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外国人签证、居留许可申请表

外国人签证、居留许可申请表

外国人签证、居留许可申请表

Visa or Residence Permit Application Form

请用蓝黑色或者黑色墨水笔填写申请表内容

Please complete the form with a dark blue or black ink pen

 

 

 

1、英文姓名     姓:________________名

   Name in English:    Surname           Given name

 

中文姓名:___________________________  性别:  男 □  女 □

   Name in Chinese                         Sex     M.      F.

  

   出生日期_________年_______________日    国籍:______________

   Date of birth          Y        M       D     Nationality

 

在哈住址                                                        

   Address in Harbin                              

 

所属派出所                            来华职业或身份                

 

Police station in the vicinity          Occupation or status in China   

 

在哈单位名称                                     电话:                 

   Name of employer/school                               Tel

  

2、护照种类:           外交 □          公务(官员)□         普通 □          其他 □    

   Passport type         Diplomatic        Service(Official)         Ordinary          Other

 

   护照号码                       有效期至:________年________月________

   Passport No.                       Valid until         Y         M        D

 

3、本次入境签证种类:      L □    F □    Z □    X □   J-1 □   J-2□   C □   G □    

Current visa category   D □    居留许可 □          团签 □       免签 □         其他 □

Residence permit    Group visa   Exempt        Other            

 

   签证号码:                  入境次数:______次      有效期至:_______年_____月______日

Visa No.                     Number of entries         Valid until         Y      M      D

 

4、使用同一护照的偕行人  

Dependents on applicant’s Passport

   

姓            名                   性别     出生年月          与申请人关系

Surname     Given name         Sex    Date of birth     Relationship w/applicant

    

____________                        ____    _______________                                         

   

 

____________                        ____    _______________                           

   

  

 

5、申请签证类填写 Forvisaapplicationonly

F 商务 □    L 探亲  □        L 旅游  □       L 因其他私人事务 □      团签 □

Business    Visiting family    Tourist         Other private reasons     Group visa

J-2 记者 □     G过境  □      C乘务  □        寄养   □             团分 □

Journalist        Transit          Crew          Child with custodian    Separation from group visa  

申请入境次数:      零次 □      一次 □     二次 □       多次 □  

Number of entries     Zero         Single      Double       Multiple       

申请日期至:_______________________________

Desired validity until        Y         M          D

 

6、请居留许可类填写 Forresidencepermitapplicationonly

任职 □

任职者家属 □

就业 □

 

就业者家属 □

Executive

&/

Accompanying family member

Employee

 

Accompanying family member

记者 □

记者家属 □

学习 □

其他 □

Journalist

&/

Accompanying family member

Study

Other

首次申请居留许可 □      申请居留许可 □      申请有效期至: _________年______月_______日

1st time application          Renewal             Desired validity date until   Y      M        D

 

7、变更:         住址 □       身份 □           单位 □        院校 □        其他 □

Change of      Residence     Employment status   Employer       School         Other              

增 □      减 □         偕行人                        如其他请注明                       

Increase    Decrease    of dependents                 or other, please specify

 

迁出 □      迁往____________省(市)                                               单位

Move out    to            Province(city)                               Employer/Organisation

 

8、申请其他证件Other documents application

外国人出入境证 □                   外国人旅行证 □                     其他 □ 

Foreign citizen exit-entry permit         Foreign citizen travel documents        Other         

旅行地点:                          有效期至 :         _________年________月_________日

Destination                           Desired validity date until      Y        M        D  

 

9、备注:Notes

我保证以上填写的内容真实、准确、完整,并保证在居(停)留期间遵守中华人民共和国的法律。

I hereby declare that the information given above is true, correct, current and complete.  I shall abide by the Law of the Peoples Republic of China during my stay in its territory, and understand I shall otherwise subject myself to legal liabilities.

申请人签字:                                 代办人签字:                          

Applicant’s signature                          Agent’ signature

联系电话 Tel:_________________________     联系电话Tel.:_________________________

申请日期:             年     月     日      

Application date         Y     M      D      单位印章Company/School chop:

 

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