Professional Documents
Culture Documents
BRASILIA, BRAZIL
PHOTO (FOTO)
3 x 4
(Outros nomes)
________________________________________________________________________________________________
2. (a) Sex (Sexo): M F (b) Marital Status (Estado Civil): _______________ (c) CPF No: ___________________
3. (a) Present Nationality: ______________________________(b) Previous Nationality: ________________________________
(Nacionalidade Atual)
(Nacionalidade Anterior)
(Local de Nascimento)
(Altura)
(N do Passaporte)
(Data de emisso)
(Vlido at)
(Governo/rgo Expedidor)
Yes
No
(Sim)
(No)
(Tempo de Servio)
13. (a) Type of Visa required: Diplomatic Official Transit Tourist Business TWP STR
(Tipo de Visto solicitado) (Diplomtico)
(b) No of Entries:
o
(N . de Entradas)
(Oficial)
(Trnsito)
(Turista)
(Negcios)
(Uma)
( Mltiplas)
(d) Purpose of journey (please give full details) {Qual o motivo da viagem (favor informar em detalhes)} ______________
____________________________________________________________________________________________
14. (a) Proposed date of travel: ________________________ (b). Mode of travel: _____________________________
(Data prevista para realizar a viagem)
( Meio de transporte)
16. If your reason for journey to Nigeria is for employment, state (Se o motivo da viagem para a Nigria for emprego, indicar):
Name of Employers (Nomes dos Empregadores): _______________________________________________________
(a) Post to be occupied (Cargo a ser preenchido): ______________________________________________________
(b) Give a full description of job (Descreve em detalhes o tipo de emprego): __________________________________
17. If joining Spouses/Parents or relatives, please give full particulars of the person(s) in Nigeria including the
residential address (Se o solicitante pretender se reunir com seu (s) Cnjuge/Parentes ou familiares, favor enumerar os dados
pessoais da (s) pessoa (s) na Nigria incluindo o seu endereo residencial):
_______________________________________
____________________________________________________________________________________________
18. How long has/have your spouse/parents lived in Nigeria: ______________________________________________
(H quanto tempo mora (m) seu (s) cnjuge/parentes na Nigria)
19. Intended address in Nigeria (Not P. O. BOX) {Endereo na Nigria (Caixa postal no ser aceita)}: ___________________
____________________________________________________________________________________________
20. Have you ever applied for a Nigerian visa before? Yes No ; If Yes, where: __________________
(J solicitou antes visto de entrada na Nigria?)
(Sim)
( No)
(City/Country)
(Cidade/Pas)
(Oficial)
(Trnsito)
(Turismo)
(Negcios)
24. State the period of these visits and the addresses at which you stayed in Nigeria:
(Enumere os perodos em que visitou e os endereos de permanncia na Nigria)
From (De)
To (At)
Address (Endereo)
i.) ___________________
____________________
___________________________________________
ii.) ___________________
____________________
___________________________________________
iii.) ___________________
____________________
___________________________________________
25. How long have you lived in the country where you are applying for visa? _________________________________
(Desde quando mora no pas de onde est solicitando visto?)
26. ALL APPLICANTS MUST COMPLETE THE FOLLOWING: Have you ever:
(TODOS OS SOLICITANTES DEVEM PREENCHER OS SEGUINTES TENS: Voc j:)
(a) been infected by any contagious disease (e.g. Tuberculosis) or suffered serious mental illness?
(contraiu doenas infecto-contagiosas (ex. Tuberculose) ou sofrido de distrbio mental grave?)
(b) been arrested/convicted or pardoned for any crime in the course of any legal action?
(foi preso(a) /condenado (a) ou absolvido (a) por quaisquer crimes em processos judiciais?)
Yes
No
(Sim)
(No)
27. Name countries and cities you have lived in for more than a year during the last five years:
(Nomes dos pases e cidades em que morou por um perodo de mais de um ano nos ltimos cinco anos)
Country (Pas)
City (Cidade)
Date (Data)
__________________________
__________________________
__________________________
__________________________
_____________________
_____________________
_____________________
_____________________
____________________________
____________________________
____________________________
____________________________
28. Name the countries which you have visited during the last twelve (12) months?
(Nomes dos pases que visitou nos ltimos (12) meses?)
Country (Pas)
City (Cidade)
Date (Data)
__________________________
__________________________
__________________________
__________________________
_____________________
_____________________
_____________________
_____________________
____________________________
____________________________
____________________________
____________________________
29. Declaration: I declare that the above personal data are true. Any misleading information will lead to the rejection
and denial of entry visa. I fully understand and accept the requirements for the issuance of visa to Nigeria.
(Declarao: Declaro que os dados pessoais acima so verdadeiros. Quaisquer informaes falsas/enganosas resultaro na rejeio
desta solicitao e na recusa do visto solicitado. Compreendo plenamente e aceito os requisitos para a emisso de visto de entrada na
Nigria.)
REMARKS