恢复中华人民共和国国籍申请表.docVIP

恢复中华人民共和国国籍申请表 编号Serial No. Application for Restoration of Chinese Nationality 一、个人信息Personal Information 1.1 中文姓名/ Chinese Name 姓/Family Name: 名/Given Name: 照片/Photo 1.2 英文姓名/ English Name Exactly As It Appears on Your Passport 姓/Family Name: 中间名/Middle Name: 名/Given Name: 1.3 别名或曾用名/ Other Name(s) 1.4 性别/ Gender ￡ 男/Male ￡ 女/Female 1.5 出生日期/ Date of Birth (yyyy-mm-dd) 1.6 出生地（国家/城市）/ Place of Birth(City/Country) 1.7 婚姻状况/ Marital Status ￡ 未婚/ Single, Never Married ￡ 已婚/Married ￡ 离异/Divorced ￡ 丧偶/Widowed ￡ 其他（请注明）Other(Specify): 1.8 原户口所在地（如有）/ Place of Former Household Registration (if applicable) 1.9 原户口注销时间/ Date of Cancellation of Former Household Registration 1.10 原公民身份号码（如有）/ Former Chinese Resident Identity Card Number(if applicable) 1.11 现有国籍/ Current Nationality(ies) ￡ 无国籍/Stateless ￡ 单一国籍/ Single Nationality 请详细说明具体国籍、何时因何种原因取得该国籍/ Please specify what nationality you acquired, and when and for what reason you acquired it: ￡ 双重或多重国籍/ Dual or Multiple Nationalities 请详细说明具体国籍、何时因何种原因取得该国籍/ Please specify what nationalities you acquired, and when and for what reason you acquired them: 1.12 现持护照或旅行证件/ Current Passport/Travel Document 证件种类/ Type of Document 证件号码/ Document Number 签发日期/ Date of Issue 签发国家或地区/ Place of Issue 失效日期/ Date of Expiry 1.13 现持有效中国停居留证件/ Current Valid Chinese Visa/ Stay Permit/Residence Permit/ Foreign Permanent Resident ID Card ￡ 签证/ Visa 请注明签证号码、有效期限及可停留天数/Please specify the visa number, expiry date and duration of each stay: ￡ 停留居留证件/ Stay Permit/Residence Permit 请注明证件号码、有效期限/Please specify the permit number and expiry date: ￡ 永久居留身份/ Foreign Permanent Resident ID Card 请注明证件号码、有效期限/ Please specify the ID Card number and expiry date: ￡ 其他证件/