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‫ﺳﻔﺎرة اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﯿﺔ اﻟﺴﻌﻮدﯾﺔ‬

‫ﺻﻮرة‬ ‫اﻟﻘﺴﻢ اﻟﻘﻨﺼﻠﻰ‬
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Photo EMBASSY OF SAUDI ARABIA
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CONSULAR SECTION
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Full name MR. :‫اﻻﺳﻢ اﻟﻜﺎﻣﻞ‬

Mother’s name: Mrs.MUHAMMAD RAZZAQ KHAN :‫اﺳﻢ اﻷم‬
Date of birth01/01/1990 ‫ ﺗﺎرﯾﺦ اﻟﻮﻻدة‬Place ofbirth: ‫ﻣﺤﻞ اﻟﻮﻻدة‬
Sex: Male ‫ذﻛﺮ‬ :‫ اﻟﺠﻨﺲ‬Marital Status: UNMARRIED :‫اﻟﺤﺎﻟﺔاﻷﺟﻨﻤﺎﻋﯿﺔ‬
Sect:- Sunni ISLAM ‫اﻟﺪﯾﺎﻧﺔ‬
‫ اﻟﻤﺬھﺐ‬Religion:
Place of issue Pakistan Qualification:- :‫اﻟﻤﮭﻨﺔ‬
Profession: - ‫ﻋﺎﻣل‬
Home address and telephone No: :‫ﻋﻨﻮان اﻟﻤﻨﺰل ورﻗﻢ ا ﻟﺘﻠﻔﻮن‬
Business address and telephone No.

‫ﻋﻤﻞ‬ ‫ﻣﺮور‬ ‫زﯾﺎرة‬ ‫ﻋﻤﺮة‬ ‫ﻟﻸﻗﺎﻣﺔ‬ ‫ﺣﺞ‬ ‫دﺑﻠﻮﻣﺎﺳﯿﺔ‬

Purpose of travel: Work Transit Visit Umrah Residence Hajj Diplomacy
‫اﻟﻐﺎﯾﺔﻣﻦ اﻟﺴﻔﺮ‬

Place of issue: PAK :‫ ﻣﺤﻞ اﻻء ﺻﺪار‬Date passport issued: ‫ ﺗﺎرﯾﺦ اﻻءﺻﺪار‬Passport No. ‫رﻗﻢ اﻟﺠﻮاز‬
Date of Passport’s Expiry:-17/11/2021 18/11/2016
Duration of stay in the Kingdom: Date of arrival: Date of departure
‫ﺗﺎرﯾﺦ اﻟﻤﻐﺎدرة‬
2 Years SOON Soon
:‫ﺗﺎرﯾﺦ‬ : ‫) ( اﯾﺼﺎل رﻗﻢ‬ :‫ﺗﺎرﯾﺦ‬ :‫طﺮﯾﻘﺔ اﻟﺪﻓﻊ) (ﻣﺠﺎﻣﻠﺔ ) (ﻧﻘﺪأ ) ( ﺑﺸﯿﻚ رﻗﻢ‬
Mode of Payment:( )Free ( ) Cash ( ) Cheque No. Date ( ) No. Date:
Relationship: :‫ﺻﻠﺘﮫ‬ ‫اﺳﻢ اﻟﻤﺤﺮم‬
Destination: RIYADH KSA :‫ ﺟﮭﺔ اﻟﻮﺻﻮل اﻟﻤﻤﻠﻜﺔ‬Carrier’s name: SV ‫اﺳﻢ اﺷﺮ ﻛﺔ اﻟﻨﺎ ﻗﻠﺔ‬
Dependents traveling in the same passport: :‫اﯾﻀﺎﺣﺎت ﺗﺨﺺ أﻓﺮاد اﻟﻌﺎﺋﻠﺔ )اﻟﻤﻀﺎﻓﯿﻦ( ﻋﻠﻰ ﻧﻔﺲ ﺟﻮازاﻟﺴﻔﺮ‬
‫ﻧﻮع اﻟﺼﻠﺔﺗﺎرﯾﺦ اﻟﻤﺒﻼ داﻟﺠﻨﺴﺎﻻﺳﻢ ﺑﺎﻟﻜﺎﻣﻞ‬
Relationship Date of BirthSex Full name

Name and address of company or individual in the kingdom: ‫اﺳﻢ وﻋﻨﻮان اﻟﺸﺮﻛﺔ أواﺳﻢ ﻟﺸﺨﺺ وﻋﻨﻮاﻧﮫ ﺑﺎﻟﻤﻠﻜﺔ‬
M/S: -
‫ﻓرع ﺷرﻛﺔ اﯾﻛﺎل ﻟﻠﻣوارد اﻟﺑﺷرﯾﺔ ﻗطﺎع اﻻﻋﻣﺎل‬
The undersigned hereby certify that all the information I have provided are correct. ‫أﻧﺎاﻟﻤﻮﻗﻊ أدﻧﺎه أﻗﺮﺑﺎن ﻛﻞ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺘﻰ دوﻧﺘﮭﺎ ﺻﺤﯿﺤﺔ‬
I will abide by the laws of the kingdom during the period of my residence in
For official use only:
:‫ﻟﻼﺳﺘﻌﻤﺎ ل اﻟﺮﺳﻤﻰ ﻓﻘﻂ‬
AZHAR HUSSAIN

Date: :‫ﺗﺎرﯾﺨﮫ‬Authorization: :‫رﻗﻢ اﻻﻣﺮ اﻟﻤﻌﺘﻤﺪﻋﻠﯿﮫ ﻓﻰ اﻋﻄﺎء اﻟﺘﺎﺷﯿﺮة‬

Visit / Work for: :‫ﻟﺰﯾﺎرة – اﻟﻌﻤﻞ ﻟﺪى‬
Date: :‫ ﺗﺎرﯾﺦ‬Visa No: :‫أﺷﺮﻟﮫ ﺑﺮﻗﻢ‬
Fee COLLECTED: ‫اﻟﻤﺒﻠﻎ اﻟﻤﺤﺼﻞ‬ Type: :‫ﻧﻮﻋﮭﺎ‬ Duration: :‫ﻣﺪﺗﺤﺎ‬
‫رﺋﯿﺲ اﻟﻘﺴﻢ اﻟﻘﻨﺼﻠﻰ‬ ‫ﻣﺪﻗﻖ اﻟﺒﯿﺎﻧﺎت‬
Head of consular section Checked by: