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ORSZÁGOS
IDEGENRENDÉSZETI
FÓIGAZGATÓSÁG

Notification of accommodat ion

For comp_letion bl!: the authoritJ[.J

Authoritv receivino the notification /code and name l:

Time of receivino the notification:

year month day --·

PLEASE COMPLETE THE FORM LEGIBL Y IN B LOCK t [t:,{ ~ •C.iS!NG l ATIN CHARACTERS
·- - -·-- · •·· -·--
Telephone number:
--- -- ·-·-· - --
t::-mau auuress:

l. Personal data of the a llcant:

1. Sumame: GA.60 A <'i1t:J\ Sex: Y\ 1>o,. L1=
Forename(s): 'Fi Citizenshi :

2 . Mother's sumame and forename at birth:

3. Date of birth: --/',C,o--1<-.,n year month day Place of birth: A, 1¡h!A

. Marital status:
r!single o married
o divorced o widow(er)

5. Passport number and validity: A-AH Ge,C> Z31 Q.~ year ~ month ~1 day

Number of residence perrnit:

. Address of accommodation (precise):

Postal code: AO 8"~ Land register ref. number 34~1/01 /A/A6.

Locality: GuO~'P 'é.(l District: \/lll .
N;amP. nf n11hlir. nl;ar.P.: ~A-l1o-.S: \
Type of public place (road, street, square, etc):
Building number:

Building: -/\ Block: Floor: ?,. • Door: ~

7. Legal tiUe of residence al the accommodation :

o owner
o tenant
o other: ..... .................. .

Date: ... J.:-:-.~:Z,....~ ..:...¿_.<?.:._1.......... .