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DHL

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Fitri Pipoy
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87 views4 pages

DHL

Uploaded by

Fitri Pipoy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
Form 'C' Arrival Report of Foreigner in Institute Accomodation Details Name (Ohatpo Monastery ress ‘haloo Shaping MonastyVPO Kelsi Kuly LP, ‘cryibisit KULLU Star Rating iter | Mobile wo, lonieanares Personal Details ‘Surname Fm Date of wih ‘ares Special Category, Nationality INOGNESIA Address in country where residing permanently Address JALAN SEDERHNANA NO 63 BANDUNG uy [BANDUNG ‘Couniry INCONESA ‘Address/Reference in India site HIACHAL PRADESH Passport Details Passport No, xS3586 Date ofissue 21022017 Expiry Date 2127022 Visa Details Place of iene pew dts, NDIA Vie Subtype Arrival Details Time fla frend Dron of Sain |s0 Whether Employed in India " Other Detaits _|sate ‘Coniact Wain nia) Mabie No ei) ‘Conti NoPermanenty esding Mei NejPomanety sin ese Applicant ID : 250721200160 HC 25072120U1G0 pis Titet D/ Sn aang Gunawan R/O VéP.0. Kats Testi and Distt, Kullu 4-P. db hareby plannly affiun and declare on oath ag undert= 4 1. 1 am resident of atove said mentioned place. aAlTesseu Shivanic my ngme is entered as Fitri in my Pass pert copy,wrereas my NOTARY PLBLIG WLU 6 Phame is entered as Vivie in my receipt, 3. That 7 declare that Fitri and Vivie is one and only one person name 7 ato chloe nanes are same person nanes ae Pood, the above nated deponent further declare thatthe tatemett"St wis affidavit is true and correct and no pa 19 9951623, false Dothing has been @ncegled therefrom veri fled at Kuli pe learn. eat ana mericaatan, —NIKM o00s403527-1A53J19905CRQT SOEKARNO HATTA PKLDNK

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