1b
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- ::171:1'10
D'1i'i1
*Name in full
..... '" DWi1 1K $.. :.u ". ---:
... ............ ...
or formername
.I;'~ ~..
Maiden name
.'"
If; --
D"1313DW... ::.
.. ....
All countries
Passport valid for
nuo"'lJ(:"I7:1
., 9i'n l1:J,m ~.",,"
:
. ..,t-.......... . ".
.,,-.e~...'.
Signature of bearer On receipt of passport sign here
u::;;T'
--
. . . . . . . . . . . . . ... . . .amended
--
r'~"""""~
- see page _
iEI!~
PASSPORT 1')"
STATEOF ISRAEl
, , Surnamo Type I :no
"
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'11.3)1MIC' - M311D ............... ...
--
Code of Stalo I
Pj
')1nl])'
N'1I301'mu
I1J"lD Passport No. I )D'T1 'go
ISR
9995015 nn!>'I>D
TAMIR GIven
name
1'O'1!>D'I>
DORONYACOV
JpV' p", mmm n"N'\!>'
Nalional'iIy
ISRAELI Dato oI./JIrth I
I.D.No. I Inn! '1>D
n"~ 1"11I1
20/09/1948 Sox II'D
0-0861952-0 mDJpt!
Place ofbiI1h
MI T
ISRAEL
Dateof Issue I n~n
1'1Nn
'N'ID' Datoofoxpiry I ~jM m"~ ""11I1
15/04/2003 Authority
D'I>
"I:)\)
- I.C. Passport
14/04/2013 at.
-3 D'rtn,
KFAR-SABA
P
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MDD - n\:Jno
