ÀÍÊÅÒÀ ÄËß ËÈÖÀ, ÇÀÏÐÀØÈÂÀÞÙÅÃÎ ÂÈÇÓ.


1. ÔÀÌÈËÈß _____________________________________________________________________________________


2. ÏÐÎ×ÈÅ ÔÀÌÈËÈÈ (äåâè÷üÿ, ïñåâäîíèì, ïðåæíèå ôàìèëèè) ___________________________________________


3. ÈÌß è ÎÒ×ÅÑÒÂÎ _______________________________________________________________________________


4. ÄÀÒÀ è ÌÅÑÒÎ ÐÎÆÄÅÍÈß ______________________________________________________________________


5. ÃÐÀÆÄÀÍÑÒÂÎ íûíåøíåå ____________________________ ïåðâîíà÷àëüíîå ____________________________


6. ÑÅÌÅÉÍÎÅ ÏÎËÎÆÅÍÈÅ________________________________________________________________________


7. ÔÀÌÈËÈß, ÏÐÅÆÍÈÅ ÔÀÌÈËÈÈ, ÈÌß, ÎÒ×ÅÑÒÂÎ, ÄÀÒÀ, ÌÅÑÒÎ ÐÎÆÄÅÍÈß è ÃÐÀÆÄÀÍÑÒÂÎ
ÑÓÏÐÓÃÀ


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8. Ô.È.Î., ÄÀÒÀ, ÌÅÑÒÎ ÐÎÆÄÅÍÈß è ÃÐÀÆÄÀÍÑÒÂÎ
  ÐÎÄÈÒÅËÅÉ:  

Ìàòü____________________________________________________________________________________________


Îòåö ____________________________________________________________________________________________


9. ÑÅÐÈß è ÍÎÌÅÐ ÇÀÃÐÀÍÏÀÑÏÎÐÒÀ _______________________________________________________________


ÄÀÒÀ ÂÛÄÀ×È ____________ ÎÐÃÀÍ, ÂÛÄÀÂØÈÉ ÄÎÊÓÌÅÍÒ______________ÄÅÉÑÒÂÈÒÅËÅÍ ÄÎ____________


10. ÄÎÌÀØÍÈÉ ÀÄÐÅÑ È ÒÅËÅÔÎÍ__________________________________________________________________


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11. ÏÐÎÔÅÑÑÈß __________________________________________________________________________________


12. ÌÅÑÒÎ ÐÀÁÎÒÛ è ÄÎËÆÍÎÑÒÜ __________________________________________________________________


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13. ÑËÓÆÅÁÍÛÉ ÀÄÐÅÑ È ÒÅËÅÔÎÍ__________________________________________________________________


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14. ÏÐÅÄÏÎËÀÃÀÅÌÀß ÑÒÐÀÍÀ  ÏÎÅÇÄÊÈ, ÑÐÎÊ ÏÐÅÁÛÂÀÍÈß è ÄÀÒÀ ÂÚÅÇÄÀ


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15. ÅÑËÈ ÂÛ ÁÛËÈ ÐÀÍÅÅ Â ÑÒÐÀÍÀÕ ØÅÍÃÅÍÑÊÎÉ ÃÐÓÏÏÛ, ÓÊÀÆÈÒÅ ÂÐÅÌß È ÌÅÑÒÎ


ÏÎÑËÅÄÍÅÃÎ ÏÐÅÁÛÂÀÍÈß ñ ____________ 199____ã. ïî___________ 199____ ã. ñòðàíà______________________


ÊÎÃÄÀ È ÃÄÅ ÁÛËÀ ÎÔÎÐÌËÅÍÀ ÏÎÑËÅÄÍßß ØÅÍÃÅÍÑÊÀß ÂÈÇÀ ________________________________________


16. ÂÀØÈ ÊÎÍÒÀÊÒÍÛÅ ÒÅËÅÔÎÍÛ: ÑËÓÆÅÁÍÛÉ ____________________ ÄÎÌÀØÍÈÉ______________________


ÓÊÀÆÈÒÅ, ÊÎÌÓ ÂÛ ÄÎÂÅÐßÅÒÅ ÏÎËÓ×ÈÒÜ Ó ÍÀÑ ÏÀÑÏÎÐÒ ÏÎÑËÅ ÎÔÎÐÌËÅÍÈß (åñëè äîêóìåíòû
ñäàåò
òóð.
ôèðìà, óêàæèòå íàçâàíèå ôèðìû, êîíòàêòíûé òåëåôîí è âàøè
ïðåäëîæåíèÿ ïî äîñòàâêå èëè
âûäà÷å ïàñïîðòà)

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Ñ óñëîâèÿìè îôîðìëåíèÿ îçíàêîìëåí, íà âîïðîñû àíêåòû îòâåòèë ïðàâèëüíî.

"___" ____________________200   ã. ______________________________(ïîäïèñü)