I know, that obviously false data in the application can entail refusal in delivery of the passport for travel abroad

THE APPLICATION FOR DELIVERY OF THE PASSPORT

Surname, name, patronymic ________________________________________________________________________________________________________________________________

If had others a surname, a name, a patronymic earlier, specify them

2.Day, month, year of a birth _______________________ 3. Sex______________

(male, female)

4. The birthplace __________________________________________________________

Republic, territory, area, settlement

5. A residence _____________________________________________________________

_________________________________________________________________________

Flat, house, street, index, town, region

6. Citizenship _________________________ If simultaneously is present citizenship of

other state, it is underlined, which ___________________________________________

7. The basic document certifying the person (passport) of the citizen of the Russian Federation:

A seriesNumber Is given

_________________________________________________________________________

_________________________________________________________________________

To specify whom it is given

8. The purpose of reception of the passport ________________________________________

For time trips abroad

__________________________________________________________________________________________

For residing abroad (in what country)

9. Reception of the passport: primary, instead of used, spoiled, lost (necessary to emphasize).

__________________________________________________________________________

10. Whether was on you for the period of work (study, services) it is made out the admission to data special importance or it is perfect to the classified information related to the state secret?

_____________________________________________________________________________

(if yes, by what organization and in what year)

Whether you have the contractual, contract obligations interfering trip abroad?

_____________________________________________________________________________

(if yes, with what organization and in what year are made out)

11. Whether you are called on military service or whether are directed on alternative civil service?

__________________________________________________________________________

(for men at the age of from 18 till 27 years old )

12. Whether you are condemned for fulfilment of a crime or involved as accused?

__________________________________________________________________________

13. Whether you evade from execution of the obligations imposed by court?

___________________________________________________________________________

I ask to bring to the passport of data on my children, citizens of the Russian Federation, at the age of till 16 years old.

I ask to give out passports for travel abroad to my children (unnecessary to cross out)

Surname, name, patronymic	Day, month, year and the birthplace

15. An extract from a work-record card about labour activity for last 10 years (including study in educational institutions and military service):

Month and year	Post and place of work with the instruction	Place a present address
Receipts	Leaving	The ministries (department), without reductions	The enterprises, establishments, the organizations

The data specified in the application, are verified with the basic document certifying the person of the citizen of the Russian Federation, the identity card and a work-record card.

«__________________» 200__

_____________________________________

The signature, surname of the official

The enterprises, establishments, the organizations phone

16. I have the passport (foreign) series _____________________________________, given

_______________________________________________________________________

By whom it is given

I KNOW, THAT OBVIOUSLY FALSE DATA IN THE APPLICATION CAN ENTAIL REFUSAL IN DELIVERY OF THE PASSPORT FOR TRAVEL ABROAD

«__________________» 200__ ________________________(the signature of the applicant)

Date of reception of documents «_________________» 200__ Registration number ______

The signature, surname of the employee who has accepted the application ______________

The passport of a series number is given «________________» 200__ (date of its delivery)

The passport has received (the signature of the applicant)_____________________________

Дата добавления: 2015-11-14