Ходатайство о транзите в соответствии со статьей 15 Соглашения между Правительством Российской Федерации и Правительством Исландии о реадмиссии (англ.)

Annex 6 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
...................................
To
...................................
...................................
...................................
___________________________________
(Designation of the competent
authority of the requested State)

TRANSIT APPLICATION
pursuant to Article 15 of the Agreement
between the Government of the Russian Federation
and the Government of Iceland and on readmission

A. Personal details                                     ------------------
1. Full name (underline surname):                       ¦                ¦
...........................................             ¦                ¦
2. Maiden name:                                         ¦   Photograph   ¦
...........................................             ¦                ¦
¦                ¦
3. Date and place of birth:                             ¦                ¦
...........................................             ------------------
4.  Sex  and  physical  description  (height, color of eyes, distinguishing
marks etc.):
...........................................................................
6.  Also  known  as  (earlier  names,  other  names used/by which known, or
aliases):
...........................................................................
7. Nationality and language:
...........................................................................
8. Type and number of travel document:
...........................................................................
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. Transit operation
1. Type of transit
-¬            -¬            -¬
L- by air     L- by sea     L- by land
2. State of final destination
...........................................................................
3. Possible other States of transit
...........................................................................
4.  Proposed  border  crossing  point,  date, time of transfer and possible
escorts
...........................................................................
...........................................................................
...........................................................................
5.  Admission  assured in any other transit State and in the State of final
destination (Article 14 (2) of the Agreement between the Russian Federation
and Iceland on readmission)
-¬           -¬
L- yes       L- no
6.  Knowledge of any reason for a refusal of transit (Article 14 (3) of the
Agreement  between  the  Government  of  the  Russian  Federation  and  the
Government of Iceland on readmission)
-¬           -¬
L- yes       L- no
D. Observations
...........................................................................
...........................................................................
...........................................................................
...........................................................................

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

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