乌兹别克斯坦签证申请

MINISTRY OF FOREIGN AFFAIRS

OF THE REPUBLIC OF UZBEKISTAN

签证申请表

VISA APPLICATION FORM

请用英语或汉语填写，请用正体字或打字形式填表格，

如字迹潦草或填写表格不完整将不予以发签证！Registration No____________

1.姓名(请用汉字和拼音)

Last name, First name

2.国籍

Citizenship 中国

3.出生日期日月年出生地址

Date of birth: Place or birth

4.婚姻状况

Marital status__ __ male

5.护照种类和号码签发地点

Passport number and type issued by__

签发日期有效期至

Date of issue 年月日 valid until 年月日

6.工作单位、职务、工作地点、电话号码

Place of work or study, position, address, phone number

7.户口地址，电话号码

Permanent address of residence, phone number

8.去乌事由（详细）

Purpose of visit (in details)

9.入境乌日期从年月日到年月日

10.去乌次数

Number of entries__________________________

11.乌方邀请人（单位），其地址，电话号码

Name of inviting organization (company), person, address, phone number

12.在乌逗留期间的住址

Address while in Uzbekistan

13.赴乌要访问的城市

Cities in Uzbekistan to be visited

14.上次到乌的访问：去乌的日期和邀请人（单位）

Previous visits to Uzbekistan (when, organization (companies) or person visited) _

15.在乌的亲属，什么亲属关系

Do you have relatives in Uzbekistan? If “yes”, what is their relationship to you?

16.随行人员

Persons traveling with you

17.申请人证明此申请表填写的内容是真实的

I declare that the information given in this application is true and correct__ ______

注意：如果申请人在此申请表中所提供的内容不属实或不完整，将不予以发签证。Note：False or incomplete information given in this application may result in refusal of issuance visa or its Cancellation

Signature ______________ Date ____________

签字申请签证日期