KONSULAT JENDERAL REPUBLIK INDONESIA The Consulate General of the Republic of Indonesia SYDNEY – AUSTRALIA NO. FILE: ……………….

PERMOHONAN PINDAH ALAMAT

Nama Lengkap (sesuai paspor) Tempat, Tgl. Lahir Jenis kelamin No. Paspor - Dikeluarkan di - Tanggal - Berlaku s/d Nama Sponsor/Majikan/Sekolah - Alamat - No. Telepon/Fax Alamat di Australia No. Telp./HP Alamat di Indonesia No. Telepon

: : : : : : : : : : : : : :

PAS FOTO 3X4

Dibuat di Tertanggal

: :

(nama & ttd pemohon)

236-238 Maroubra Road, Maroubra NSW 2035 Telephone: (02) 93449933 Fax: (02) 93496854 Homepage: www.indonesianconsulatesydney.org.au

2. $543847./ .

.3..

$04. .9 4 %00543.2.

.2.  4 %05 .. .9/:897.

9/3/4308.  4 %00543    !$ %                                                                           -:.3.74:-7.0 3/4308.#4.2.2.! .438:.: ./ .3.74:-7.9/       %079.908/30 47 .$  %005430  . 99/502443     .            3.   4205.

Sign up to vote on this title
UsefulNot useful