Form TP/QT-2010-KTLL
Photography
(4x6) / THE SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom – Happiness
BIOGRAPHY FORM

Full Name (1)…………………………………………………………

Sex: Male………. ……………..Female…………………………..

Date of birth……………………………………………………………

Place of birth (2)……………………………………………………….

Place of birth registration (3)…………………………………………..

Nationality at present4)………………………………………………...

Passaport/ substitute legal documents (5)……………………………...

Dated issue…………………..,Agency issue…………………………..

………………………………………………………………………….

Current residence………………………………………………………

Ocuppation…………………………………………………………….

Place of employment………………………………………………….

SUMMARY ABOUT YOURSELF

Previous to now, living, working and where

……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

SUMMARY OF FAMILY

Full name of father:…………………………………………………………

Date of birth:……………………………………………………………….

Nationality:…………………………………………………………………..

Place of residence……………………………………………………………

……………………………………………………………………………….

Full name of mother…………………………………………………………

Date of birth:……………………………………………………………….

Nationality:…………………………………………………………………..

Place of residence……………………………………………………………

……………………………………………………………………………….

Full name of husband/wife…………………………………………………..

Dae of birth:…………………………………………………………………..

Place of birth………………………………………………………………….

Nationality:…………………………………………………………………..

Place of residence……………………………………………………………

……………………………………………………………………………….

Full name of first child………………………………………………………..

Dae of birth:………………………………………………………………….

Place of birth………………………………………………………………….

Nationality:……………………………………………………………………

Place of residence…………………………………………………………….

………………………………………………………………………………..

Full name of second child……………………………………..

Dae of birth:………………………………………………………………….

Place of birth………………………………………………………………….

Nationality:……………………………………………………………………

Place of residence……………………………………………………………

……………………………………………………………………………….

I hereby declare that the above statements are true and would be responsible under the law of Vietnam on my testimony.

Date….....

Declarant

(Signed and full name)

Remarks:

(1)  Print letter as passport/legal substitute documents;

(2)  Write an administrative place or hostpital;

(3)  Write the office of birth registration;

(4)  Specify in each nationality in case of two or more;

(5)  Specify what types of documentation.

1