Surname (Family name) (x) IGNATEV

										PHOTO
				Application for Schengen Visa This application form is free

1. Surname (Family name) (x) IGNATEV

For offical use only

Date of application:

Visa application number:

Application lodged at

□ Embassy/consulate

□ CAC

□ Service provider

□ Commercial intermediary

□ Border

Name :

□ Other

File handled by:

Supporting documents:

□ Travel document

□ Means of subsistence

□ Invitation

□ Means of transport

□ TMI

□ Other:

Visa decision:

□ Refused

□ Issued:

□ A

□ C

□ VTL

□ Valid :

From ………………………

Until ………………………

Number of entries:

□ 1 □ 2 □ Multiple

Number of days:

2. Surname at birth (Former family name(s)) (x) IGNATEV

3. First name(s) (Given names(s)) (x) ALEKSANDR

4. Date of birth (day-month-year)

03/02/1986

5. Place of birth

MAKEEVKA

6. Country of birth

USSR

7. Current nationality

RUSSIE

Nationality at birth, if different: USSR

8. Sex

■ Male □ Female

9. Marital status

■ Single □ Married □ Separated □ Divorced □ Widow(er) □ Other (please specify)

10. In the case of minors: Surname, first name, address (if different from applicant’s) and nationality of parental authority/legal guardian

11. National identity number, where applicable

12. Type of travel document

■ Ordinary passport □ Diplomatic passport □ Service passport □ Official passport □ Special passport □ Other travel document (please specify)

13. Number of travel document 71 7399859

14. Date of issue

19/01/2012

15. Valid until

19/01/2022

16. Issued by FMS70001

17. Applicant’s home address and e-mail address

TOMSK, INTERNATSIONALISTOV STREET, 12/1-102

Telephone number(s)

+79138818158

18. Residence in a country other than the country of current nationality

⇐ Предыдущая 123 Следующая ⇒