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Thursday, August 10, 2006 Thank you for contacting CIBT, your ...

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(1of 2 pages)REPÚBLICA DE ANGOLASECTOR CONSULAR DA EMBAIXADAEM WASHINGTON, D.C., ESTADOS UNIDOS DA AMÉRICA2<strong>10</strong>0 16TH STREET N.W., WASHINGTON, D.C. 20009PEDIDO DE VISTO DE ENTRADAVISA REQUIREMENT FORMPlease complete the <strong>for</strong>m in black ink Your current passport andTick the boxes which apply and attach Two recent passport-sized photographsA letter of invitation or correspondence sent by the individual or institution to be contacted in AngolaTRANSITORDINARYWORK PERMITRESIDENT PERMITTRÃNSITO ORDINÃRIO FAXAÇÃO DE RESIDÉNCIATRABALHOPERSONAL DATA1. NameNome2.SurnameApelido4. Date of birth (dd/mm/yy)5. Nationality:6. Nationality of origin:Data de nascimentoNacionalidadeNacionalidade de origem7. Place of birth:8. Country of birth: 9. Other nationalities:Local de nascimentoPais onde nasceuOutras nacionalidades<strong>10</strong>. Father's name: Mother's name:Nome do paiNome da mãe11. Marital status: Single Maffied Separated Divorced WidowedEstado civilSolteiro (a)Casado (a) Separado (a)Divorciado (a) Viúvo (a)12. Mailing address: Tel:Endereço permanenteTel13. Trade or profession:14. EmployerProfissão ou ocupaçãoEmpregador15. Office/Employer's address:Tel:Escritôrio/Endereço do EmpregadorTel16. Individual traveling with <strong>you</strong>:Pessoas que o(a) acompanham17.Person, company or Institution to be contacted in Angola:Pessoa, companhia ou institução que vai contractar em Angola18. Name of persons who can provide in<strong>for</strong>mation: (Name or references, address and nationality phone / fax #)Nome da pessoa que pode <strong>for</strong>necer in<strong>for</strong>maçôesIntended stay in AngolaPeriodo de estada em AngolaPASSPORT INFORMATION3. Sex: M FSexo19. Ordinary passport Diplomatic/ Official passport Other document: # of Passport:Passaporte ordinãrio Passaporte Diplomatico/Oficial Outro documentoNr do Passaporte20. Name of issuing authority19. Issue date: (dd/mm/yy)Nome da entidade emisoraData da emissão20. Valid until (dd/mm/yy)Vàlido atéPage 5 of 7

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