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  • 4 A 05 B 46 F 930 Cace

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    Thameur Labiod
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    GOOD ONE

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    GOOD ONE

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    1K views1 page

    4 A 05 B 46 F 930 Cace

    Uploaded by

    Thameur Labiod
    GOOD ONE

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    ‫تصريح شرفي بعدم إمتلكا جواز سفر‬

    ‫المولود‬ ‫__________________________________________________________________‬ ‫أنا الممضي أسفله السيد‪:‬‬


    ‫______________________________________________________‬ ‫بتاريخ‪__________________________________________ :‬بــ‬
    ‫_________________________________________________________________________________________________‬ ‫الساكن بـ‬

    ‫الصادرة‬ ‫_____________________________________‬ ‫و الحامل لبطاقة التعريف الوطنية رقم‬


    ‫______________________________________________________‬ ‫بتاريخ____________________________________عن دائرة‬

    ‫ولية ‪ ،______________________________________________________ :‬أصرح بمقتضى شرفي أنني لم يسبق‬


    ‫لــــــي استخراج شهــــادة الـ ‪ s12‬ول أمــتلك جـــواز سـفر من قبل‪.‬‬

    ‫مصادقة البلدية‬ ‫إمضاء المعني‬

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