1

5 2004

"" (/Departure)

"A" (/Arrival)

Federation

Migration Card

Russian
Republic of Belarus
/
Serial

Federation

Migration Card

Russian
Republic of Belarus
/
Serial

/Surname
name)
/Given name(s)

(Family

/Patronymic
/
Day
1

/Date of birth
/
Month
0
0
6

/
Year
1 9

, /Passport or other ID
6 2 5 3 4 1 0
6
2 5 3 4 1 0
( )/
Purpose of travel (to be underlined):
/Official, /Tourism,
/Business,
/Education, /Employment,
/Private, /Transit

/Sex
./Female
/Nationality
0


/Visa number:
________________________________________
________________________________________
./Male

(
, , , ()
), /Name of host person or company,
locality:
_ . , -, .
115__________________________________________________
_________________________________________________
____________________________________________________
/Duration of stay:
/Signature:
/From: 25.07.2007 .
/To: 24.10.2007

/For official use only

/ /Date of / /Date of
arrival in the Russian Federation/Republic departure
from
the
Russian
of Belarus
Federation/Republic of Belarus

/Surname
(Family name)
/Given name(s)
/Patronymic

/Sex
./Male
./Female
/ Nationality
7 0


, /Passport or /Visa number:
________________________________________
other ID
________________________________________
6 2 5 3 4 1 0
6 2 5 3 4 1 0
( )/
(
, , , ()
Purpose of travel (to be underlined):
), /Name of host person or company,
/Official, /Tourism,
locality: ___ . , -, .
/Business,
115________________________________________________
/Education, /Employment,
____________________________________________________
/Private, /Transit
____________________________________________________
/Duration of stay:
/Signature:
/From: 25.07.2007
/To: 24.10.2007
/
Day
1

/Date of birth
/
/
Month
Year
0
0
6
1 9

/For official use only

/ /Date / /Date
of
arrival
in
the
Russian of departure from the Russian
Federation/Republic of Belarus
Federation/Republic of Belarus