Mẫu giấy trình báo mất thẻ ABTC nước ngoài

Mẫu TK17B REPORT ON ABTC CARD'S LOSS OR STEAL (1) To:                                                                                            1- Surname and given names........................................................................................................................... 2- Sex................... 3- Date of birth (Day/Month/Year)............................................................................................................................................... 4- Permanent resident address: House number or Hamlet .................................................. Street/Road............................... Ward/Commun .......................................... District/Town ............................................ Province (city) ................................... 5- Name, Contact address and Phone mumber of the Applicant's Company/Organisation ................................................ ............................................................................................................................................................................................................ 6- I have been granted by Vietnam Immigration Department an ABTC Card No: ................................................................ Date of expiry........./............./............(Day/Month/Year) I would like to report to the Local Authority that my ABTC Card has been lost/stolen at................................................. ............................................................................................................................... on.........../............/...........(Day/Month/Year) for reasons: ...................................................................................................................................................................................... ............................................................................................................................................................................................................ You are kindly requested to authenticate this declaration. I undertake to inform the competent Authority in Viet Nam to cancel my lost/stolen ABTC Card. I swear that my declaration is true and correct for which I will be full responsible to the Law. Authentication by the compotent Authority In the local Economy On.............../............./..................(Day/Month/Year) (Signature, full name, position and stamp of the Authenticator) Done at.......................................On............./............/.............                                         (Day/Month/Year) Signature and full name of the Applicant (2)   Note: (1)This form is used in the case of the Applicant's ABTC Card lost or stolen in the ABTC Participating Economies.             (2) 02 copies of this form which authentication by foreign competent Authority in the country where the Card             was lost or stolen should be filled in and forwarded to the Immigration Department - Ministry of Public Security of             Vietnam immediately after the Card holder's return to Vietnam.