Scribd Logo
Upload

Welcome to Scribd!

  • 125eb69c-39b2-483b-940c-24edebabb3f4

    Uploaded by

    khalil soualhi
    8 views2 pages

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    8 views2 pages

    125eb69c-39b2-483b-940c-24edebabb3f4

    Uploaded by

    khalil soualhi

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 2

    ‫ﺗـﺮﺧﻴﺺ ﺃﺑﻮﻱ ﻻﺳﺘﺨﺮﺍﺝ ‪ /‬ﻟﺘﺠﺪﻳﺪ ﺟﻮﺍﺯ ﺍﻟﺴﻔﺮ‬

    ‫ﺇﻧﻲ ﺍﻟﻣــﻣﺿــــﻲ)ﺓ( ﺃﺳﻔﻠــــــــﻪ‪:‬‬


    ‫‪....................................................................................‬‬
    ‫ﺻﺎﺣـﺏ)ﺓ( ﺑﻁﺎﻗﺔ ﺍﻟﺗﻌﺭﻳﻑ ﺍﻟﻭﻁﻧﻳﺔ ﻋﺩﺩ‪............................................................ :‬‬
    ‫ﻣﺅﺭﺧﺔ ﻓﻲ ‪.................................................................................................... :‬‬
    ‫ﺍﻟـﻘـــﺎﻁــﻥ ﺑــ ‪................................................................................................ :‬‬
    ‫‪........................................................................................................................‬‬

    ‫ﺃﺭﺧــــــﺹ ﻹﺑـﻧـ)ــﺗـ(ـﻲ‪ /‬ﺃﺑﻧﺎﺋـﻲ ﺍﺳﺗﺧﺭﺍﺝ ‪ /‬ﺗﺟﺩﻳﺩ ﺟﻭﺍﺯ ﺍﻟﺳﻔﺭ‪:‬‬

    ‫‪........................‬‬ ‫ﺍﻻﺳﻡ‪.................................................... :‬ﺍﻟﻣﻭﻟﻭﺩ)ﺓ( ﺑﺗﺎﺭﻳﺦ‪ ............................... :‬ﺑـ‪:‬‬


    ‫‪........................‬‬ ‫ﺍﻻﺳﻡ‪.................................................... :‬ﺍﻟﻣﻭﻟﻭﺩ)ﺓ( ﺑﺗﺎﺭﻳﺦ‪ ............................... :‬ﺑـ‪:‬‬
    ‫‪........................‬‬ ‫ﺍﻻﺳﻡ‪.................................................... :‬ﺍﻟﻣﻭﻟﻭﺩ)ﺓ( ﺑﺗﺎﺭﻳﺦ‪ ............................... :‬ﺑـ‪:‬‬
    ‫‪........................‬‬ ‫ﺍﻻﺳﻡ‪.................................................... :‬ﺍﻟﻣﻭﻟﻭﺩ)ﺓ( ﺑﺗﺎﺭﻳﺦ‪ ............................... :‬ﺑـ‪:‬‬

    ‫‪......../......./.......‬‬ ‫ﺣـــــــــﺭﺭ ﺑﺗــﺎﺭﻳــــﺦ ‪:‬‬

    ‫ﺍﻹﻣــــﺿـــــﺎء )ﻣﻌﺭﻓﺎ ﺑﻪ( ‪:‬‬


    ‫ﺗﺭﺧــﻳــﺹ ﺃﺑــــــﻭﻱ‬

    ‫‪............................................................................................‬‬ ‫ﺇﻧﻲ ﺍﻟﻤﻤﻀﻲ)ﺓ( ﺃﺳﻔﻪ ‪:‬‬


    ‫ﺍﻟﻘﺎﻁﻥ ﺑـ‪................................................................................................................ :‬‬

    ‫ﺻﺎﺣﺐ ﺟﻮﺍﺯ ﺳﻔﺮ ‪ /‬ﺑﻄﺎﻗﺔ ﺍﻟﺘﻌﺮﻳﻒ ﺍﻟﻮﻁﻨﻴﺔ ﻋﺪﺩ‪................................................ :‬‬

    ‫ﺻﺎﺩﺭ)ﺓ( ﺑـﺘﺎﺭﻳﺦ ‪................................................................................................. :‬‬

    ‫ﺃﺭﺧﺺ ﻻﺑﻨﻲ )ﺗﻲ(‪.............................................................................................. :‬‬

    ‫ﻓﻲ‬
    ‫ﺍﺳﺘﺨﺮﺍﺝ ﺟﻮﺍﺯ ﺳﻔﺮ ﻷﻭﻝ ﻣﺮﺓ‬
    ‫ﺗﺠﺪﻳﺪ ﺟﻮﺍﺯ ﺳﻔﺮ‬

    ‫‪ ....................................‬ﻓﻲ‬
    ‫‪.................................‬‬

    ‫ﺍﻹﻣﻀﺎء )ﻣﻌﺮﻓﺎ ﺑﻪ(‬

    You might also like