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UNITED NATIONS NATIONS UNIES

United Nations Organization Mission in Mission de l’Organisation des Nations


the Democratic Republic of Congo Unies en République Démocratique du
Congo

MONUSCO
Request form for MONUSCO ID - card

TO BE FILLED UP BY REQUESTING & APPROVING OFFICER DATE: 


Name & Signature of the Senior Company representative (For contractor personnel only):

Name & Signature of the MONUSCO requesting Officer :

Section:
ID Status: International/ Local/ Military/ International Contractor/Local Contractor/Subcontractor/
Daily Worker/ Local Police Detachment/ Press /Commissariat General/ UN Volunteer /
Official Visitor / Official Visitor(UN Agency,NGO,Embassy) / JMC/ CIVPOL
REMARK:

ACCESS: All MONUSCO Premises HQ  Alcatel IvecoAgetraf AirportMonuc Beach


Kinshasa  Other
New Issue  Renewal Period of Validity:

Approved by: Office: CCPO/CMPO/CCMS/CAS/DOA /OIC


CIVPOL
Signature: Date:

TO BE FILLED UP BY THE APPLICANT (Please write in CAPITAL letters)


Last Name/Surname/Family Name: National Passport No/ No. Passport National:
RAHMAN E00007712
First Name/Prénom: MD HAFIZUR
Date of Birth /Date de naissance
UN grade: MILITARY
(DD/MM/YYYY):
Rank (For Military personnel Only): MWO
10/05/1972
Nationality/Nationalité:BANGLADESHI Blood Group/GroupeSanguin:
A+
Job Title/Function:UNIT LOAD MASTER Telephone #:5015
Department :
Contractor Company Name (if applied): Vehicle:

Height/Taille(cm):168 CM Ch/Call Sign:

Weight/Poids(kg):64 KG UN Index:

Eyes Color/Couleur yeux: BLACK UN Laissez-Passez:

Hair Color/Couleurcheveux:BLACK Address /Adresse:

Note: The requesting officer and the approving officer are two different persons
TO BE FILLED UP BY ISSUER

ID # Issued: ---------------------------------------------- ID – Issued by: ----------------------------------


Date of issuance: --------------------------------------

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