Aas gauull day pail ASlaall doles Lebeiill Biya ROYAL CONSULATE GENERAL Photo OF SAUDI ARABIA Full name: Mother's name: Date of birth: Hay 0 _ Place of birth: Previous nationality: LIZ! Present nationality sex: [Female 51] Male 55] ‘ot! Marital Status: Religion: Teal pa Place of issue: Profession: Home address and telephone No.: Business address and telephone No.: “pall ghny gh) SA olge find wa a EEN EL) Purpose of travel: _LWerk vaidlt Umrah} | Residence Piplomacy] I aL Place of issue: MT punpor ised AT sont No ain Date’ of passport’s expiry: Sila Dhe oly ae SAL LUY Se sdpegl ae alll @ Duration of stay in the Kingdom: Date of arrival: Date of departure: ft ipidbal( ie pte) BC) ele) rgd, Mode of Payment: (_) Free _(_)Cash__(_) Cheque No, Date () No Date: Relationship: tallest Destination: Slab Speyll ier Carrier's name: USL 5 aed ‘Dependents traveling in the same passport: phe Shy nl de (laa) asta abl a? ola) Dalles ea a) PSI A Relationship Date of Birth Sex Full name Name and address of company or individual in the kingdom: ‘The undersigned hereby certify that all the information I have provided are correct. [will abide by the laws ofthe Kingdom during the period of my residence init. ARLALY wey at pol VAS eg pal Ree ge legit Js ol stl ro Le agapms Bab ok SSL cage Lple ySg Date: sq). Signature: wl B gel dW 2445 Authorization: atLil ene J ate tell Mobs Visit / Work for: si) Jal Date: abs Visa No. nd al FEE COLLECTED: hentia type: ‘yey Duration: cul jal bt gi Consul General