Mu (Form) NA2

Ban hnh km theo thng t s 04 /2015/TT-BCA

ngy 05 thng 01 nm 2015

..........................(1)
Tr s ti:
in thoi:
S: ...............
V/v nhp cnh ca
khch nc ngoi

............. ngy.....thng...... nm ......

Knh gi : CC QUN L XUT NHP CNH (B CNG AN)

......................................(1) ngh Cc Qun l xut nhp cnh xem xt vic nhp cnh

ca ......... ngi nc ngoi, c th nh sau:

S
TT

H tn
(ch in hoa)

Gii
tnh

Ngy thng
nm sinh

Quc tch
Gc

S, loi
h chiu

Chc v hoc
ngh nghip

Hin nay

c nhp cnh Vit Nam ...........ln, t ngy ........./...../....... n ngy......../..... / .....

Vi mc ch:..................................................................................................................................
Chng trnh hot ng ti cc a phng:..............................................................................
...........................................................................................................................................................
...........................................................................................................................................................
D kin a ch tm tr ti:...........................................................................................................
.........................................................................................................................................................
C quan, t chc n tip, qun l: .........................................................................................

ngh Cc Qun l XNC: (2)

- Thng bo cho c quan i din Vit Nam ti nc ............................. cp th thc.
- Gii quyt cho khch nhn th thc ti ca khu ................................. l do .......................
........................................................................................................................................................
- ngh khc (3) ...........................................................................................................................
\
Ni nhn:

Th trng c quan/ t chc

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