越南落地签空白表格
T?KHAI ?? NGH? C?P TH? TH?C VI?T NAM (1) Array VIETNAMESE VISA APPLICATION FORM
(Dùng cho ng??i n??c ngoài – For foreigners)
1- H? tên (ch? in hoa) : ........................................................................................................ Full name (in capital letters)
2- Gi?i tính: Nam N?3- Sinh ngày .......... tháng ........... n?m .........................
Sex Male Female Date of birth (day, month, year)
4- N?i sinh : ..........................................................................................................................
Place of birth
5- Qu?c t?ch g?c : ................................ 6- Qu?c t?ch hi?n nay:.............................................
Nationality at birth Current nationality
7- T?n giáo: ............................................ 8- Ngh? nghi?p: ...................................................
Religion Occupation
9- N?i làm vi?c : ...................................................................................................................
Employer and business address
10- ??a ch?th??ng trú: ........................................................................................................... Permanent residential address ......................................................................S??i?n tho?i/Email: .....................................
Telephone/Email
Passport or International Travel Document number
C? quan c?p: ................................... có giá tr???n ngày .................../............./..............
Issuing authority: Expiry date (day, month, year)
13- Ngày nh?p xu?t c?nh Vi?t Nam g?n nh?t (n?u có): .....................................................
Date of previous entry into Viet Nam (if any)
14- D? ki?n nh?p c?nh Vi?t Nam ngày ........./......./............; t?m trú? Vi?t Nam ..............ngày
Intended date of entry (Day, Month, Year) Intended length of stay in Viet Nam: days
15- M?c ?ích nh?p c?nh: ....................................................................................................
Purpose of entry
16- D? ki?n ??a ch? t?m trú?Viet Nam:………………………………………………....
Intended temporary residential address in Viet Nam
17- C? quan, t? ch?c ho?c cá nhan t?i Vi?t Nam m?i, b?o l?nh:
Hosting organisation/ individual in Viet Nam
- C? quan, t? ch?c: .......................................................................................................... Name of hosting organization
??a ch ?: ........................................................................................................................
Address
- Cá nhan: (h ? tên) ............................................................................................................ Hosting individual (full name)
??a ch ?..........................................................................................................................
Address
Quan h ? v ?i b ?n than ..................................................................................................
Relationship to the applicant
18- Tr ? em d??i 14 tu ?i ?i cùng h? chi ?u (n ?u có):
Accompanying child(ren) under 14 years old included in your passport (if any)
19- ?? ngh ? c ?p th ? th ?c: m ?t l ?n nhi ?u l ?n
Applying for a visa Single Multiple
T ? n gày:............../......../.............??n ngày:........../........../..........
Valid from (Day, Month, Year) to (Day, Month, Year)
20- ?? ngh ? khác liên quan vi ?c c ?p th ? th ?c (n ?u có):..................................................... Other requests (if any)
......................................................................................................................................
T?i xin cam ?oan nh?ng n ?i dung trên ?ay là ?úng s? th ?t.
I declare to the best of any knowledge that all the above particular are corect.
Làm t ?i: ....................... ngày ...... tháng …...n?m ...........
Done at date (Day, Month, Year )
Ng??i ?? ngh ? (ky, ghi r? h ? tên)
The applicant’s signature and full name
Ghi chú/Notes:
(1) M ?i ng??i khai 01 b ?n kèm theo h ? chi ?u ho ?c gi ?y t ? ?i l?i qu ?c t ?, n ?p tr ?c ti ?p t ?i c? quan ??i di ?n Vi ?t Nam ? n??c ngoài ho ?c ??n v? ki ?m soát xu ?t nh ?p c ?nh t ?i c ?a kh ?u qu ?c t ? n?i nh?n th ? th ?c.
Submit in person one completed application form enclosed with passport or International Travel Document at the Vietnamese Diplomatic Mission abroad or at the international border checkpoint immigration office where the visa is issued.
(2) Kèm 02 ?nh m ?i ch
?p, c ? 4 x 6 cm, ph?ng n ?n tr ?ng, m ?t nhì
n th ?ng, ??u ?? tr ?n, kh?ng ?eo kín h m ?u (01 ?nh dán vào t ? khai, 01 ?nh ?? r ?i).
Enclose 2 recently taken photos in 4x6cm size, with white background, front view, bare head, without sunglasses (one of the form and the other separate)
(3) Ghi r? b ?, m ?, v ?, ch ?ng, con, anh, ch ?, em ru ?t (n ?u có).
State clearly the information about parents, spouse, children and siblings (if any).
(4) Ghi r? lo ?i h ? chi ?u ph ? th?ng, c?ng v ?, ngo ?i giao ho ?c gi ?y t ? có giá tr ? ?i l?i qu ?c t ?.
Specific type of passport whether it is Ordinary, Official or Diplomatic or specify name of the International Travel Document.