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1、哈萨克斯坦共和国签证申请表The Republic of KazakhstanVISA APPLICATION FORM注意！请用正题完整认真填写此申请表，未按准确要求填写的申请表会成为被拒签的原因之一Attention!Application form should be filled in fully and accurately, in block letters.Wrong filling of application form can become a cause of refuse in issue of entry visa.1. 姓名/Surname(s) First name
2、s(pinyin)2. 其他姓名/Other names and surnames:3. 性别 / Gender: 口 男/Male口 女/Female4. 出生日期 /Date of birth:年/yeaI I I |月/month5. 国籍/Nationality:出生地点(市县和国家)/Place of birth (city and country):6. 出生时的国籍/Nationality by birth:7. 家庭情 况/Marital status:未 婚/single已 婚/married离婚 / divorced丧偶 widow(er)8.已婚者请填写妻子或丈夫的姓名及
3、其国籍/If you are married, please, inform your spouses full name and nationality:9. 固定地址和电话 /Your permanent home address/tel: 10. 职务和职业资格/Occupation (educational background and position):11. 工作单位/Place of work:12. 单位地址和电话/address/tel.:13./service护照类型/Type of passportl 外交 /diplomatic | | 公务 编 号/Number:有
4、效期限/validity:| H私/ordinary其他类证 件/other type of document签发地 点/issued by:14. 您曾经是否访问过哈萨克斯坦?/Have you visited the Republic of Kazakhstan before? 否/No是/Yes若是，请出示访问时间和访问目的/If yes, indicate the date and purpose of the visit(s):15. 以前是否被拒绝入境哈萨克斯坦?/Have you ever been refused entry to the Republic of Kazakhs
5、tan?:否/NoI 是/Yes. 若是，请写明原因，何时被谁拒绝川yes, please give details below (when and by whom): 16- 访问目的/Purpose of travel:17. 邀请方(地址、电话.)/Inviting organization (address, tel.):或者担保人的信息(全称.地址电话)/or person, arranging your visit to Kazakhstan (full name, address, tel ):18. 在哈萨克斯坦访问的几个地点/Places of destination in
6、the Republic of Kazakhstan:19. 在哈萨克斯坦的第一个访问地点/The first place of entry into the Republic of Kazakhstan:20. 在哈萨克斯坦停留期间的住址/Temporary address in Kazakhstan:21. 谁会承担您的旅行路费以及在哈萨克斯坦停留期间的生活支出?/Who is paying for your cost of traveling and foryour costs of living during your stay in Kazakhstan?:22. 您是否为在哈萨克斯
7、坦的停留期间购买了保险?/Have you got an insurance for the period of your stay in Kazakhstan?: 否/NO 是/Yes.D若是，请指出该保险的有效期限和保险公司的名称/If yes, please indicate its validity and the nameof insurance company:23. 若您是办理从哈萨克斯坦过境的签证，您是否取得前往国家的签证或拘留证Kazakhstan, have you got an entry visa or residence permit for your destina
8、tion?:口 否/No 是/Yes.若是,请指出前往国家/Ifyes, indicate the country of destination:?/In case of transit through入境口 岸/borderpoint through which entry is planned过境路线/route of tra nsit至 / | to _多次往返/multiple24. 所申请的签证期限/Period of requested visa:自/from_25. 所申请签证的入境次 数/Number of entries requested:26. 若注册至您护照的孩子与您同
9、行，请填写 /Children (please indicate whether they are traveling with you and are entered in your passport):姓名 / Surname, First names出生地点和日期/ Date and plase of birth国 籍/NationalityI undertake that the above mentioned personal data are full and correct. I am aware, that wrong data can cause refuse and can
10、celing of already issued visa. I am obliged to leave the territory of the Republic of Kazakhstan before visa expiration.I am told, that in accordance with the article 554 of the Tax Code of the Republic of- Kazak IV of the 10 of December 2008 the sum of money paid as consular fee is not subject for
11、return; the issued visa does not fully guarantee entry into Kazakhstan and will not serve as basis for compensation in case the authorized bodies of the Republic of Kazakhstan refuse entry for the owner of visa into territory of Kazakhstan.我保证以上提到的个人信息是完整准确的。我明白错误的信息会导致拒发签证或取消已发签 证。我有责任在签证到期之前离开哈萨克斯
12、坦。根据2008年12月10日哈萨克斯坦共和国税收法NO.99-IV第554款，我得知所付的领事费用 不能退还。发放的签证不能完全保证能够进入哈萨克斯坦国境。一旦哈萨克斯坦共和国授权机构拒 绝入境，我不能要求退还签证费用。日 期 / Date: 20_ 年 / year签 名 / Signature:DO NOT WRITE BELOW /请勿填写下列表BH3AHKAnCHPMAHMH；TYBIPmEriHIH；OPHHBu3a 6epymiH迥 kohm:Eckepiy:Bu3aHMH MopTeciKaTeropuflcuTe3加a酋Mep3iMi 20bmgaH 6acran20沁LFa geAiHKoHCvdMK arabiMKBUTaH口U/HblH HOMepiBu3a 6epirareH kyh 20 從
