‫ﻣﺴﺘﻨﺪ ﺗﺄﺷﻴﺮة‬

‫اﻟﺮﺟﺎء ﻃﺒﺎﻋﺔ اﻟﻤﺴﺘﻨﺪ وﻣﺮاﺟﻌﺔ ﻣﻤﺜﻠﻴﺔ اﻟﻤﻤﻠﻜﺔ ﻹﺻﺪار ﺗﺄﺷﻴﺮة اﻟﺪﺧﻮل‬

‫‪Please print the document and communicate with any of the visa services offices accredited to the mission to provide documents and to introduce visa‬‬
‫‪.application electronically‬‬

‫‪14370505‬‬ ‫ﺗﺎرﻳﺦ‪ ‬اﻟﺘﺄﺷﻴﺮة‪Date of Visa / ‬‬ ‫‪7003573425‬‬ ‫رﻗﻢ‪ ‬اﻟﺘﺄﺷﻴﺮة‪Visa No / ‬‬

‫‪2370696144‬‬ ‫رﻗﻢ‪ ‬اﻟﺴﺠﻞ‪ / ‬اﻻﻗﺎﻣﻪ‪ID / ‬‬ ‫ﺯﻛﺮﻳﺎء‪ ‬ﻟﻤﺮﺍﺑﻂ‬ ‫اﺳﻢ‪ ‬ﺻﺎﺣﺐ‪ ‬اﻟﻄﻠﺐ‪Name / ‬‬

‫ﺍﻟﻌﺰﻳﺰﻳﺔ‪ ‬ﺍﻟﺠﻨﻮﺑﻴﺔ‬ ‫اﻟﻌﻨﻮان‪Address / ‬‬

‫ﻣﺪة‪ ‬اﻻﻗﺎﻣﺔ‬ ‫اﻟﻤﻬﻨﺔ‪ ‬أو‬
‫ﻋﺪد‪ ‬ﻣﺮات‪ ‬اﻟﺪﺧﻮل‬
‫اﻻﺳﻢ‪ ‬‬ ‫اﻟﻌﻤﺮ‪ ‬‬ ‫اﻟﺠﻨﺲ‪ ‬‬ ‫ﺗﺎرﻳﺦ‪ ‬اﻟﻤﻴﻼد‪ ‬‬ ‫ﺑﺎﻟﻴﻮم‪ ‬‬ ‫اﻟﻌﻼﻗﺔ‪ ‬‬ ‫اﻟﺠﻨﺴﻴﺔ‪ ‬‬ ‫ﺟﻬﺔ‪ ‬اﻟﻘﺪوم‪ ‬‬ ‫ﻧﻮع‪ ‬اﻟﺘﺄﺷﻴﺮة‪ ‬‬
‫وﻓﺘﺮة‪ ‬اﻟﺼﻼﺣﻴﺔ‪ ‬‬
‫)‪( Name ‬‬ ‫)‪( Age ‬‬ ‫)‪(Gender‬‬ ‫)‪( Date Of Birth ‬‬ ‫)‪Duration Stay‬‬ ‫)‪Profession‬‬ ‫)‪(Nationality‬‬ ‫)‪(Saudi Mission‬‬ ‫)‪(Type of Visa‬‬
‫)‪(Number of Entry‬‬
‫‪(in Days‬‬ ‫‪(Or Relation‬‬
‫ﺳﻔﺮة‪ ‬واﺣﺪة‬
‫ﺳﻌﺎد‪ ‬اﻟﻄﻮﻳﻞ‬ ‫‪20‬‬ ‫اﻧﺜﻰ‬ ‫­‬ ‫‪90‬‬ ‫زوﺟﻪ‬ ‫اﻟﻤﻐﺮب‬ ‫اﻟﺮﺑﺎط‬ ‫زﻳﺎرة‪ ‬ﻋﺎﺋﻠﻴﺔ‬
‫ﺑﺼﻼﺣﻴﺔ‪ 90 ‬ﻳﻮم‬

‫*‪ ‬إن‪ ‬اﻟﻤﻮاﻓﻘﺔ‪ ‬ﻋﻠﻰ‪ ‬اﻟﻄﻠﺐ‪ ‬ﻻ‪ ‬ﺗﻌﻨﻲ‪ ‬ﺑﺄي‪ ‬ﺣﺎل‪ ‬ﻣﻦ‪ ‬اﻻﺣﻮال‪ ‬ﺿﻤﺎن‪ ‬إﺻﺪار‪ ‬اﻟﺘﺄﺷﻴﺮة‪ .‬‬
‫*‪.Please be informed that approving the request dose not mean approving the visa ‬‬

‫ﺟﻤﻴﻊ‪ ‬اﻟﺤﻘﻮق‪ ‬ﻣﺤﻔﻮﻇﺔ‪1435 ­ 1426 ‬ﻫـ‪ 2014 – 2005 | ‬م‪ ‬وزارة‪ ‬ﺧﺎرﺟﻴﺔ‪ ‬اﻟﻤﻤﻠﻜﺔ‪ ‬اﻟﻌﺮﺑﻴﺔ‪ ‬اﻟﺴﻌﻮدﻳﺔ‬