A. Personal data	1.	Surname	

Recent
Passport Photograph

Please, do not staple!

FOR OFFICIAL USE ONLY
Êîíñóëûí àæèëòàí áºãëºíº
ÄÒÃ-ûí êîä 

À.Âèç îëãîñîí ¿íäýñëýë

ÃÕß-íû çºâøººðºë
Äóãààð  :
Îãíîî	 :
ÃÈÕÀÝÀ-íû çºâøººðºë
Äóãààð  :
Îãíîî    : 

Áóñàä ¿íäýñëýë:

 ßàðàëòàé
 Ýíãèéí 
Á. Øèéäâýð
Âèçèéí àíãèëàë 	     J
ßëãàà 		îðîõ/ãàðàõ 
Áàéõ õóãàöàà 	     õîíîã

________________

ãàðûí ¿ñýã	
	2.	Given names		
	3.	Other names 
		( Name  assumed/ previous/ maiden etc) 		
	4.	Date of  birth
	5.	Country of birth		
	6.	Nationality	7.	Sex   Male  Female		
	8.	Address
Street	
City
Country		

	9.	Phone/Fax

10.	E-mail
		
	11.	Employer/University’s  address 

12.	Phone/Fax			
		
	Children (Complete this section if children included on your passport and traveling with you)		
	13.	Names 	14.	Date & place of birth	15.	Nationalities		

					
					
	16.	Type of passport:
     Diplomatic Official Ordinary 	17.	Number 
		
	18.	Date of Issue
	19.	Validity
	20.	Place of issue
		
B. Travel & visa 	21.	Address & Phone of the travel agent 

		
	22.	Means of support (during your stay) Cash Credit Card Other

23.	Tourist visa requested for  days

24.	I declare that to the best of my knowledge the above particulars are correct and complete. I undertake to leave the territory of Mongolia upon the expiring date of the visa, if granted. I realize that possession of a visa is only on or the prerequisites for entry into the territory of Mongolia. If entry is refused I will have no claim to compensation. 

25.	I would get registered within a week after my arrival in Mongolia at the Foreign Citizens and Naturalization Office and get deregistered before the departure at same office, if my stay lengths over thirty days. 
		
C. Control sector	Ýíý õýñýãò âèçèéí õóóäàñíû òàñàëáàðûã íààíà				Òóñãàé òýìäýãëýë	

Place _______________			Date _________________

Applicant’s signature	_________________________________________
(In case of minors, signature of parents or guardian)