aJh$e5CJ\aJhQ8*h$e6] h$e6]h~|h$e6h$e hQ8*h$eh3Qh$eCJ]aJ |`64*d|668 9b99r:; j J }[$\$gd1! <[$\$gd1! [$\$gd1E  [$\$gd$e [$\$`gd$e [$\$gd$e [$\$gd$e:JZh\^b*46`bt4Lln&*n䷫ʣ÷ԷԖԖԎԷhZh$e]hlh$e] h$e6homh$e6hjqh$eCJ]aJhZh$eCJ]aJ hQ8*h$ehQ8*h$e6]h$eCJ]aJ hZh$eh$e h 06] h$e6]hZh$e6]8:JTbnNr6666p6t6z6|6~666666667777777788 8.8R8T8j89"9R9ݳ h 06]h1!h$eCJ]aJh1!h1!CJaJh1! hr=h$eUh$eCJ]aJhr=h$e]hr=h$eCJ]aJ hQ8*h$e h2gy6] h$e6]hQ8*h$e6]h$e:  ngh: ............................................... (3) Relationship to the applicant a ch thng tr/tm tr ti Vit Nam: ........................................................................ Permanent/temporary residential address in Viet Nam in thoi lin h/Email: ..................................................................................................... Contact telephone number/Email III- Ni dung  ngh Requests: 1- Cp th thc: mt ln nhiu ln c gi tr n ngy: ......../........./........... To issue a visa Single Multiple Valid to (Day, Month, Year) 2- Gia hn tm tr n ngy: ........../............/............. To extend the duration of stay until (Day, Month, Year) 3- L do Reason(s)......................................................................................................................... IV- Nhng iu cn trnh by thm Additional statements: ........................................... ........................................................................................................................................................... Lm ti & & ... ngy.......thng........ nm.......... Done at ............. date (Day, Month, Year) Xc nhn (4) Certified by (k, ghi r h tn, chc v, ng du) Signature, full name, title and stamp Ngi bo lnh (k, ghi r h tn) The sponsor s signature and full name  Ngi  ngh (k, ghi r h tn) The applicant s signature and full name  Ghi ch Notes: (1) Mi ngi khai 1 bn, km h chiu hoc giy t c gi tr i li quc t v 01 nh mi chp c 4x6cm, phng nn trng, mt nhn thng, u  trn, khng eo knh mu, np trc tip ti c quan qun l xut nhp cnh. Submit in person one completed application form enclosed with passport or International Travel Document and one recently taken photo in 4x6cm size, with white background, front view, bare head without sunglasses at the Immigration Office. (2) Ghi r loi h chiu ph thng, cng v, ngoi giao hoc giy t c gi tr i li quc t. Specify type of passport whether it is Ordinary, Official or Diplomatic; or specify name of the International Travel Document. (3) Km theo giy t chng minh quan h. Enclose supporting documents to prove the family relationship (4) Trng hp do c quan, t chc mi, bo lnh, hoc ngi nc ngoi c th tm tr mi, bo lnh th th trng c quan, t chc xc nhn. Be certified by the head of the organization if the sponsor is an organisation or a foreigner with Temporary Resident Card. Trng hp cng dn Vit Nam, ngi nc ngoi c th thng tr mi, bo lnh, th Trng Cng an phng, x xc nhn cc ni dung ti im 2 Mc II. 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