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申請用紙 | 旅行関連事業 | ATC

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Ы

Э

Э

VISA APPLICATION FOR MONGOLIA

: .

Please read carefully before you fill in.

1. / Surname (as in passport)/ 2. / Given and Middle names (as in passport)/

Э

. /For for official use only/

ө шөө өл л

а а / у у л а/

ө шөө л у аа

………... ...

Ол а лал

………...

а у а аа

………...

ял аа

2

2

1

6

Ол у аа

ү :

...

... / ү /

:

...

... / ү /

О а ө ө

………...

3. я / Current nationality(ies)/

4. / Date of birth/

(year-month-day) 5. / Place and country of birth/

6. Х / Sex/

Э /Male Э /Female

7. /Marital status/

Single Married

8. , /Profession & Occupation/

ddress Street

City Country Phone/ Fax

9. я, / Permanent address and telephone number in your home country/

Address:

Telephone number:

10. / Type of passport /

Э /Ordinary /Diplomatic /Service

я / Other travel document(please specify):

11. / Number of passport/ 12. / Valid until/ (year-month-day)

13. , , я

/Name and address of host person or organization in Mongolia/

Company name:

Address:

14. я, / Your home address and telephone number in Mongolia/

Address:

Telephone number

15. я / Purpose of travel/

Ж /Tourism /Business / Study /Employment

ү /Visiting or joining family /Transit Х /Private

/Other

16. Х / Number of entries requested/

/ Single Х ё / Double / Multiple entries

3*4 photo (taken within the last six months 3*4

( үү 6

(2)

. , .

I hereby declare that the statement given above is true and correct. I understand that any false or misleading statement may result in the permanent refusal of a visa or denial of entry into Mongolia.

………... ………...

/Applicant’s signature/ Date(year-month-day)

17. Х я 16 / Children under 16 years travelling with you/

ү үү .

(Applications must be submitted separately for each passport)

И я /

Current nationality(ies)/

/Surname/ /Given name/

/Date of birth/

я

/Relationship to Applicant /

1

2

3

18. Х Х .

PLEASE READ AND GIVE ANSWERS TO THE FOLLOWING QUESTIONS.

A. ?

Have you ever been refused a visa at a Mongolian diplomatic mission?

Yes... No

B. үү ?

Have you ever applied for Mongolian visa with a different name?

Yes... No

19. Э үү үү ү үү.

/Please complete this section if you are filling this form on behalf of visa applicant/

1. Э үү ү

... /Name of person completed the form/

…...

2. я

... /Relationship to the applicant/.

...

3. я,

... /Address and phone number/

...

4. ү ... /Signature/

I agree to my person data on this appliation form being communicated to the appropriate authorities of Mongolia if necessary for the issue of visa

I declare that to the best of my knowledge the above particulars are correct and complete. I am aware that any false statements will lead to my application being rejected or to the annulment of visa already granted and may also render me liable to prosecution under the law of Mongolia.

I undertake to leave the territory of Mongolia upon the expiring date of the visa, if granted.

I realize that possession of a visa is only on or the prerequisite for entry into the territory of Mongolia.

参照

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