MFA Common App for VISA version 10 Sep



457200-980440Please attach 1photograph taken withinthe last 6 months (4x 6cm)00Please attach 1photograph taken withinthe last 6 months (4x 6cm)APPLICATION FOR VISARoyal Thai Embassy, MoscowPlease Indicate Type of Visa Requested53492407429500Diplomatic Visa Official Visa Courtesy VisaNon-Immigrant VisavTourist VisaTransit VisaNumber of Entries Requested19144006223000137160062230001793875205105005149856223000 V Mr.Mrs.MissIvan Ivanovich PetrovFirst NameMiddle NameFamily Name(in BLOCK letters)Former Name (if any) NationalityBelarus Nationality at Birth Belarus Birth Place Novopolotsk Marital Status married 177736545339000Date of Birth26 01 1991 Type of Travel DocumentPassportNo. MP3982885Issued at Ministry of Internal AffairsDate of Issue 29 05 2017 Expiry Date 29 04 2017 Occupation (specify present position and name of employer)45720016573500manager LLC ?Kolokolchyk?Current Address Minsk, Pupkina ,4-178Countries for which travel document is valid4115435193675007766050-1714500for allProposed Address in Thailand Bella Express, Pattaya 366|32 14.9. Central Pattaya , Nongprue Banglamung, Chonburi 20150 Name and Address of Local GuarantorAndrei Ivanov, Novopoltsk Molodejnaya 19-114 Tel./Fax. (29) 593-62-04 Name and Address of Guarantor in Thailand403923513779500Bella Express, Pattaya 366|32 14.9. Central Pattaya , Nongprue Banglamung, Chonburi 20150Tel./Fax. +66 38428104 I hereby declare that I will not request any refund frommy paid visa fee even if my application has been declined.3996055-537210Signature29.02.2018Attention for Tourist and Transit Visas ApplicantsI hereby declare that the purpose of my visit to Thailandis for pleasure or transit only and that in no case shall I engage myself in any profession or occupation while in the country.SignatureDate 29.012201800Signature29.02.2018Attention for Tourist and Transit Visas ApplicantsI hereby declare that the purpose of my visit to Thailandis for pleasure or transit only and that in no case shall I engage myself in any profession or occupation while in the country.SignatureDate 29.012201865976518161000Tel. (029) 9362859E-mail Permanent Address (if different from above) the same 658495181610003991610-76835FOR OFFICIAL USEmfavisaform10092007Application/Reference No. Visa No. Type of Visa:Diplomatic VisaOfficial VisaCourtesy Visa Non-Immigrant VisaTourist VisaTransit VisaCategory of Visa: Number of Entries:SingleDoubleMultipleEntriesDate of IssueFee Expiry Date Documents Submitted Authorized Signature and Seal 00FOR OFFICIAL USEmfavisaform10092007Application/Reference No. Visa No. Type of Visa:Diplomatic VisaOfficial VisaCourtesy Visa Non-Immigrant VisaTourist VisaTransit VisaCategory of Visa: Number of Entries:SingleDoubleMultipleEntriesDate of IssueFee Expiry Date Documents Submitted Authorized Signature and Seal Tel.Names, dates and places of birth of minor children (ifaccompanying)193865516827500Date of Arrival in Thailand19 mar 2018Traveling by Etihad Aiways Flight No. or Vessel’s name: EY406 Duration of Proposed Stay: 18 days 155130539179500256159039179500155130570612000Date of Previous Visit to Thailand: NO_____ Purpose of Visit: v Tourism Transit636905635000BusinessDiplomatic/Official6369056350000Other (please specify) ................
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