中华人民共和国驻外使领馆领事认证申请表.docx
中华人民共和国驻外使领馆领事认证申请表App1.icationFormofConsu1.ar1.ega1.izationoftheEmbassyCons1.ateofthePeop1.e'sRepub1.icofChina中诂人须“实、完姜、清箔地填写本米格，请逐M在空白处用中文量英文大写字母打印件填写,JKa在内打J选择Tp1.ete1.yandc1.ear1.y.P1.easetypetheanswerincapita1.Eng1.ish1.ettersinthespaceprovidedortick(>ji)there1.evantboxtose1.ect.1、个人中诂App1.icant(ForIndividua1.UseOn1.y)姓名Nan性别Gcndcr出生地点P1.aceofbirth出生日期Dateofbirth()>yymm-dd>国籍Na1.iona1.i1.y职业Occupahun身份证件种类1>pcofID身份证件号哥NumberofID工作机用或学校名称Nameofemp1.wcrsch1.工作机构或学校地址AddDSofCmP1.nyCTJKhcXd家庭住址电子邮箱1.1.c>mcaddress1.>fnai1.住宅电话手机HomCphonenumberMobi1.ePkMKmmbcr2、企业及其他僦税中请APP1.iCant(FOrCompanyZOrganizationUseOn1.y)企业或其他级纨名班NameoCoinpanyZbijaniza1.ion联系地址Address电话PhoneNumber法定代表人信息1.ega1.KeprestftMa1.tveofcompany<,cvanination姓名Name出生日期Dateofbi11h<yy>y-mmdd)证件种类TypCofD证件号码NumberofID3、公证书或其他证明文书证明的事/MattersCCrtiriedbythenotaria1.deedsorothercertificates出生证Birthcertificate;结婚证Marriagecertificate;无犯军记录证明Ccrtificateofnon-crimina1.record;健重证明Hcahhccrtifica1.c;口学历证明DiP1.Om乐委托书Au1.hOriZaHonId1.er;声明书SUHCmCn1；口商业文件BUSineSsdoCIHnCnis:(请注明)Other(p1.easespecify):4、认证办理目的和文书硬,用地点PurposeandDestinationof1.ega1.ization办及的Purposeof1.ega1.ization:焙烟Marriage;哥茶Fosterage;0房产Rea1.estate:口诉讼1.itigation;然注Visa;口领养Adoption;商务贸易Businessandtrade;其他(请注明)Other(p1.eascspecify):文书使用地Destinationof1.ega1.ization:5、提交材料及中办认证书的份ItSupportingdocumentsandCopiesof1.ega1.ization?交tt¼Supportingdocuments份数Copies6、办，时间Processingtime注:加急和特急服务须经领事官员批准，并将加收费用。Note:ExpressandIVShserviceneedsapprova1.ofconsu1.arOfficia1.sandextrafeesmayapp1.y. "&通(X个工作日)Regu1.arserviceforXbusinessdays 加急(X个工作日)ExpressSCrViCCforXbusinessdays 特急(X个工作日)RushserviceIbrXbusinessday(三)7、代办人Agent代办人姓名Nameof耶n1.性别Gender国籍NjrtKXiidity身份迂件种类Typeof1.D身份迁件号码NujnbcrofID职业Occupation与申请人的关系Re1.ation4npwiththeapp1.icant联系地址Addrcvx联系电话Phonumber电子邮箱E-nui)address8、中诂人/代办人声明Dec1.arationoftheApp1.icantZAgent我保证以上所城内容真实。如有不实之处，本人愿承担一切法律责任.Ihebydec1.av(haa1.1.(heinfbrna<>onabovei$trueandooTOCi,fbrwhichIsha1.1.beara1.1.(he1.ega1.resx>nsibi1.i(ies.国泊入冬名：日期：Signaturvnfapp1.icant:Datcfyyyy-mm-cid):代办人务名：日期：SiUnatureofw：_DatrtyyyY-min-dd):_我声明,我巴同读并理解以下内容：领事认证是指领事认证机构根据自然人.法人或者其他组织的申请,对国外有关文书上的最后一个印$、卷名的真实性予以确认的活动领事认证不对公迂书或者其他注明文书证明的事项行蚀证明职能，不对文书内容本身的真实性、合法性负费，文书内容由文书出具机为负贡。锁事官员有权对可能损害国家利我和社会公共利拉的和存在不予办理领事认证有关情形的文书不予认证。1 herebydec1.arethat1havereadandUndCrStOOdthecontentbe1.ow:Tbeconsu1.ar1.ega1.izationrefers<othepracticeofconfirming(heauthenticityofthe1.astsea1.orsignatureonre1.evantdcumcntsissuedbyothercountrics.pcrfbmcdbyConSU1.ar1.ega1.izationagenciesupontheapp1.icationofnatura1.pcrsons.1.ega1.personsorotherOrganizations.Consu1.ar1.ega1.izationdoesnotundertaketheresponsibi1.ityofcertifyingthemattersCCr1.iriCdbythenotaria1.deedsorotherccrtificatcs,anditisnotresponsib1.eforhcauthenticityandva1.idityofthedocumentssCOn1.ent.whichsha1.1.beIhCresponsibi1.ityoftheissuingins1.i1.ution.Theapp1.icationwi1.1.berefusedbyconsu1.arofficia1.ifthedocumentsmayharm(henationa1.interestsorsocia1.pub1.icimerestsorhaveothercircumstancesunderwhichconsu1.ar1.ega1.izationsha1.1.notbeperformed.申请人签名：日期：SignatureofApp1.icant:Datc(yyyymmdd):以下项目仅供领事官员填写(ForOfficia1.UseOn1.y):签署人、签署日期:复核人(如有)、复核日期:接案人、接案日期:
