申报表示范文本.doc

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申报表申报表Declaration Form1.签证申请人姓名 Full Name of the visa applicant:2.现有国籍 Current Nationality:3. 护照号码 Passport Number:4.请按时间顺序列 明申请人最近两 周访问过的国家 或州。 Please list countries or US states that the applicant has visited in the past 2 weeks in a time sequence.本人郑重承诺以上申报内容属实，没有隐瞒或虚构事实。 I certify that the above declaration is truthful with no concealment or fabrication.填表人签名/ Signed by: 时间/Date(YYYY-MM-DD): *他人代填此表的，请注明与申请人关系/ For Declaration Form completed by another person on behalf of the visa applicant, please indicate his/her relationship to the applicant: