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1、OBRAZAC 1Ovaj obrazac se ne naplaCuje. /This application form is free. / 此表免费请用英文填写此申请表prijamnf Stambilj stamp of receipt cac/iet de reception单面按顺序复印ZAHTJEV ZA VIZUVISA APPLICATION克罗地亚共和国签证申请表格PRODUUENJEEXTENSION延长IZDAVANJEISSUANCE颁布Prezfme (bivse odnosno rodeno prezime) Surname (also maiden surname
2、 for married women) 姓Popunjava sluzbena osobaTo be filled out by official person此栏为签证官填写Datum obrade zahtjeva Date application Date dintroduction de la demandeIme / Given name(s) / 名Ime oca i majke / Given name(s) of father and mother / 父亲和母亲的姓名Datum rodenja / Date of birth / 出生日期Mjesto i dr2ava rod
3、enja / Place and country of birth / 出生地及国家SadaSnje dr2avljanstvo/drtavljanstva / Current nationality/nationalities / 现国籍Potpis slu2bene osobe File handled by Hesponsable du dossierDr2avljanstvo pri rotJenju / Original nationality (nationality at birth) / 原国籍 2enski / Female/女 MuSki/Male/男Spol/Sex/性别
4、Prilozena dokumentacija Supporting documents Documents justificatifsValjana putovnica Valid passportPasseport en cours de validteNeozenjen/neudana / Single / 单身 OZenjen/udana / Married / 己婚 Razveden(a) / Divorced / 离婚 Odvojen(a) / Separated I 分居 Udovac(a) / Widow(er) I 丧偶 Ostalo /Other / 其他Bracno st
5、anje Marital status 婚姻状况Novcana sredstva za uzdrzavanje Financial means Moyens financiersPozivInvitationInvitation 10. Vrsta putne isprave Type of passport.护照种类ObiCna putovnica / National passport / 私人护照 Diplomatska putovnica / Diplomatic passport / 外交护照 Sluzbena putovnica / Service passport /公务护照 P
6、utna isprava po Konvenciji iz 1951.Travel document (1951 Convention)旅行证件(1951公约)Putna isprava po Konvenciji iz 1954.Travel document (1954 Convention)旅行证件(1954公约）Druga putna isprava (navesti koja)Other travel document (please specify)其他旅行证件(请注明） Naiin putovanja Means of transport Moyens de transportP
7、utno osiguranje Travel insurance Assurance voyageDrugoOtherAutresVizaVisaBroj putne isprave / Number of passport / 护照号码Izdana od / Issued by / 发照机关Datum izdavanja / Date of issue / 发照日期Rok valjanosti / Valid until / 有效期至OdbijenaRefusedRefuseOdobrenaApprovedAccordeBroj osobne iskaznice (nije obavezno
8、) / ID-number (optional) / 身份证号码（如有则填）15.16. Ako boravite u zemlji koja nije va5a zemlja podrijetla, imate li dopuStenje vratiti se?If you reside in a country other than your country of origin, have you permission to return to that country? 如果你的居住国不是你的国籍所在国，那么你是否被允许返回居住国 NE / NO / 不 DA (broj i valja
9、nost) YES (number and validity)是（号码和有效期）11.12.13.14.Zanimanje / Current occupation / 现职业17.Vrsta vize Type of visa Type de visa A B CBroj ulazaka Number of entries Nombre dentres 1 2 NRok valjanosti Period of validity Periode de validity od fromdudo18. Poslodavac (naziv, adresa, broj telefona), za s
10、tudente/uCenike naziv i adresa SkoleEmployer and employers address and telephone number. For students, name and address of school. 工作单位名称、地址及电话,学生填写学校名称及地址Dr2ava odredista / Main destination / 主要目的地19.20. Druge vize izdane u posljednje tri godine i razdoblje njihove valjanosti Other visas (issued du
11、ring the past three years) and their period of validity 其他签证(最近三年内）及有效期至21. U slucaju tranzita, imate li dozvolu ulaska u tredu zemlju?In the case of transit, have you an entry permit for the final country of destination? 如需过境,你是否有进入最终目的地国家的入境许可？ Zrakoplovno tranzitna (A) / Airport transit (A) / 机场过
12、境(A) Tranzitna (B)/Transit (B/过境(B) Putna (C) /Trave丨(C) /旅行(C)一Vrsta vize Type of visa 签证类型22.au. Jedan/One/次 Dva/Two/两次 NeograniCen/Multiple/多次Trajanje boravkaDuration of stay Duree du sejour Dana DaysJoursBroj ulazaka Number of entries 申请入境次数23.24.Trajanje boravka / Duration of stay / 停留时间.dana /
13、 days / 天U Turizam/Tourism/旅游 Pos 丨 ovno/Business/商务NapomeneRemarksRemarquesSiuzbeno / Official / 公务 Kultura/sport / Cultural/Sports / 文化 / 体育 Privatni posjet / Visit to Family or Friends / 探亲访友 Zdravstveni razlozi I Medical reasons / 医疗 Ostalo (molimo navesti) / Other (please specify) / 其他（请详细注明25.
14、Svrha putovanjaPurpose of travel 旅行目的26.Fizika hi pravna osoba koju posjeCujete (ime, adresa, broj telefona i faksa, e-mail) Natural or legal person you are visiting (Name, address, telephone, telefax, e-mail)邀请人的姓名,地址及电话27.28.Adresa boravka u Republic! Hrvatskoj Address where you will be staying in the Republic of Croatia 你将在克罗地亚的居住地址Tko snosi troSkove putovanja i boravka?Who is paying for your costs of travelling and for your costs of living during your stay?谁支付你的路费和在国外停留期间的生活费用？ Osobno / Myself / 申请人口 FiziCka osoba/pozivatelj / Host person(s)/遨请人 Pravna osoba (koja 丨 kakcO /
