Fill and Sign the Domestic Violence Order of Protection Consent Order North Carolina Nccourts Form

Embassy of the Russian Federation in USA VISA APPLICATION IMPORTANT! Please type or print using ballpoint pen I declare that to the best of my knowledge all particulars supplied by me are correct and complete. I am aware that any false statements will lead to my application being rejected or to the annulment of a visa already granted and may also render me liable to prosecution under the legislation of the Russian Federation. I undertake to leave the territory of the Russian Federation upon the expiry of the visa, if granted/ I am aware that the fact that a visa has been granted to me does not mean that I will be entitled to enter the territory of the Russian Federation, if any reasons are appear. In a case of refusal of entry I do not have a right to compensation of damage. ** - Not to be filled by holders of diplomatic and official passports 1. Present citizenship (if you formerly had USSR or Russian citizenship, please indicate when and why you lost it) 2. Last name (as in passport, in capital letters) 3. First and middle names (as in passport) 4. Other names ever used (maiden name, professional, religious aliases) 5. Place of birth (if born in Russia, please indicate when and to what country you emigrated) 6. Date of birth (DD/MM/YY) 7. Sex M F 9. Russian institution or organization to be visited (name and address, phone, fax number, E-mail (if known), name of contact person) 8. Purpose of visit official tourism private medical cultural business sports other, please specify **10. Itinerary (places to be visited) 11. Date of entry (DD/MM/YY) 13. Number of entries 14. Passport number Passport issued by diplomatic 15.Type of passport other (please specify) official 12. Date of departure (DD/MM/YY) 1 2 multiple Date of issue tourist Valid until seaman’s passport alien’s travel document **16. Name and reference number of the tourist group **17. Do you have а medical insurance policy valid in Russia (please specify)? 18. Who will pay for your trip to and stay in Russia? 19. Marital status мarried single (never married) divorced 20. Spouse’s full name (even if divorced or separated, please indicate maiden name if applicable) separated widowed 21.Spouse’s date of birth (dd/mm/yy) 22. Spouse’s place of birth **23. Your father’s full name **24. Your mother’s full name 25. Have you ever been issued a Russian visa? Yes When? Where? No Yes **26. Have you ever lost your passport or had one stolen? **27. List all countries you have visited in the last ten years and indicate the year of visit **29. List your last two places of work, excluding the current one 1. Name Address Your position 2. Name Address Your position Phone number Your supervisor’s full name Dates of employment Phone number Your supervisor’s full name Dates of employment No **28. List all countries which have previously issued you a passport **30. List all educational institutions you ever attended, except high schools 1. Name Address and phone number Course of study 2. Name Dates of admission and graduation Address and phone number Course of study Dates of admission and graduation **31. List all professional, civil and charity organizations which you **32. Do you have any specialized skills, training or experience related to fire-arms and explosives or to nuclear, biological or chemical activities? If are (were) a member of, or contribute (contributed) to, or work «Yes», please explain (worked) with **33. Have you ever performed military service? If «Yes», indicate the country, branch of service, rank, military occupation and dates of service **34. Have you ever been involved in an armed conflict, either as a member of the military service or a victim? If «Yes», please explain 35. Are any of your relatives mentioned below staying in Russia now? Is he (she) a permanent resident or citizen of Russia? If «Yes», indicate that person’s full name, address and status in Russia (citizen of Russia, permanent or temporary resident, visiting, studying, working, etc.) Husband/Wife Father/Mother Brother/Sister Bridegroom/Bride Son/Daughter 36. IMPORTANT! EACH APPLICANT MUST READ AND GIVE ANSWERS TO THE FOLOWING QUESTIONS A visa may not be issued to persons belonging to specific categories, defined by the Law as undesirable, except in cases when a waiver has been obtained in advance. Have you ever been arrested or convicted for any offence? Yes When? Where?  No Have you ever been sick with a communicable disease of risk for the public or suffered a dangerous physical or mental disorder? Have you ever abused drugs or been a drug-addict? Yes No  Have you ever been refused a Russian visa? Yes When? Where? No  Has your Russian visa ever been canceled? Yes When? Where? No   Have you ever tried to obtain or assisted others to obtain a Russian visa or enter Russia by providing misleading or false information? Yes No Have you ever overstayed your Russian visa or stayed unlawfully in Russia? No Yes  Have you ever been deported from Russia? Yes When? Where? No While an affirmative answer does not automatically mean ineligibility for a visa, if you answered «Yes» you will have to appear in person before a Consular officer. 37. Your permanent address, phone, fax number and E-mail address 38. Place of work or study (name, address, phone and fax number, E-mail address), present position 40. Has anyone assisted you in completing this application form? If «Yes», have the assisting person complete item 41 Yes No Place for photograph 41. Application completed by Name Relationship to applicant Address 39. Name, address and phone number of person or hotel in Russia that you plan to stay with Applicant’s signature, Date Signature of person completing the form,Date