tsta solicitudes de aistibucion gratuta Secretaria de Relaciones Exteriores Visa application Form Photo Consular Office located in Reference Number An application must be filled out by each interested artv in anv kind of non-erasable print form. Oficial use only Personal Information STUB 1. Names(s) they anger nthe psu deny and aveldocuen 2 Fist Last Name 3. Second Last Name (asthe arp on thesaipr riety anal doce 450 Female Male '.Date of Bit 7 7 GARE 7.Place of Birt 8, National 9. Passport or identity andtravel document number '@) Country issuing the document ) Issue Date 7 7 (© Expiration Date 7 7 I Additional Information 10. Marital status © single mmartied ‘common law 11. Current address 12. Phone number 13. Esmall 14. Current occupation 15. Name of Company or institution 116. Country of residence 17 Legal Residence: Yes No 18 Do youhave a criminal recordin Mexico or any other country Yes © No 19. the answer is yes please explain Ill Information and purpose of the trip Tipo de visa macacon wa Vistante sn permis pararealar actividades remuneradas Vistante sin permis para ealar actividades emuneradas(arga Duracin) Vistante con permiso para realizar actividades remuneradas Vistante pata real tries de adonein Resident temporal estudante Residencia temporal Residencia permanente Diplomstica ofc sen Tipo de pasaporte asa canvna x Ordinaio No Crdnaio © Lassex Passer 20.Date of entry into Mexico: 7 / 21. Point of entry: 22. Lenght of stay Less than 180 days More than 180 and less than 4 years Definitve 23, Have you ever been to Mexico. Yes No Observaciones: 24, Have you ever been deported: © Yes © No (from Mexico) 25. the answer is yes please explain: 26. Purpose of your visit ta México ‘conact: vera res Magn no. 2.93 Col Guero Deleon Cuaténog, (CP 06300 Gudad de Moa Tekfona (55) 3686-5100 Conc decrsricodgsconslesose gobi erate?tsta solicitudes de aistibucton gratuta gob mx Secretaria de Relaciones Exteriores Iv. Minors In the case of gil, boys. teenagers or persons under legal custody according to civil law, must present their application signed by mother and father or by whomever has paternity rights or legal custody. If the application fs only presented by one af the parents, notarized written ‘authorization must be given by the other parent to apply forthe visa ‘When they travel alone or with a third adult person, hey must shaw written authorization by both parents or whomever has legal paternity rights or legal custody given before a Notary Public or before the caresponding authority In the case of rinors, the signature must be of te parents, tutors or whomever has paternity rights. V. __ Attached supporting documents Dv. 2 3) 4) 5) In the cases in which the appicant presents altered, madfied, false or fraudulently abtained documents, the applicant wil be registered in the immigration controllist and will not beable ta obtain a visa to enter Mexico, According to the Immigration Law and its Regulation, the Mexican visa allows the bearer to request entry inta Mexican teritary atthe point of ‘entry. The Mexican visa does not guarantee entrance into Mexico. The final admission into Mexico is subject to the authorization of immigration ‘and Saritary authorities atthe point of entry, who may at any given time verify the requirements established an all applicable egal dispositions, You are hereby informed that al the personal data collected during the visa process i protected by law according tothe Ley General de Proteccién de Datos Fersonales en Posesién de Sujetos Obligados. You may vetfy the integral and simplified privacy natice in the following link Place and Date Place: Date wo / ww ‘ m Applicant’s Name and Siganture Mother's Name and signature Father's Name and Signature arora eg (asin order gd Recibié Entrevist6 Capturd iene yma ane ast amie yea craton) rie ira en cats Autoriz6 Sethe sas bre oN ‘conactn vera res Magn no. 2.93 Col Guero Deleon Cuaténog, (CP 06300 Gudad de Moa Tekfona (55) 3686-5100 Conc decrsricodgsconslesose gobi Pesan?