ON-LINE VISA APPLICATION FORM 20002-43229262 \ 20.03.
2024 6:40:32 EMBASSY OF THE RUSSIAN FEDERATION IN TURKISH 1. Nationality (if you formerly had TURKEY USSR or Russian citizenship, please indicate when and why you lost it).
2. Surname (as in passport). DELIORMAN
3. First name, other names, patronimic CEM I CAN
(as in passport).
4. Date of birth (dd/mm/yyyy). 05/11/1984
5. Sex. MALE
6. Passport. Passport No: U23196260 Date of issue: 19/02/2020 Valid until: 19/02/2030
7. Purpose of visit. BUSINESS
8. Category and type of visa. COMMON BUSINESS
9. Number of entries. MULTI
10. Date of arrival and departure. 02/04/2024 - 02/04/2025
12. Route of journey (destination ST. PETERSBURG, MOSCOW
points).
Photograph and signature. Service information (automatically generated).
Application form recipient: EMBASSY OF THE RUSSIAN FEDERATION IN
TURKISH Basis (voucher, dir. No, inv. No): NONE The estimated date of visit to the RC: Place for Application No (web-site): 43229262 photograph The date of processing: 3/20/2024 *2000243229262*
Application No (VAC): The date of processing by the VAC:
Request No in Russian Consulate (RC):
I hereby agree to the processing and transfer of my personal data in electronic form for the purposes of making a decision on visa issuance. I declare that data provided in the application form are full and Date (dd/mm/yyyy), personal signature correct. I am aware that any false information may be a cause for the denial of visa or for the cancellation of the previously issued visa and may lead to other consequences provided for by the legislation of the Russian Federation. Subject to the receipt of visa, I pledge to leave the territory of the Russian Federation before the visa expiration date. I am aware that valid visa does not automatically allow to enter the territory of the Russian Federation. In case of denial of entry, I will not seek any compensation for potential losses.
Page 1 of 2 13. Children under 16 years and other relatives written in your passport. Do you travel with children under 16 NO years or other relatives written in your passport?
14. Your permanent address, telephone NO
number, fax number, E-mail.
15. Current/latest place of work. NONE
16. Information about your previous
trips to Russia. How many times have you been to Russia? 5 Date of last trip to Russia 24/01/2024 - 10/02/2024 (dd/mm/yyyy):
17. Information about health insurance.
Do you have health insurance that is NO valid in Russia?
18. Other names used in the past NONE
(maiden, pen-name, religious, etc.).
19. Your place of birth (if you were ESKISEHIR
born in Russia, please specify when and which country you emigrated to).
20. Additional information about your
relatives. Do you currently have relatives in NO Russia?
