Ходатайство о реадмиссии в соответствии со статьей 7 Соглашения между Правительством Российской Федерации и Правительством Исландии о реадмиссии (англ.)

Annex 1 to the Agreement between the Government of the Russian Federation and the Government of Iceland on readmission

[Emblem of the Russian Federation]                      [Emblem of Iceland]

....................................    ...................................
____________________________________              (Place and date)
(Designation of the competent
authority of the requesting State)

Reference...........................
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¦ ¦ ACCELERATED PROCEDURE
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To
....................................
....................................
....................................
(Designation of the competent
authority of the requested State)

READMISSION APPLICATION
Pursuant to Article 7 of the Agreement
Between the Government of the Russian Federation
and the Government of Iceland on readmission
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A. Personal details                                      ¦              ¦
1. Full name (underline surname):                        ¦              ¦
...............................................          ¦  Photograph  ¦
2. Maiden name:                                          ¦              ¦
...............................................          ¦              ¦
3. Date and place of birth:                              ¦              ¦
...............................................          ----------------
4.  Sex  and  physical  description (height, colour of eyes, distinguishing
marks etc.):
...........................................................................
5.  Also  known  as  (earlier  names,  other  names  used/by which known or
aliases):
...........................................................................
6. Nationality and language:
...........................................................................
-¬         -¬        -¬          -¬
7. Civil status (where possible) L-married  L-single  L-divorced  L-widowed
If married: name of spouse.................................................
Names and age of children (if any)
....................................................
....................................................
....................................................
....................................................
8. Last address in the requesting State:
...........................................................................
9. Last place of residence in the requested State
...........................................................................
B. Special circumstances relating to the transferee
1. State of health
(E.g.  possible reference to special medical care; latin name of contagious
disease):
...........................................................................
2. Indication of particularly dangerous person
(e.g. suspected of serious offence; aggressive behaviour):
...........................................................................
C. Means of evidence attached
1.                                       ..................................
....................................     ..........
.........                                    (date and place of issue)
(Passport No.)
..................................
....................................     ..........
.........                                             (expiry date)
(issuing authority)
2.                                       ..................................
....................................     ..........
.........                                    (date and place of issue)
(Identity card No.)
..................................
....................................     ..........
.........                                             (expiry date)
(issuing authority)
3.                                       ..................................
....................................     ..........
.........                                    (date and place of issue)
(Driving licence No.)
..................................
....................................     ..........
.........                                             (expiry date)
(issuing authority)
4.                                       ..................................
....................................     ..........
..........                                     (date and place of issue)
(Other official document No.)
..................................
....................................     ..........
.........                                             (expiry date)
(issuing authority)
D. Observations
...........................................................................
...........................................................................
...........................................................................

.........................
(Signature of the competent authority of the requesting State) (Seal/stamp)

Источник - Соглашение между Правительством Российской Федерации и Правительством Исландии от 23.09.2008