تصريح إتلاف جواز السفر

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تصريح إتلاف جواز السفر

التصريح (مكتوب):

تصريح بالإتلاف

أنا الموقعة أسفله:

السيدة: ............... الحاملة للبطاقة الوطنية رقم:.................. والساكن بـــ .....................................................

أشهد على نفسي شهادة الطوع والرضا وأصرح على جواز السفر الخاص بي الحامل لرقم: ...................... قد تعرض للتلف نتيجة تعرضه للتمزق مما أدى إلى ضياع جميع بياناته.

بهذا أصرح وعليه امضي.

الإمضاء:

التصريح بصيغة الوورد Word :

تـــــحــمـــيـــل

تصاريح

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Wattiqa

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