中华人民共和国驻外使领馆领事认证申请表.docx
中华人民共和国驻外使领馆领事认证申请表（死亡证明认证）ApplicationFormofConsularLegalizationoftheEmbassyZConsulateofthePeople,sRepublicofChina（LegalizationforDeathCertificate）申请人须如实、完整、清楚地填写本表格，请逐项在空白处用中文或英文大写字母打印体填写，或在0内打选择oTheapplicantshouldfillinthisformtruthfully,completelyandclearly.PleasetypetheanswerincapitalEnglishlettersinthespaceprovidedortickN）therelevantboxtoselect.1、死者信息Informationofthedeceased死者姓名Nameofdeceased性别Gender出生地点Placeofbirth出生日期Dateofbirth（yyyy-mm-dd）国籍Nationality职业Occupation身份证件种类TypeofID身份证件号码NumberofID工作机构或学校名称Nameofemployer/school工作机构或学校地址Addressofemployer/school家庭住址Homeaddress2、认证办理目的和文书使用地点PurposeandDestinationofLegalization办理目的Purposeoflegalization:文书使用地Destinationoflegalization:3、提交材料及申办认证书的份数SupportingdocumentsandCopiesofLegalization提交材料Supportingdocuments份数Copies4、办理时间Processingtime注：加急和特急服务须经领事官员批准，并将加收费用。Note:Expressandrushserviceneedsapprovalofconsularofficials,andextrafeesmayapply. 普通（4个工作日）Regularservicefor4businessdays 加急（3个工作日）Expressservicefor3businessdays 特急（2个工作日）Rushservicefor2businessday（三）5、代办人Agent姓名Name性别Gender国籍Nationality身份证件种类TypeofID身份证件号码NumberofID职业Occupation与申请人的关系Relationshipwiththedeceased联系地址Address联系电话电子邮箱PhonenumberE-mailaddress6、代办人声明DeclarationoftheAgent我保证以上所填内容真实。如有不实之处，本人愿承担一切法律责任。Iherebydeclarethatalltheinfo11nationaboveistrueandcorrect,forwhichIshallbearallthelegalresponsibilities.代办人签名：日期：Signatureofagent:Date(yyyy-mm-dd):我声明，我已阅读并理解以下内容：领事认证是指领事认证机构根据自然人、法人或者其他组织的申请，对国外有关文书上的最后一个印鉴、签名的真实性予以确认的活动。领事认证不对公证书或者其他证明文书证明的事项行使证明职能，不对文书内容本身的真实性、合法性负责，文书内容由文书出具机构负责。领事官员有权对可能损害国家利益和社会公共利益的和存在不予办理领事认证有关情形的文书不予认证。IherebydeclarethatIhavereadandunderstoodthecontentbelow:Theconsularlegalizationreferstothepracticeofconfirmingtheauthenticityofthelastsealorsignatureonrelevantdocumentsissuedbyothercountries,performedbyconsularlegalizationagenciesupontheapplicationolnaturalpersons,legalpersonsorotherorganizations.Consularlegalizationdoesnotundertaketheresponsibilityoicertifyingthematterscertifiedbythenotarialdeedsorothercertificates,anditisnotresponsiblefortheauthenticityandvalidityofthedocuments,scontent,whichshallbetheresponsibilityoftheissuinginstitution.Theapplicationwillberefusedbyconsularofficialifthedocumentsmayharmthenationalinterestsorsocialpublicinterestsorhaveothercircumstancesunderwhichconsularlegalizationshallnotbeperformed.代办人签名：日期：Signatureofagent:Date(yyyy-mm-dd):以下项目仅供领事官员填写(ForofficialUseOnly):接案人、接案日期：签署人、签署日期：复核人(如有)、复核日期：
