Biroul migraie i azil al

Ministerului Afacerilor Interne

DEMERS
pentru eliberarea invitaiei
I. Date despre persoana invitat
Numele

____________________________________________________________________________

Prenumele

___________________________________________________________________________

Prenumele tatlui_______________________________________________________________________
Cetenia

_____________________________ data i locul naterii_____________________________

domiciliat

________________________________________________________sexul______________
(se indica tara. regiunea)

datele actului de identitate: tipul_________________________________ seria______________________

nr. ________________ data eliberrii________________________ valabil pn la___________________
Locul perfectrii vizei____________________________________________________________________
Intrarea n RM: din______________________________Scopul cltoriei:
______________________________________________
(aiaceri, turism, la munca, la studii)

Tipul vizei solicitate________________________Punctul de trecere a frontierei ______________________

Durata sejurului n Republica Moldova___________________________ zile
Date despre ederi anterioare n Republica Moldova __________________________________________
(anul. luna, durata)

Asigurarea medical va fi efectuat din contul_________________________________________________

II. Date despre copiii minori care nsoesc persoana invitat

Numele

____________________________

Prenumele

__________________________________

Patronimicul

___________________________ Data naterii __________________________________

Numele

___________________________

Patronimicul ___________________________

Prenumele

__________________________________

Data naterii __________________________________

III. Date despre persoana juridic care invit ceteanul strin/apatridul

Denumirea complet i tipul organizaiei, ntreprinderii, instituiei
____________________________________________________________________________________
____________________________________________________________________________________
Numele, prenumele i patronimicul conductorului ___________________________________________
Nr. de nregistrare _____________________________________________________________________
IDNO_______________________________________________________________________________
Adresa juridic, tel/fax ________________________________________________________________
Adresa oficiului tel/fax, e-mail_____________________________________________________________
Declar, n deplin cunotin de cauz, c toate informaiile furnizate de mine sunt corecte i complete. Am
fost informat c orice declaraie fals din partea mea va atrage refuzul eliberrii invitaiei.
(I confirm, that all information delivered by me is correct and completed. I was informed that any false
information offered can cause denial of my application for the invitation)
M oblig de a suporta cheltuielile legate de edere i de eventuala ndeprtare a strinului de pe teritoriul rii
n cazul n care acesta nu prsete teritoriul rii n termenul acordat de viz.
(I undertake to bear the cost of residence and any removal of aliens from the country in case it does not leave
the country within the time allowed of visa)
Sunt de acord cu prelucrarea datelor prezentate n conformitate cu Legea nr. 133 din 08.07.2011 cu privire la
protecia datelor cu caracter personal.
(I agree with processing of data presented in accoding with Law no. 133/08.07.2011 on protection of personal
data)

Solicitantul:________________________________
(semntura conductorului)

L. .
_________________________________________20___

Demersul a fost primit de

:__________________________________________________________________
(semntura funcionarului)