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E Passport Application Form .pdf


Original filename: E-Passport-Application-Form.pdf
Title: English
Author: Suellen Rumley

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Islamic Republic of Afghanistan
‫ﺟﻤﻬﻮری اﺳﻼﻣﯽ اﻓﻐﺎﻧﺴﺘﺎن‬

Passport Application Form
‫ﻓﻮرﻣﻪ درﺧﻮاﺳﺖ ﭘﺎﺳﭙﻮرت‬
Personal Details
Title:

Yahya
Family Name:
Rezai
Given Names:
Yahya
Father’s Full Name:
Abdullah
Grandfather’s Full Name:
Zabihullah
Date of Birth (Gregorian): 04
DD / 02
MMM / 1976
YYYY
Place of Birth details:
Afghanistan
- Country:

† Engaged
† Widow / Widower

† Male

† Unknown

Child:

† Yes

† No

Country of Residence:
Other Nationalities:

sweden
swedish

Height (cm):
Hair Colour: † Black
† Red

† Blonde
† Grey

Eye colour: † Blue † Brown
† Grey † Hazel
Other Distinguishing Marks:

:‫اﺳﻢ ﻣﮑﻤﻞ ﭘﺪر‬
:‫اﺳﻢ ﻣﮑﻤﻞ ﭘﺪرﮐﻼن‬
‫ﺟﺰﺋﻴﺎت ﻣﺤﻞ ﺗﻮﻟﺪ‬
‫ ﻣﻤﻠﮑﺖ؛‬‫ وﻻﻳﺖ؛‬‫ ﻧﺎﺣﻴﻪ؛‬/‫ وﻟﺴﻮاﻟﯽ‬-

‫داراﺑﺎد‬

Gender: † Female
(Under 18 Years)

:‫اﺳﻢ‬

‫اﻓﻐﺎﻧﺳﺗﺎن‬
‫ﻓراه‬

Darabad

Marital Status: † Single
† Married
† Separated
† Divorced

:‫اﺳﻢ ﺧﺎﻧﻮادﮔﯽ‬

:(‫ﺗﺎرﻳﺦ ﺗﻮﻟﺪ )هﺠﺮی ﺷﻤﺴﯽ‬

‫ ﺳﺎل‬/ 11
‫ ﻣﺎﻩ‬/ 15
‫روز‬
1354

- District / Suburb:
- Village:

:‫ﻟﻘﺐ‬

‫ذﺑﯾﺢ هللا‬

Farah

- Province / State:

‫ﺷﻬﺮت ﻣﮑﻤﻞ‬

‫ﯾﺤﯿﯽ‬
‫رﺿﺎﯾﯽ‬
‫ﯾﺤﯿﯽ‬
‫ﻋﺒﺪاﻟﻠﻪ‬

† Brown
† Brunette
† Green
† Other

‫† ﻧﺎﻣﺰد‬
‫ ﺑﻴﻮﻩ‬/‫† زﻧﻤﺮدﻩ‬
‫† ﻧﺎﻣﻌﻠﻮم‬
‫† ﻧﯽ‬

‫ ﻗﺮﻳﻪ؛‬‫ † ﻣﺠﺮد‬:‫ﺣﺎﻟﺖ ﻣﺪﻧﯽ‬
‫† ﺟﺪا ﺷﺪﻩ‬
‫† ﻣﺘﺎهﻞ‬
‫† ﻃﻼق ﺷﺪﻩ‬
‫† ﻣﺬﮐﺮ‬
‫† ﻣﻮﻧﺚ‬
:‫ﺟﻨﺲ‬
‫† ﺑﻠﯽ‬

(18 ‫ )زﻳﺮ ﺳﻦ‬:‫ﻃﻔﻞ‬

:‫ﻣﻤﻠﮑﺖ ﻣﺤﻞ اﻗﺎﻣﺖ‬
‫ﺳوﺋدن‬
:‫ﺗﺎﺑﻌﻴﺖ هﺎی دﻳﮕﺮ‬
‫ﺳوﺋدی‬
175 :(‫ﻗﺪ )ﺑﻪ ﺳﺎﻧﺘﯽ ﻣﺘﺮ‬

‫† ﺧﺮﻣﺎﻳﯽ‬
‫† زرد‬
‫† ﻣﺸﮑﯽ‬
‫† ﺳﻔﻴﺪ‬
‫† ﺳﺒﺰ‬
‫† ﺧﺮﻣﺎﻳﯽ‬
‫† دﻳﮕﺮ‬
‫† ﻓﻨﺪﻗﯽ‬

‫ † ﺳﻴﺎﻩ‬:‫رﻧﮓ ﻣﻮ‬
‫† ﺳﺮخ‬
‫ † ﺁﺑﯽ‬:‫رﻧﮓ ﭼﺸﻢ‬
‫† ﺧﺎﮐﺴﺘﺮی‬
:‫ﻋﻼﺋﻢ ﻓﺎرﻗﻪ دﻳﮕﺮ‬

:‫ﺟﺰﺋﻴﺎت ﺗﻤﺎس‬
Björnbergs Väg 23 lgh 1101 :‫ﺁدرس ﻓﻌﻠﯽ‬
433 34 Partille Göteborg sweden

Contact Details
Current Address:

:‫ﺁدرس ﻗﺒﻠﯽ‬

Previous Address:

yahya7622@gmail.com

Email Address:
Mobile:

Work Tel:

0762304589Fax:

Home Tel:

Employment Details
Occupation:
Employer:
Employers Address:

Version 1

student

:‫ﺗﻴﻠﻔﻮن ﻣﺤﻞ ﮐﺎر‬

:‫ﭘﺴﺖ ﺑﺮﻗﯽ‬

:‫ﺗﻴﻠﻔﻮن هﻤﺮاﻩ‬

:‫ ﻓﮑﺲ‬0762304589:‫ﺗﻴﻠﻔﻮن ﻣﻨﺰل‬

‫ﻣﺣﺻل‬

‫ﺟﺰﺋﻴﺎت وﻇﻴﻔﻪ‬
:‫ﺷﻐﻞ‬
:‫ﮐﺎرﻓﺮﻣﺎ‬
:‫ﺁدرس ﮐﺎرﻓﺮﻣﺎ‬

Page 1

Previous Employer:

:‫ﮐﺎرﻓﺮﻣﺎی ﻗﺒﻠﯽ‬

Employers Address:

:‫ﺁدرس ﮐﺎرﻓﺮﻣﺎ‬

‫ﻣﺸﺨﺼﺎت دﻳﮕﺮ‬

Other Details
Passport Type:

† Ordinary

:‫ﻧﻮع ﭘﺎﺳﭙﻮرت‬

† Diplomatic

‫ﻋﺎدی‬

† Service

‫ﺳﻴﺎﺳﯽ‬

If Diplomatic Passport or Service Passport, please enter your Job Title:

‫ﺧﺪﻣﺖ‬

‫ ﻟﻄﻔﺎ ﻣﻘﺎم ﺧﻮد را درج ﻧﻤﺎﻳﻴﺪ؛‬،‫در ﺻﻮرﺗﯽ ﮐﻪ ﭘﺎﺳﭙﻮرت ﺳﻴﺎﺳﯽ ﻳﺎ ﺧﺪﻣﺖ ﺑﺎﺷﺪ‬
Identification:

† Identity Card

‫ ﺗﺸﺨﻴﺺ هﻮﻳﺖ‬:

† Marriage Certificate † Birth Certificate

‫ﮐﺎرت هﻮﻳﺖ‬

‫ﺗﺼﺪﻳﻖ ازدواج‬

Have you ever had an Afghan passport?

‫ﮔﻮاهﯽ ﺗﻮﻟﺪ‬

† Yes

† No

‫ﺑﻠﯽ‬

‫ﻧﯽ‬

‫ﺁﻳﺎ ﮔﺎهﯽ ﭘﺎﺳﭙﻮرت اﻓﻐﺎﻧﯽ داﺷﺘﻪ اﻳﺪ؟‬

If yes, please provide:

† Passport

‫ﭘﺎﺳﭙﻮرت‬

‫ ﻟﻄﻔﺂ ﺟﺰﺋﻴﺎت ذﻳﻞ را ﺗﮑﻤﻴﻞ ﻧﻤﺎﺋﻴﺪ؛‬،‫اﮔﺮ داﺷﺘﻴﺪ‬

Previous Passport Number:

‫؛ ﺷﻤﺎرﻩ ﭘﺎﺳﭙﻮرت ﻗﺒﻠﯽ‬
Passport Type:

‫؛ﻧﻮع ﭘﺎﺳﭙﻮرت‬
Issue Date:

1383688

‫ﻋﺎدی‬

Expiry Date:

1391/08/10

‫؛ﺗﺎرﻳﺦ ﺻﺪور‬

1396/08/09

‫؛ﺗﺎرﻳﺦ اﻧﻘﻀﺎ‬

Place of Issue (In English and Dari):

(‫؛ ﻣﺤﻞ ﺻﺪور )ﺑﻪ دری و اﻧﮕﻠﻴﺴﯽ‬
Do you have a criminal record?

† Yes

‫ﺁﻳﺎ ﺳﺎﺑﻘﻪ ﺟﻨﺎﻳﯽ دارﻳﺪ ؟‬

‫ﺑﻠﯽ‬

If Yes, please provide details: (attach separate sheet if more
room is required)

Purpose of Travel:

‫هﺪف ﻣﺴﺎﻓﺮت‬

† Business

‫ﺗﺠﺎرت‬

† Exhibition

† No

‫ﻧﯽ‬
‫ ﻟﻄﻔﺂ ﺗﺸﺮﻳﺢ دهﻴﺪ؛) اﮔﺮ ﺟﺎی ﮐﺎﻓﯽ ﻧﻴﺴﺖ در‬،‫در ﺻﻮرت داﺷﺘﻦ‬
(‫ورق ﺟﺪاﮔﺎﻧﻪ ﻧﻮﺷﺘﻪ و ﺿﻤﻴﻤﻪ ﻧﻤﺎﻳﻴﺪ‬

† Convention / Conference

‫ﮐﺎﻧﻮﻳﻨﺴﻴﻮن‬/‫ﮐﺎﻧﻔﺮاﻧﺲ‬

† Visiting Friends / Family

‫ﻧﻤﺎﻳﺸﮕﺎﻩ‬

‫ﺧﺎﻧﻮادﻩ‬/‫دﻳﺪار ﺑﺎ دوﺳﺘﺎن‬

† Education

‫ﺗﺤﺼﻴﻞ‬

† Holiday

‫ﮔﺬراﻧﺪن رﺧﺼﺘﯽ‬

† Employment
† Other

‫ﮐﺎر‬

‫دﻳﮕﺮ‬

I declare that:
- to the best of my knowledge and belief I am an Afghan Citizen
- the statements made in this application are true and correct

:‫ﺑﺎ اﮔﺎهﯽ ﮐﺎﻣﻞ اﻗﺮار ﻣﻴﺪارم اﻳﻨﮑﻪ‬
‫ ﻣﻦ ﻳﮏ ﺷﻬﺮوﻧﺪ اﻓﻐﺎن هﺴﺘﻢ‬‫ اﻇﻬﺎرات ﻣﻦ درﻳﻦ درﺧﻮاﺳﺖ راﺳﺖ و درﺳﺖ ﻣﻴﺒﺎﺷﺪ‬Passport Photograph:

‫ﻋﮑﺲ ﭘﺎﺳﭙﻮرت‬
Signature: (please sign within the box)

Note: The photograph must comply with guidelines.

.‫ ﻋﮑﺲ ﺑﺎﻳﺪ ﻣﻄﺎﺑﻖ ﺑﻪ رهﻨﻤﻮد هﺎ ﺑﺎﺷﺪ‬: ‫ﻧﻮت‬

‫)ﻟﻄﻔﺂ در داﺧﻞ ﭼﻮﮐﺎت ذﻳﻞ اﻣﻀﺎ ﻧﻤﺎﺋﻴﺪ( اﻣﻀﺎ‬

Guarantor must
endorse the photo

Please Attach
Photo Here
‫ﻟﻄﻔﺎ ﻋﮑﺲ را درﻳﻦ ﺟﺎ‬
‫اﻟﺼﺎق ﻧﻤﺎﻳﻴﺪ‬
Date:

‫ﺗﺎرﻳﺦ‬

:

Version 1

DD / MMM / YYYY
‫ روز‬/ ‫ﻣﺎﻩ‬
/ ‫ﺳﺎل‬

‫ﺿﻤﺎﻧﺖ ﮐﻨﻨﺪﻩ ﺑﺎﻳﺪ در ﻋﮑﺲ‬
‫ﺗﺼﺪﻳﻖ ﻧﻤﺎﻳﺪ‬
This is a true photo of:

‫اﻳﻦ اﺳﺖ ﻋﮑﺲ واﻗﻌﯽ‬
-----------------------------(name of applicant)

(‫)اﺳﻢ درﺧﻮاﺳﺖ ﮐﻨﻨﺪﻩ‬

-----------------------------(signature of guarantor)
(‫)اﻣﻀﺎ ﺿﻤﺎﻧﺖ ﮐﻨﻨﺪﻩ‬

Page 2

Islamic Republic of Afghanistan
‫ﺟﻤﻬﻮری اﺳﻼﻣﯽ اﻓﻐﺎﻧﺴﺘﺎن‬

Passport Application Form
‫ﻓﻮرم درﺧﻮاﺳﺘﯽ ﭘﺎﺳﭙﻮرت‬
OFFICE USE ONLY

‫ﺑﺮای اﺳﺘﻔﺎدﻩ رﺳﻤﯽ‬
RECEIVING OFFICE:

‫دﻓﺘﺮ ﮔﻴﺮﻧﺪﻩ‬
PROOF OF IDENTITY

‫ﺗﺜﺒﻴﺖ هﻮﻳﺖ‬
TYPE:

‫ﻧﻮع‬
DOCUMENT NUMBER:

‫ﺷﻤﺎرﻩ ﺳﻨﺪ‬
ISSUED BY:

‫ﺻﺎدر ﮐﻨﻨﺪﻩ‬
Certified Copy Supplied

‫ﮐﺎﭘﯽ ﺗﺼﺪﻳﻖ ﺷﺪﻩ درﻳﺎﻓﺖ ﺷﺪ‬
Original Document Sighted

‫ﺳﻨﺪ اﺻﻠﯽ دﻳﺪﻩ ﺷﺪ‬
PROOF OF RESIDENCY:

‫ﺗﺜﺒﻴﺖ ﻣﺤﻞ اﻗﺎﻣﺖ‬
Supplied

‫درﻳﺎﻓﺖ ﺷﺪ‬
Authorising Body:

‫ﻣﺮﺟﻊ ﺗﺼﻮﻳﺐ ﮐﻨﻨﺪﻩ‬
INTERVIEW

‫ﻣﺼﺎﺣﺒﻪ‬
BY:

‫ﺗﻮﺳﻂ‬
LOCATION:

‫ﻣﺤﻞ‬
Comments:

‫ﺗﻮﺿﻴﺤﺎت‬

Signature of Interviewer:

‫اﻣﻀﺎ ﻣﺼﺎﺣﺒﻪ ﮐﻨﻨﺪﻩ‬
Date:

‫ﺗﺎرﻳﺦ‬

‫‪Islamic Republic of Afghanistan‬‬
‫ﺟﻤﻬﻮری اﺳﻼﻣﯽ اﻓﻐﺎﻧﺴﺘﺎن‬

‫‪Passport Application Form‬‬
‫ﻓﻮرم درﺧﻮاﺳﺘﯽ ﭘﺎﺳﭙﻮرت‬
‫‪† No‬‬

‫ﻧﯽ‬

‫‪PASSPORT ISSUED: †Yes‬‬

‫ﺑﻠﯽ ﭘﺎﺳﭙﻮرت ﺻﺎدر ﮔﺮدﻳﺪ‬
‫‪PASSPORT NUMBER:‬‬

‫ﺷﻤﺎرﻩ ﭘﺎﺳﭙﻮرت‬
‫‪ISSUED BY:‬‬

‫ﺻﺎدر ﮔﺮدﻳﺪ ﺗﻮﺳﻂ‬
‫‪ISSUING OFFICE:‬‬

‫دﻓﺘﺮ ﺻﺎدر ﮐﻨﻨﺪﻩ‬
‫‪DATE:‬‬

‫ﺗﺎرﻳﺦ‬
‫‪COLLECTED BY:‬‬

‫درﻳﺎﻓﺖ ﺷﺪ ﺗﻮﺳﻂ‬

‫‪(Note, if collected by someone other than the applicant, written authorisation must be provided by‬‬
‫)‪the applicant and retained on file‬‬

‫)ﻳﺎدداﺷﺖ‪ ،‬ﺑﺨﺎﻃﺮ ﺁﻧﮑﻪ ﺷﺨﺺ دﻳﮕﺮی ﺑﺘﻮاﻧﺪ ﭘﺎﺳﭙﻮرت را ﺑﻪ ﻧﻤﺎﻳﻨﺪﮔﯽ از درﺧﻮاﺳﺖ ﮐﻨﻨﺪ ﺗﺴﻠﻴﻢ ﺷﻮد‪ ،‬ﺑﺎﻳﺪ اﺟﺎزﻩ ﻧﺎﻣﻪ ﮐﺘﺒﯽ از‬
‫درﺧﻮاﺳﺖ ﮐﻨﻨﺪﻩ اراﻳﻪ ﺑﺪارد‪ .‬اﺟﺎزﻩ ﻧﺎﻣﻪ ﺑﻌﺪًا ﻗﻴﺪ دوﺳﻴﻪ ﻣﺮﺑﻮﻃﻪ ﻣﻴﮕﺮدد‪.‬‬


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