‫‪Kin‬‬

‫‪ng Fahd University of Petroleum‬‬

‫‪P‬‬ ‫‪& Minerals‬‬ ‫اﻟﻤﻠﻚ ﻓﻬﺪ ﻟﻠﺒﺘﺮوول واﻟﻤﻌﺎدن‬
‫ﺟﺎﻣﻌﺔ ﻚ‬
‫‪Deanship of Faculty & Personnel Affairs‬‬
‫‪A‬‬ ‫ﻋﻤﺎدة ﺷﺆﺆون اﻷﺳﺎﺗﺬة وواﻟﻤﻮﻇﻔﻴﻦ‬
‫‪Faculty & Person‬‬‫‪nnel Services‬‬
‫‪s‬‬ ‫ﺧﺪﻣﺎت اﻷﺳﺎﺗﺬة واﻟﻤﻤﻮﻇﻔﻴﻦ‬
‫ت‬

‫ﻃﻠــــــــــﺐ ﺗـــﺄﺷﻴـــــــﺮة ﺧــــــــــﺮوج ﻧﻬﻬـــﺎﺋﻲ‬

‫‪APPLIICATION FO‬‬
‫‪ORM FOR FINAL EXIT VISA‬‬

‫اﻟﻤﻮﻇﻒ‬
‫ﻒ‬ ‫رﻗﻢ ﺑﻄﺎﻗـــــــﺔ‬ ‫اﻟﻘﺴـــــــــﻢ ‪ /‬اﻟﻮﻇﻴﻔـــــــــــﺔ‬
‫ﻢ‬ ‫إﺳــــــــــــــــﻢ ﺣـــﺎﻣﻞ ﺟﻮاز اﻟﺴـــــــــﻔﺮ‬ ‫ﻹﻗﺎﻣـــــــــﺔ‬
‫رﻗـــــــــﻢ اﻹ‬
‫‪EMPLOYEE’S ID‬‬ ‫‪D#‬‬ ‫‪DEPARTMENT‬‬ ‫‪T / RANK‬‬ ‫‪PASSPORT‬‬ ‫‪T HOLDER’S NA‬‬ ‫‪AME‬‬ ‫‪RESIDENT PER‬‬ ‫‪RMIT (IQAMA) #‬‬

‫ﺗـﺎرﻳـــــــــﺦ اﻟﻤﻐــــــــــــــﺎددرة‬ ‫ﺻﻠــــــﺔ اﻟﻘﺮاﺑــــــﺔ‬ ‫اﻟﺠﻨﺴــــــــــــــــــﻴﺔ‬ ‫ي(‬‫ﺗﺎرﻳﻳـــــﺦ إﻧﺘﻬـــــﺎء اﻹﻗﻗــــﺎﻣـــﺔ )اﻟﻬــﺠﺮي‬

‫‪DA‬‬‫‪ATE OF DEPARTTURE‬‬ ‫‪RELATIONSHIP‬‬ ‫‪NA‬‬‫‪ATIONALITY‬‬ ‫‪RESSIDENT PERMIT‬‬ ‫)‪T EXPIRY (Hijri date‬‬ ‫‪d‬‬
‫‪ ‬‬ ‫‪ ‬‬

‫‪NAME‬‬
‫‪ES OF ACCOMP‬‬
‫‪PANYING CHILD‬‬
‫‪DREN ENDORSE‬‬
‫‪ED ON THE SAM‬‬
‫‪ME PASSPORT‬‬ ‫اﻷول ﻓﻘــﻂ(‬
‫ﻓــــﻰ ﺟـــــــﻮاز اﻟﺴﻔـــــــــــﺮ )اﻻﺳـﻢ ل‬
‫اﺳﻤـــﺎء اﻟﻤــﺮاﻓﻘﻴـــﻦ ﻰ‬
‫ء‬

‫اﻻﺳــــﻢ‬ ‫ﺻﻠـــــــﺔ اﻟﻟﻘﺮاﺑــــﺔ‬ ‫اﻻﺳــــﻢ‬ ‫ﺻﻠــــــــﺔ اﻟﻘﺮاﺑــــﺔ‬

‫‪NAME‬‬ ‫‪RELATTIONSHIP‬‬ ‫‪NAME‬‬ ‫‪RELATION‬‬ ‫‪NSHIP‬‬

‫ارﻗــــــــﺎم اﻟﺘــــــــﻮاﺻﻞ )داﺧــــﻞ اﻟﻤﻤﻠﻜـــــــــﺔ(‬ ‫ﺑـﻴﺎﻧــﺎت ااﻟﺘﻮاﺻـــﻞ )ﺧــﺎرج اﻟﻤﻤﻠﻜــﺔ(‬

‫)‪CONTACT DETAILS (SAUDI ARABIA‬‬ ‫‪CONTAC‬‬ ‫‪CT DETAILS AB‬‬ ‫‪BROAD‬‬

‫‪Telephoone:‬‬ ‫هـــــﺎﺗـﺗـــــــــــﻒ‪:‬‬
‫‪MOBILE:‬‬ ‫ﺟﻮال‪:‬‬
‫‪Mobile::‬‬ ‫ﺟـــــــــــــــــﻮال‪:‬‬
‫‪OFFIC‬‬
‫‪CE:‬‬ ‫ﻣﻜﺘﺐ‪:‬‬
‫‪:‬‬
‫‪Addresss:‬‬ ‫ﻋـــــــــﻨــــﻮان‪:‬‬
‫‪HOME:‬‬ ‫ﻣﻨﺰل‪:‬‬
‫‪Email:‬‬ ‫ﺑﺮﻳﺪ ااﻟﻜﺘﺮوﻧﻰ‪:‬‬

‫ررﺋﻴــــــــــــــــﺲ اﻟﻘﻘﺴـــــــــــــــــﻢ‬
‫‪HEAD OF THE DEPARTMENT‬‬ ‫‪Employee’s Name:‬‬ ‫____‬ ‫ﺳـﻢ‪:‬‬
‫اﻻﺳ‬

‫‪Signature:‬‬ ‫اﻟﺘﻮﻗﻗﻴﻊ‪:‬‬

‫‪Signaature:‬‬ ‫اﻟﺘﻮﻗﻴﻊ‪:‬‬ ‫‪Datte:‬‬ ‫اﻟﺘﺎرﻳﻳﺦ‪:‬‬

 ‫ﺗـــﺄﺷﻴــــــﺮة ﺧـــــــــﺮوج ﻧﻬـــﺎﺋﻲ‬
FINAL EXIT VISA
Please only print the form (first page only) (‫ﻳﺮﺟﻰ ﻃﺒﺎﻋﺔ اﻟﻨﻤﻮذج ﻓﻘﻂ )اﻟﺼﻔﺤﺔ اﻷوﻟﻰ ﻓﻘﻂ‬

1. Please submit this form at least three days before the date of
‫ اﺳﺎﺑﻴﻊ ﻣﻦ ﺗﺎرﻳﺦ اﻟﺴﻔﺮ اﻟﻰ ﻗﺴﻢ ﺧﺪﻣﺎت اﻻﺳﺎﺗﺬة‬٣ ‫ﻳﻘﺪم اﻟﻄﻠﺐ ﻗﺒﻞ‬ .1
travel to Faculty & Personnel Services Department with
:‫واﻟﻤﻮﻇﻔﻴﻦ ﻣﺮﻓﻘًﺎ ﺑﻪ ﻣﺎ ﻳﻠﻰ‬
following documents
 One passport size color picture .‫ ﺻﻮرة ﺷﺨﺼﻴﺔ ﻣﻠﻮﻧﺔ ﺑﺤﺠﻢ ﺻﻮرة اﻟﺠﻮاز‬
 Final Exit Visa Application form
.‫ ﻧﻤﻮذج ﻃﻠﺐ ﺗﺄﺷﻴﺮة اﻟﺨﺮوج اﻟﻨﻬﺎﺋﻰ‬
 Original Passport
.‫ أﺻﻞ ﺟﻮاز اﻟﺴﻔﺮ‬
 Final Clearance Form duty signed and stamped by all
the departments concerned. .‫ ﻧﻤﻮذج إﺧﻼء ﻃﺮف ﻧﻬﺎﺋﻲ ﻣﻮﻗﻊ ﻣﻦ آﺎﻓﺔ اﻷﻗﺴﺎم اﻟﻤﻌﻨﻴﺔ‬
 Original KFUPM ID
.‫ أﺻﻞ ﺑﻄﺎﻗﺔ اﻟﻬﻮﻳﺔ اﻟﺠﺎﻣﻌﻴﺔ‬
 Original resident permit(s)/Iqama(s) of staff and his
‫ إﺻﻞ ﺑﻄﺎﻗﺔ اﻹﻗﺎﻣﻪ ﻟﻠﻤﻮﻇﻔﻴﻦ و اﻟﺘﺎﺑﻌﻴﻦ‬
dependents.

2. Fill in the Final Exit Visa Application form and have it signed ‫إﻣﻸ ﻧﻤﻮذج ﻃﻠﺐ ﺗﺄﺷﻴﺮة اﻟﺨﺮوج اﻟﻨﻬﺎﺋﻲ واﻃﻠﺐ ﻣﻦ رﺋﻴﺲ اﻟﻘﺴﻢ‬ .2

by the department head concerned (for the employee only). .(‫ﺗﻮﻗﻴﻌﻪ )ﻟﻠﻤﻮﻇﻔﻴﻦ ﻓﻘﻂ‬
3. For dependents the Final Exit Visa can be issued online by
."‫ ﻳﻤﻜﻦ اﺻﺪار ﺗﺄﺷﻴﺮاﺗﻬﻢ ﻋﻦ ﻃﺮﻳﻖ ﻧﻈﺎم "أﺑﺸﺮ‬،‫ﻟﻠﺘﺎﺑﻌﻴﻦ‬ .3
the head of the family through (ABSHER system).
4. The original Resident Permit (Iqama) will be submitted at the .ً‫ﻳﺘﻢ ﺗﺴﻠﻴﻢ أﺻﻞ اﻹﻗﺎﻣﺎت ﻓﻰ اﻟﻤﻄﺎر ﻟﻠﻤﻮﻇﻒ و ﻟﻠﺘﺎﺑﻌﻴﻦ أﻳﻀﺎ‬ .4

airport both for employees and dependents.
5. In case the employee owns a vehicle, he should sell it and
make sure that the ownership title is transferred to the new
owner’s name before applying for a final exit visa.
‫ ﻋﻠﻴﻪ ﻳﺒﻴﻌﻬﺎ و أن ﻳﺘﺄآﺪ أﻧﻪ ﻗﺪ ﺗﻢ ﻧﻘﻞ‬،‫ﻓﻲ ﺣﺎﻟﺔ اﻣﺘﻼك اﻟﻤﻮﻇﻒ ﺳﻴﺎرة‬ .5
.‫ﻣﻠﻜﻴﺘﻬﺎ ﻟﻠﻤﺎﻟﻚ اﻟﺠﺪﻳﺪ ﻗﺒﻞ ﻃﻠﺐ ﺗﺄﺷﻴﺮة اﻟﺨﺮوج اﻟﻨﻬﺎﺋﻲ‬
‫ ﻳﺠﺐ اﻟﺘﺄآﺪ‬،‫ ﻋﺎﻣًﺎ أو أآﺜﺮ‬17 ‫إذا آﺎن ﺣﺎﻣﻞ ﺟﻮاز اﻟﺴﻔﺮ ﻳﺒﻠﻎ ﻣﻦ اﻟﻌﻤﺮ‬ .6

6. If the passport holder’s age is 17 year or above, please make
sure that his/her finger prints are available in the Government
passport system. To enter finger prints go to Jawazat office
in Al-Khobar.
‫ وﻹدﺧﺎل اﻟﺒﺼﻤﺎت‬.‫ﻣﻦ إدراج ﺑﺼﻤﺎﺗﻪ ﻓﻰ ﻧﻈﺎم اﻟﺠﻮازات اﻟﺤﻜﻮﻣﻰ‬
.‫إذهﺐ إﻟﻰ ﻣﻜﺘﺐ ﺟﻮازات اﻟﺨﺒﺮ‬
‫ وإذا ﻟﻢ ﻳﻐﺎدر‬.‫ﻋﻠﻰ ﺣﺎﻣﻞ اﻟﺠﻮاز ﻣﻐﺎدرة اﻟﻤﻤﻠﻜﺔ ﻓﻰ اﻟﻤﻮﻋﺪ اﻟﻤﺤﺪد‬ .7

7. The holder of the passport with exit visa must leave the
Kingdom on the authorized date. If for some reasons he fails
to do so, he must return the passport immediately to Faculty
& Personnel Services Department. Otherwise, a penalty of
.‫ﻟﺴﺒﺐ ﻣﺎ ﻓﻌﻠﻴﻪ أن ﻳﻌﻴﺪ اﻟﺠﻮاز إﻟﻰ ﻣﻜﺘﺐ ﺧﺪﻣﺎت اﻷﺳﺎﺗﺬة و اﻟﻤﻮﻇﻔﻴﻦ‬
.‫س‬.‫ ر‬1000 ‫ وإﻻ ﺗﻌﺮض ﻟﻐﺮاﻣﺔ ﻗﺪرهﺎ‬.‫ﻟﺘﺠﺪﻳﺪ أو إﻟﻐﺎء اﻟﺘﺄﺷﻴﺮة‬
.‫ﺻﻼﺣﻴﺔ اﻟﺘﺄﺷﻴﺮة ُﺗﺤﺴﺐ ﺑﺎﻟﺘﺎرﻳﺦ اﻟﻬﺠﺮي‬ .8

SR1000/- will be imposed for the cancellation / renewal of exit

visa.
8. Hijri Calendar is to be used for validity of the visa.