Mẫu X07: Giấy trình báo mất thẻ ABTC ở nước ngoài - Biểu mẫu xuất nhập cảnh

(Ban hành kèm theo Thông tư số 02/2013/TT-BCA ngày 05 tháng 01 năm 2013)            

 

  NOTIFICATION ON LOSING ABTCCARD (1) 

                              To:

1- Surname and given names………………………………………2- Sex………………

3- Date of birth…………………………………………………………..….………………

4- Permanent address: Home address (hamlet, small village)……………...……Street……………...........

Ward (commune, town) ………………District town (district, township)………………Province (city) …………

5- Name, address and phone mumber of Company/Organisation………………………

…………………………………………………………………………………………………

6- Issued ABTC Card by Vietnam immigration Dept. No:………………….. Date of expiry……../………./……

I would like to inform the local competent agency that I’ve lost my ABTC card, mentioned- above, at..………

……………………………. Date ………/………/…………….…Reason of losing:………………

Please authenticate my declaration. I’ll inform Vietnam’s competent agency to cancel validity of my lost ABTC card.

I confirm the truth of above declaration; I’m personally responsible to the State Law for that.

Authentication of members’ competent agencies.

Date ……../……../………

(Signature, position and stamp of the Authenticator)

             Done at………….. Date………/………/……

Signature of Applicant  (2)

 

  _______________________________

Note:
(1) This form used in the case of loosing ABTC cards at member economies.

(2) Business people fulfill 02 of this form with authentication of foreign competent agencies and personally

lodge or send to the Vietnam Immigration Dept., Ministry of Public Security right after returning to Vietnam