C C
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ﻨﻤﻭﺫﺝ ﺍﺴﺘﺒﻴﺎﻥ ﻹﺼﺩﺍﺭ ﺒﻁﺎﻗﺔ ﺭﻗﻡ ﻗﻭﻤﻲ ﻟﻠﻤﺼﺭﻴﻴﻥ ﺒﺎﻟﺨﺎﺭﺝ ﺍﻻﺴﻡ ﺍﻟﺸﺨﺼﻲ:
ﺍﻟﻨﻭﻉ: ﺍﻟﺠﻨﺴﻴﺔ:
ﺍﻟﺩﻴﺎﻨﺔ:
א א
א
א
ﺘﺎﺭﻴﺦ ﺍﻟﻤﻴﻼﺩ:
ﻤﺤل ﺍﻟﻤﻴﻼﺩ:
א
א א
/
ﻤﺭﻜﺯ:
א
א
/
ﻤﺤﺎﻓﻅﺔ:
א
א
א
ﺍﻟﻤﻬﻨﺔ: ﻤﺤل ﺍﻹﻗﺎﻤﺔ:
א
א
א א
א
) א א /א
/א
(
ﻴﻠﺯﻡ ﻤﻭﺍﻓﺎﺓ ﻗﻁﺎﻉ ﺍﻷﺤﻭﺍل ﺍﻟﻤﺩﻨﻴﺔ ﻤﻊ ﻫﺫﺍ ﺍﻟﻨﻤﻭﺫﺝ ﺒﺼﻭﺭﺓ ﻤﻥ ﺍﻟﻤﺴﺘﻨﺩﺍﺕ ﺍﻟﻤﺅﻴﺩﺓ ﻟﻠﺒﻴﺎﻨﺎﺕ ﺒﻌﺎﻟﻴﻪ ﻭﺫﻟﻙ ﻟﻠﻤﺭﺍﺠﻌﺔ ﻗﺒل ﺍﻟﻘﻴﺎﻡ ﺒﺎﻟﻤﺄﻤﻭﺭﻴﺔ، ﻋﻠﻰ ﺃﻥ ﺘﻜﻭﻥ ﺃﺼﻭﻟﻬﺎ ﻤﻊ ﺍﻟﻤﻭﺍﻁﻥ ﻭﻗﺕ ﺍﻟﺘﺼﻭﻴﺭ ﺃﻭ ﺘﻌﺘﻤﺩ ﺼﻭﺭ ﻁﺒﻕ ﺍﻷﺼل ﻤﻥ ﺍﻟﻘﻨﺼﻠﻴﺔ ﻋﻠﻰ ﻤﺴﺌﻭﻟﻴﺘﻬﺎ ﻭﻫﻲ ﻜﻤﺎ ﻴﻠﻲ:
ﺇﺜﺒﺎﺕ ﺍﻟﺸﺨﺼﻴﺔ:
ﺘﺜﺒﺕ ﺒﺄﺤﺩ ﺍﻟﺒﺩﺍﺌل ﺍﻵﺘﻴﺔ :ﺍﻟﺒﻁﺎﻗﺔ )ﺸﺨﺼﻴﺔ ﺃﻭ ﻋﺎﺌﻠﻴﺔ( -ﺠﻭﺍﺯ ﺍﻟﺴﻔﺭ ﺍﻟﻤﺼﺭﻱ ﺍﻟﺴﺎﺭﻱ ﺍﻟﻤﻔﻌﻭل -ﺭﺨﺼﺔ ﻗﻴﺎﺩﺓ ﻤﺼﺭﻴﺔ ﺴﺎﺭﻴﺔ -ﻀﻤﺎﻥ ﺍﻟﻘﺭﻴﺏ ﺤﺘﻰ ﺍﻟﺩﺭﺠﺔ ﺍﻟﺜﺎﻟﺜﺔ ﻹﺜﺒﺎﺕ ﺸﺨﺼﻴﺘﻪ.
ﺇﺜﺒﺎﺕ ﺍﻟﻤﻬﻨﺔ:
ﺘﺜﺒﺕ ﺍﻟﻤﻬﻨﺔ ﻟﻠﻌﺎﻤﻠﻴﻥ ﺒﺎﻟﺨﺎﺭﺝ ﻤﻘﺭﻭﻨﺔ ﺒﻜﻠﻤﺔ )ﺒﺎﻟﺨﺎﺭﺝ( ﺒﺎﻋﺘﻤﺎﺩ ﺍﻟﻘﻨﺼﻠﻴﺔ ﺍﻟﻤﺼﺭﻴﺔ ﺒﺎﻟﺩﻭﻟﺔ ﺍﻟﺘﻲ ﻴﻌﻤل ﺒﻬﺎ.
ﺇﺜﺒﺎﺕ ﻤﺤل ﺍﻹﻗﺎﻤﺔ:
ﺘﺜﺒﺕ ﻟﻠﻤﻘﻴﻤﻴﻥ ﺒﺎﻟﺨﺎﺭﺝ ﺒﺎﻋﺘﻤﺎﺩ ﺍﻟﻘﻨﺼﻠﻴﺔ ﺍﻟﻤﺼﺭﻴﺔ. ﻴﺜﺒﺕ ﻤﺤل ﺍﻹﻗﺎﻤﺔ ﺩﺍﺨل ﺠﻤﻬﻭﺭﻴﺔ ﻤﺼﺭ ﺍﻟﻌﺭﺒﻴﺔ ﺒﻤﻭﺠﺏ ﺃﺤﺩ ﺍﻟﺒﺩﺍﺌل ﺍﻵﺘﻴﺔ :ﺍﻟﺒﻁﺎﻗﺔ )ﺸﺨﺼﻴﺔ ﺃﻭ ﻋﺎﺌﻠﻴﺔ( -ﺠﻭﺍﺯ ﺍﻟﺴﻔﺭ ﺍﻟﻤﺼﺭﻱ ﺍﻟﺴﺎﺭﻱ ﺍﻟﻤﻔﻌﻭل -ﺭﺨﺼﺔ ﺍﻟﻘﻴﺎﺩﺓ ﺍﻟﻤﺼﺭﻴﺔ ﺍﻟﺴﺎﺭﻴﺔ -ﺇﻗﺭﺍﺭ ﻤﻥ ﺃﺤﺩ ﺍﻷﻗﺎﺭﺏ ﺤﺘﻰ ﺍﻟﺩﺭﺠﺔ ﺍﻟﺜﺎﻟﺜﺔ ﺒﺈﻗﺎﻤﺘﻪ ﻤﻌﻪ ﻓﻲ ﻤﺤل ﺍﻹﻗﺎﻤﺔ ﺍﻟﺜﺎﺒﺕ ﺒﺒﻁﺎﻗﺔ ﺃﻭ ﺠﻭﺍﺯ ﺍﻟﺴﻔﺭ ﺍﻟﻤﺼﺭﻱ ﺍﻟﺴﺎﺭﻱ ﺍﻟﺨﺎﺹ ﺒﺎﻟﻘﺭﻴﺏ.
ﺇﺜﺒﺎﺕ ﺍﻟﺤﺎﻟﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ:
ﺘﺜﺒﺕ ﺍﻟﺤﺎﻟﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ )ﻤﺘﺯﻭﺝ/ﻤﻁﻠﻕ( ﺒﻤﻭﺠﺏ ﺃﺤﺩ ﺍﻟﺒﺩﺍﺌل ﺍﻵﺘﻴﺔ: ﻤﺴﺘﻨﺩﺍﺕ ﻤﺼﺭﻴﺔ :ﻗﺴﻴﻤﺔ ﺃﻭ ﺒﻴﺎﻥ ﺯﻭﺍﺝ/ﻁﻼﻕ -ﺤﻜﻡ ﻗﻀﺎﺌﻲ ﺒﺈﺜﺒﺎﺕ ﺍﻟﺯﻭﺍﺝ/ﺍﻟﻁﻼﻕ -ﻗﻴﺩ ﻋﺎﺌﻠﻲ. ﻤﺴﺘﻨﺩﺍﺕ ﺃﺠﻨﺒﻴﺔ :ﻗﺴﻴﻤﺔ ﺯﻭﺍﺝ/ﻁﻼﻕ ﻤﻌﺘﻤﺩﺓ ﻤﻥ ﺍﻟﻘﻨﺼﻠﻴﺔ ﺍﻟﻤﺼﺭﻴﺔ )ﻓﻲ ﺤﺎﻟﺔ ﻤﺎ ﺇﺫﺍ ﻜﺎﻥ ﺍﻟﺯﻭﺍﺝ ﻗﺒل ﺘﺎﺭﻴﺦ .(٢٠٠٢/٣/١ ﺘﺜﺒﺕ ﺍﻟﺤﺎﻟﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ )ﺃﺭﻤل/ﺃﺭﻤﻠﺔ( ﺒﻤﻭﺠﺏ ﺃﺤﺩ ﺍﻟﺒﺩﺍﺌل ﺍﻵﺘﻴﺔ: ﻤﺴﺘﻨﺩﺍﺕ ﻤﺼﺭﻴﺔ :ﺸﻬﺎﺩﺓ ﻭﻓﺎﺓ ﻤﺼﺭﻴﺔ -ﺤﻜﻡ ﻗﻀﺎﺌﻲ ﻤﺼﺭﻱ ﺒﺈﺜﺒﺎﺕ ﺍﻟﻭﻓﺎﺓ -ﺇﻋﻼﻡ ﻭﺭﺍﺜﺔ ﺃﻭ ﺇﻗﺭﺍﺭ ﻭﺼﺎﻴﺔ ﻤﺼﺭﻱ. ﻤﺴﺘﻨﺩﺍﺕ ﺃﺠﻨﺒﻴﺔ :ﺸﻬﺎﺩﺓ ﻭﻓﺎﺓ ﻤﻌﺘﻤﺩﺓ ﻤﻥ ﺍﻟﻘﻨﺼﻠﻴﺔ ﺍﻟﻤﺼﺭﻴﺔ )ﻟﻠﺯﻭﺝ/ﺍﻟﺯﻭﺠﺔ(.
ﺍﻟﻨﻭﻉ: ﺍﻟﺠﻨﺴﻴﺔ:
ﺍﻟﺩﻴﺎﻨﺔ:
א א
א
א
ﺘﺎﺭﻴﺦ ﺍﻟﻤﻴﻼﺩ:
ﻤﺤل ﺍﻟﻤﻴﻼﺩ:
א
א א
/
ﻤﺭﻜﺯ:
א
א
/
ﻤﺤﺎﻓﻅﺔ:
א
א
א
ﺍﻟﻤﻬﻨﺔ: ﻤﺤل ﺍﻹﻗﺎﻤﺔ:
א
א
א א
א
) א א /א
/א
(
ﻴﻠﺯﻡ ﻤﻭﺍﻓﺎﺓ ﻗﻁﺎﻉ ﺍﻷﺤﻭﺍل ﺍﻟﻤﺩﻨﻴﺔ ﻤﻊ ﻫﺫﺍ ﺍﻟﻨﻤﻭﺫﺝ ﺒﺼﻭﺭﺓ ﻤﻥ ﺍﻟﻤﺴﺘﻨﺩﺍﺕ ﺍﻟﻤﺅﻴﺩﺓ ﻟﻠﺒﻴﺎﻨﺎﺕ ﺒﻌﺎﻟﻴﻪ ﻭﺫﻟﻙ ﻟﻠﻤﺭﺍﺠﻌﺔ ﻗﺒل ﺍﻟﻘﻴﺎﻡ ﺒﺎﻟﻤﺄﻤﻭﺭﻴﺔ، ﻋﻠﻰ ﺃﻥ ﺘﻜﻭﻥ ﺃﺼﻭﻟﻬﺎ ﻤﻊ ﺍﻟﻤﻭﺍﻁﻥ ﻭﻗﺕ ﺍﻟﺘﺼﻭﻴﺭ ﺃﻭ ﺘﻌﺘﻤﺩ ﺼﻭﺭ ﻁﺒﻕ ﺍﻷﺼل ﻤﻥ ﺍﻟﻘﻨﺼﻠﻴﺔ ﻋﻠﻰ ﻤﺴﺌﻭﻟﻴﺘﻬﺎ ﻭﻫﻲ ﻜﻤﺎ ﻴﻠﻲ:
ﺇﺜﺒﺎﺕ ﺍﻟﺸﺨﺼﻴﺔ:
ﺘﺜﺒﺕ ﺒﺄﺤﺩ ﺍﻟﺒﺩﺍﺌل ﺍﻵﺘﻴﺔ :ﺍﻟﺒﻁﺎﻗﺔ )ﺸﺨﺼﻴﺔ ﺃﻭ ﻋﺎﺌﻠﻴﺔ( -ﺠﻭﺍﺯ ﺍﻟﺴﻔﺭ ﺍﻟﻤﺼﺭﻱ ﺍﻟﺴﺎﺭﻱ ﺍﻟﻤﻔﻌﻭل -ﺭﺨﺼﺔ ﻗﻴﺎﺩﺓ ﻤﺼﺭﻴﺔ ﺴﺎﺭﻴﺔ -ﻀﻤﺎﻥ ﺍﻟﻘﺭﻴﺏ ﺤﺘﻰ ﺍﻟﺩﺭﺠﺔ ﺍﻟﺜﺎﻟﺜﺔ ﻹﺜﺒﺎﺕ ﺸﺨﺼﻴﺘﻪ.
ﺇﺜﺒﺎﺕ ﺍﻟﻤﻬﻨﺔ:
ﺘﺜﺒﺕ ﺍﻟﻤﻬﻨﺔ ﻟﻠﻌﺎﻤﻠﻴﻥ ﺒﺎﻟﺨﺎﺭﺝ ﻤﻘﺭﻭﻨﺔ ﺒﻜﻠﻤﺔ )ﺒﺎﻟﺨﺎﺭﺝ( ﺒﺎﻋﺘﻤﺎﺩ ﺍﻟﻘﻨﺼﻠﻴﺔ ﺍﻟﻤﺼﺭﻴﺔ ﺒﺎﻟﺩﻭﻟﺔ ﺍﻟﺘﻲ ﻴﻌﻤل ﺒﻬﺎ.
ﺇﺜﺒﺎﺕ ﻤﺤل ﺍﻹﻗﺎﻤﺔ:
ﺘﺜﺒﺕ ﻟﻠﻤﻘﻴﻤﻴﻥ ﺒﺎﻟﺨﺎﺭﺝ ﺒﺎﻋﺘﻤﺎﺩ ﺍﻟﻘﻨﺼﻠﻴﺔ ﺍﻟﻤﺼﺭﻴﺔ. ﻴﺜﺒﺕ ﻤﺤل ﺍﻹﻗﺎﻤﺔ ﺩﺍﺨل ﺠﻤﻬﻭﺭﻴﺔ ﻤﺼﺭ ﺍﻟﻌﺭﺒﻴﺔ ﺒﻤﻭﺠﺏ ﺃﺤﺩ ﺍﻟﺒﺩﺍﺌل ﺍﻵﺘﻴﺔ :ﺍﻟﺒﻁﺎﻗﺔ )ﺸﺨﺼﻴﺔ ﺃﻭ ﻋﺎﺌﻠﻴﺔ( -ﺠﻭﺍﺯ ﺍﻟﺴﻔﺭ ﺍﻟﻤﺼﺭﻱ ﺍﻟﺴﺎﺭﻱ ﺍﻟﻤﻔﻌﻭل -ﺭﺨﺼﺔ ﺍﻟﻘﻴﺎﺩﺓ ﺍﻟﻤﺼﺭﻴﺔ ﺍﻟﺴﺎﺭﻴﺔ -ﺇﻗﺭﺍﺭ ﻤﻥ ﺃﺤﺩ ﺍﻷﻗﺎﺭﺏ ﺤﺘﻰ ﺍﻟﺩﺭﺠﺔ ﺍﻟﺜﺎﻟﺜﺔ ﺒﺈﻗﺎﻤﺘﻪ ﻤﻌﻪ ﻓﻲ ﻤﺤل ﺍﻹﻗﺎﻤﺔ ﺍﻟﺜﺎﺒﺕ ﺒﺒﻁﺎﻗﺔ ﺃﻭ ﺠﻭﺍﺯ ﺍﻟﺴﻔﺭ ﺍﻟﻤﺼﺭﻱ ﺍﻟﺴﺎﺭﻱ ﺍﻟﺨﺎﺹ ﺒﺎﻟﻘﺭﻴﺏ.
ﺇﺜﺒﺎﺕ ﺍﻟﺤﺎﻟﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ:
ﺘﺜﺒﺕ ﺍﻟﺤﺎﻟﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ )ﻤﺘﺯﻭﺝ/ﻤﻁﻠﻕ( ﺒﻤﻭﺠﺏ ﺃﺤﺩ ﺍﻟﺒﺩﺍﺌل ﺍﻵﺘﻴﺔ: ﻤﺴﺘﻨﺩﺍﺕ ﻤﺼﺭﻴﺔ :ﻗﺴﻴﻤﺔ ﺃﻭ ﺒﻴﺎﻥ ﺯﻭﺍﺝ/ﻁﻼﻕ -ﺤﻜﻡ ﻗﻀﺎﺌﻲ ﺒﺈﺜﺒﺎﺕ ﺍﻟﺯﻭﺍﺝ/ﺍﻟﻁﻼﻕ -ﻗﻴﺩ ﻋﺎﺌﻠﻲ. ﻤﺴﺘﻨﺩﺍﺕ ﺃﺠﻨﺒﻴﺔ :ﻗﺴﻴﻤﺔ ﺯﻭﺍﺝ/ﻁﻼﻕ ﻤﻌﺘﻤﺩﺓ ﻤﻥ ﺍﻟﻘﻨﺼﻠﻴﺔ ﺍﻟﻤﺼﺭﻴﺔ )ﻓﻲ ﺤﺎﻟﺔ ﻤﺎ ﺇﺫﺍ ﻜﺎﻥ ﺍﻟﺯﻭﺍﺝ ﻗﺒل ﺘﺎﺭﻴﺦ .(٢٠٠٢/٣/١ ﺘﺜﺒﺕ ﺍﻟﺤﺎﻟﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ )ﺃﺭﻤل/ﺃﺭﻤﻠﺔ( ﺒﻤﻭﺠﺏ ﺃﺤﺩ ﺍﻟﺒﺩﺍﺌل ﺍﻵﺘﻴﺔ: ﻤﺴﺘﻨﺩﺍﺕ ﻤﺼﺭﻴﺔ :ﺸﻬﺎﺩﺓ ﻭﻓﺎﺓ ﻤﺼﺭﻴﺔ -ﺤﻜﻡ ﻗﻀﺎﺌﻲ ﻤﺼﺭﻱ ﺒﺈﺜﺒﺎﺕ ﺍﻟﻭﻓﺎﺓ -ﺇﻋﻼﻡ ﻭﺭﺍﺜﺔ ﺃﻭ ﺇﻗﺭﺍﺭ ﻭﺼﺎﻴﺔ ﻤﺼﺭﻱ. ﻤﺴﺘﻨﺩﺍﺕ ﺃﺠﻨﺒﻴﺔ :ﺸﻬﺎﺩﺓ ﻭﻓﺎﺓ ﻤﻌﺘﻤﺩﺓ ﻤﻥ ﺍﻟﻘﻨﺼﻠﻴﺔ ﺍﻟﻤﺼﺭﻴﺔ )ﻟﻠﺯﻭﺝ/ﺍﻟﺯﻭﺠﺔ(.
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