人员编号            

档案编号            

外国人签证、居留许可申请表

VISA AND RESIDENCE PERMIT APPLICATION FORM

申请人               申请时间        年     月     日

受理人               受理日期        年     月     日

Name in English     

   中文姓名                国籍                      

Name in Chinese(if applicable)    Nationality                                       

   性别   男□   女□      职业                      

   Sex      M        F         Occupation

   出生日期     年     月     日    出生地           

 Date of birth               Y                    M                D              Placeof birth

2.护照或者证件种类      外交□    公务□  普通□ 其他               

  Type of passport or certificate               Diplomatic           Service        Ordinary    Others

   护照或者证件号码                        有效期至      年    月   日

  Passport or certificate number                                                                 Valid until                     Y             M         D  

3.现持签证或者居留许可号码                签发机关                   

  Current visa or residence permit number                                               Issued by

   签证种类或者居留事由                    有效期至       年    月    日

  Type of visa or purpose of residence                                                       Valid until                         Y             M           D

4.在华邀请单位名称或者个人姓名、地址和电话

 Company or person to visit inChina, name(s), address and telephone number

  申请人在华住址、电话  Address and telephone number of applicant in China

5.使用同一护照的偕行人   Accompanying persons included in passport 

   姓名                 性别         出生日期         与申请人关系

   Name                                                     Sex                                Date of birth                     Relationship to applicant

6.申请签证的种类Type of visa you are applying for

  F商务□          C乘务□            J-2记者□          G过境□

  Business                                Crew                                        Correspondent                           Transit

  L探亲□          L旅游□            L因其他私人事务□

 Visiting relatives               Sight seeing                             For other private purposes

7.申请签证的有效次数和有效期Number of entries and validity of visa you are applying for

零次□  一次□  二次□  多次□         有效期至      年    月    日

Zero               Once          Twice         Multiple                          Valid until                  Y             M             D

8.申请居留许可Applying for residence permit           

居留事由         学习□                记者□   记者家属□ 

 Purpose of residence           Study                                       Correspondent       Family member

   任职□     任职者家属□        就业□     就业者家属□      其他□

 Taking up post     Family member                    Employment             Family member                   Others

   有效期至    年   月   日  居住地址                                  

Valid until           Y         M         D      Residence address

9.申请居留情况变更登记                                                 

   Register such changes                

  住址□      就读院校□        任职或者就业单位□      其他□

  Address                 Educational institute                   Place of work                               Others

10.申请其他证件Applying for other certificate

外国人出入境证□  外国人旅行证□   其他□ 有效期至        年   月   日

liens’ Exit-Entry Permit   Aliens’ Travel Permit       Others         Valid until                      Y           M         D

我谨声明我已如实和完整地填写了上述内容并对此负责

（如属代办，代办人签字）

I hereby declare that the information given above is true, correct and complete. I shall take full responsibility for the above information.

申请人签字                       代办人签字                 年   月    日

Applicant signature                                                          Agent signature                                            Y          M              D

以下由公安机关填写