Dịch vụ
Sổ Hồ Khẩu - Form HK08 TT 81.2011.TT BCA
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SOCIALIST REPUBLIC OF VIET NAM Independence - Freedom - Happiness ------------
FAMILY RECORD BOOK
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POLICE OF BINH DUONG PROVINCE |
HOUSEHOLDER |
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FAMILY RECORD BOOK |
Full name: |
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No. |
Other name (if any): |
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Date of Birth: |
Sex: Male Female |
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Householder’s full name : |
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Native Place: |
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Permanent residence: |
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Ethnic Group: Kinh |
Nationality: |
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ID Card No. |
Passport No. |
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Occupation, place of work: |
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Last permanent residence before moving in:
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September 8, 2014 Deputy Chief Police of TDM (Signed & Sealed) Colonel: MAI ANH DUNG |
Registrar (Signed)
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September 8, 2014 Deputy Chief Police of TDM (Signed & Sealed) Colonel: MAI ANH DUNG |
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Reason of permanent resident deregistration:
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File No. 4686 |
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Registrar (Signature, full name) |
Date….month…..year… Chief Police of ……… (Signature, Seal) |
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Permanent residence Book No. |
Sheet No. |
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1 |
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Relation with the householder: |
Relation with the householder: |
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Full name: |
Full name: |
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Other name (if any): |
Other name (if any): |
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Date of Birth: |
Sex: Male Female |
Date of Birth: |
Sex: Male Female |
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Native Place: |
Native Place: |
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Ethnic Group: Kinh |
Nationality: |
Ethnic Group: Kinh |
Nationality: |
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ID Card No. |
Passport No. |
ID Card No. |
Passport No. |
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Occupation, place of work: |
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Occupation, place of work: |
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Last permanent residence before moving in:
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Last permanent residence before moving in:
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Registrar (Signed) Doan Ngoc Hong |
September 8, 2014 Deputy Chief Police of TDM (Signed & Sealed) Colonel: MAI ANH DUNG |
Registrar (Signed) Doan Ngoc Hong |
September 8, 2014 Deputy Chief Police of TDM (Signed & Sealed) Colonel: MAI ANH DUNG |
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Reason of permanent resident deregistration:
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Reason of permanent resident deregistration:
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Registrar (Signature, full name) |
Date….month…..year… Chief Police of ……… (Signature, Seal) |
Registrar (Signature, full name) |
Date….month…..year… Chief Police of ……… (Signature, Seal) |
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2 |
3 |
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Relation with the householder: |
Relation with the householder: |
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Full name: |
Full name: |
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Other name (if any): |
Other name (if any): |
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Date of Birth: |
Sex: |
Date of Birth: |
Sex: |
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Native Place: |
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Native Place: |
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Ethnic Group: |
Nationality: |
Ethnic Group: |
Nationality: |
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ID Card No.: |
Passport No.: |
ID Card No.: |
Passport No.: |
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Occupation, place of work: |
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Occupation, place of work: |
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Last permanent residence before moving in:
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Last permanent residence before moving in:
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Registrar (Signature, full name) |
Date….month…..year… Chief Police of ……… (Signature, Seal) |
Registrar (Signature, full name) |
Date….month…..year… Chief Police of ……… (Signature, Seal)
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Reason of permanent resident deregistration:
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Reason of permanent resident deregistration:
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Registrar (Signature, full name) |
Date….month…..year… Chief Police of ……… (Signature, Seal) |
Registrar (Signature, full name) |
Date….month…..year… Chief Police of ……… (Signature, Seal)
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4 |
5 |
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CHANGES, OTHER ADJUSTMENTS |
NOTES
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Content:
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Registrar (Signature, full name)
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Date….month…..year… Chief Police of ……… (Signature, Seal)
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CHANGES, OTHER ADJUSTMENTS |
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Content:
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Registrar (Signature, full name) |
Date….month…..year… Chief Police of ……… (Signature, Seal) |
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CERTIFIED TRUE COPY FROM THE ORIGINAL DOCUMENT Certified No. 3096 Book No. 02/2018 SCT/BS Date: 02/21/2018 CHIEF OF JUSTICE OFFICE OF DISTRICT 4 (Signed and sealed) Luong Nguyen Trong Tien |