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ApplicationFormofConsularLegalizationoftheEmbassyZConsulateofthePeople,sRepublicofChina申请人须如实、完整、清荒地填写本表格，请逐项在空白处用中文或英文大写字母打印体填写,或在口内打J选择。Theapplicantshouldfillinthisformtruthfully,completelyandclearly.PleasetypetheanswerincapitalEnglishlettersinthespaceprovidedortick(Y)therelevantboxtoselect.1、个人申请Applicant(ForIndividualUseOnly)姓名Name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家庭住址电子邮箱HomeaddressE-mailaddress住宅电话手机HomephonenumberMobilephonenumber2、企业及其他组织申请Applicant(ForCompanyZOrganizationUseOnly)企业或其他组织名称Nameofcompany/organization联系地址Address电话PhoneNumber法定代表人信息1.egalRepresentativeofCompanyZorganization姓名Name出生日期Dateofbirth(yyyy-mm-dd)证件种类1peofID证件号码NumberofID3、公证书或其他证明文书证明的事项Matterscertifiedbythenotarialdeedsorothercertificates出生证Birthcertificate;结婚证Marriagecertificate;无犯罪记录证明Certificateofnon-criminalrecord;健康证明HealthCertifiCate;学历证明DiPk)ma;委托书AUthoriZationIetter;声明书Statement;口商业,文件Businessdocuments;其他(请注明)Other(PleaSespecify):4、认证办理目的和文书使用地点PurposeandDestinationofLegalization办理目的Purposeoflegalization:婚姻Marriage;寄养FoSterage;房产ReaIeState;口诉讼Litigation;签证Visa;口领养Adoption;商务贸易Businessandtrade;其他(请注明)OtherS(PleaSespecify):文书使用地Destinationoflegalization:5、提交材料及申办认证书的份数SupportingdocumentsandCopiesofLegalization提交材料Supportingdocuments份数Copies6、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(X个工作日)Regular service for X business days 加急(X个工作日)Express service for X business days 特急(X个工作日)Rush service for X business day(s)代办人姓名 Name of agent 身份证件种类 Type of ID 与申请人的关系 Relationship with the applicant 联系电话Phone number性别Gender身份证件号码Number of ID国籍Nationality职业Occupation电子邮箱E-mail address8、申请人/代办人声明 Declaration of the ApplicantZAgent联系地址 Address7、代办人Agent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贲任。1herebydeclarethatalltheinformationaboveistrueandcorrect,fbrwhichIshallbearallthelegalresponsibilities.日期：Date(yyyy-mm-dd):.日期：Date(yyyy-mm-dd):.申请人签名：Signatureofapplicant:.代办人签名：Signatureofagent: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、合法性负贲，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,performedbyconsularlegalizationagenciesupontheapplicationofnaturalpersons,legalpersonsorotherorganizations.Consularlegalizationdoesnotundertaketheresponsibilityofcertifyingthematterscertifiedbythenotarialdeedsorothercertificates,anditisnotresponsiblefortheauthenticityandvalidityofthedocuments,scontent,whichshallbetheresponsibilityoftheissuinginstitution.Theapplicationwillberefusedbyconsularofficialifthedocumentsmayharmthenationalinterestsorsocialpublicinterestsorhaveothercircumstancesunderwhichconsularlegalizationshallnotbeperformed.日期：Date(yyyy-mm-dd):申请人签名：Signatureofapplicant: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:
