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Form For Registration of Temporary Residence For Visitors In Nanshan of Shenzhen

Form For Registration of Temporary Residence For Visitors In Nanshan of Shenzhen

南山区境外人员临时住宿登记表

英文姓

surname

中间名

middle name

1寸免冠

正面照片

1-inch full-faced  picture

英文名

given name

中文姓名

Chinese name

国籍/地区nationality/region
男male □    女female □ 出生日期date of birth
肤色skin color 白white□  黄yellow□  棕brown□  黑black□
教育程度

educational level

博士doctor □ 硕士post-graduate □  本科university □

专科junior college □ 职业学校vocational school □ 高中senior high school □

初中junior high school □ 小学primary school □ 学龄前preschool □

婚姻状况

marital status

未婚single □ 已婚married □ 离婚divorced □ 分居separated □

鳏居widowed □

入境所持证件type of entry certificate 号码number
有效期至valid until 签发地place of issue
入境日期date of entry 入境口岸port of entry
停留事由

object of stay

投资investment □ 就业employment □ 学习/实习/培训 study/practice/training □ 学术或科技交流academic/technical exchange □ 商务business □ 演出performance □ 探亲访友visiting □ 旅游touring □ 购房置业purchase of real estate □ 治病疗养medical treatment □ 其他other □
签证(注)

种类

type of visa

F□ L□ G□ C□ J-2□ Z□

X□ J-1□ 居留许可residence

permit □ 其他other □

可入境次数permitted entries 零次zero□ 一次one□

两次two□

多次multiple□

签证(注)号码visa/permit number 签发地place of issue
有效期至 expires on Y    M    D 在华身份occupation in China
国(境)外常住地址permanent address in home country
迁来前住处 previous address before moving in
在深圳住址

present

address

区       街道/路         小区        期      座     楼     号      district    street/road     neighborhood  phase  building  floor  number
上述地址固定电话wire phone number of the above address
本人在深手机及电子邮件地址 your mobile

phone number in Shenzhen & email address

手机mobile:

电子邮件email:

上述住址入住日期

date of moving in

年Y  月M  日D 拟居住至何日期to stay until 年Y   月M   日D
住所类别type of place of residence 亲友家中owned by relatives or friends□ 单位内部owned by organization□  租赁房屋rented□ 自购房self-owned□ 宾馆酒店hotel□

其他other□

是否物业小区Is there a housing management office for the place of residence ? 是yes□ 否no□
同住人数 mode of living (number of roommates) 单独居住 alone □ 家庭居住 with your own family □ 合伙居住sharing with partner(s) □ 集体居住 in group as in dormitory □
屋主/留宿人house owner/host 姓名name 电话Tel.
工作单位或住址address or organization of employment
证件类型type of certificate 号码No.
接待单位、就职或学习单位情况host organization, organization of employment or study
名称name
地址address
联系人contact person 电话Tel.
填表人签名He who

fills the form sign here

住宿人签名及日期signature & date of lodger/resident
变更情况登记(警务人员录入) Registration of Changes (by police staff only)
原持签证(居留

许可)延期/变更为

1、种类 签发地 2、种类 签发地 3、种类 签发地 4、种类 签发地
变更后有效期至 年  月  日 年  月  日 年  月  日 年  月  日
离开时间及去向
居留许可/签证注销情况 种类:           号码:             注销时间:


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