Russian Visa Application Form - Consulate General of the Russian Federation in San Francisco - City and County of San Francisco, California

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Consulate General of the Russian Federation in San Francisco
VISA APPLICATION
Please type or print using ballpoint pen
IMPORTANT!
I declare that to the best of my knowledge all particulars supplied by me are correct and complete. I am aware that any false statements will lead to my application being
rejected or to the annulment of a visa already granted and may also render me liable to prosecution under the legislation of the Russian Federation. I undertake to leave
the territory of the Russian Federation upon the expiry of the visa, if granted/ I am aware that the fact that a visa has been granted to me does not mean that I will be
entitled to enter the territory of the Russian Federation, if any reasons are appear. In a case of refusal of entry I do not have a right to compensation of damage.
** - Not to be filled by holders of diplomatic and official passports
1. Present citizenship (if you formerly had USSR or Russian
2. Last name (as in passport, in capital letters)
citizenship, please indicate when and why you lost it)
3. First and middle names (as in passport)
4. Other names ever used (maiden name, professional, religious aliases)
5. Place of birth (if born in Russia, please indicate when and to
6. Date of birth (DD/MM/YY)
7. Sex
what country you emigrated)
M
F
9. Russian institution or organization to be visited (name and address,
phone, fax number, E-mail (if known), name of contact person)
8. Purpose of visit
official
tourism
medical
business
private
cultural
sports
other, please specify
**10. Itinerary (places to be visited)
11. Date of entry (DD/MM/YY)
12. Date of departure (DD/MM/YY)
13. Number of entries
1
2
multiple
14. Passport number
Passport issued by
Date of issue
Valid until
15.Type of passport
diplomatic
official
tourist
seaman’s passport
alien’s travel document
other (please specify)
**16. Name and reference number of the tourist group
**17. Do you have а medical insurance policy valid in Russia (please specify)?
18. Who will pay for your trip to and stay in Russia?
19. Marital status
мarried
single (never married)
divorced
separated
widowed
20. Spouse’s full name (even if divorced or separated, please indicate maiden name if applicable)
21.Spouse’s date of birth (dd/mm/yy)
22. Spouse’s place of birth
**23. Your father’s full name
**24. Your mother’s full name
25. Have you ever been issued a Russian visa?
Yes
When?
Where?
No
**26. Have you ever lost your passport or had one stolen?
Yes
No
**27. List all countries you have visited in the last ten years and indicate the year of visit
**28. List all countries which have
previously issued you a passport
**29. List your last two places of work, excluding the current one
1. Name
Phone number
Address
Your supervisor’s full name
Your position
Dates of employment
2. Name
Phone number
Address
Your supervisor’s full name
Your position
Dates of employment
Consulate General of the Russian Federation in San Francisco
VISA APPLICATION
Please type or print using ballpoint pen
IMPORTANT!
I declare that to the best of my knowledge all particulars supplied by me are correct and complete. I am aware that any false statements will lead to my application being
rejected or to the annulment of a visa already granted and may also render me liable to prosecution under the legislation of the Russian Federation. I undertake to leave
the territory of the Russian Federation upon the expiry of the visa, if granted/ I am aware that the fact that a visa has been granted to me does not mean that I will be
entitled to enter the territory of the Russian Federation, if any reasons are appear. In a case of refusal of entry I do not have a right to compensation of damage.
** - Not to be filled by holders of diplomatic and official passports
1. Present citizenship (if you formerly had USSR or Russian
2. Last name (as in passport, in capital letters)
citizenship, please indicate when and why you lost it)
3. First and middle names (as in passport)
4. Other names ever used (maiden name, professional, religious aliases)
5. Place of birth (if born in Russia, please indicate when and to
6. Date of birth (DD/MM/YY)
7. Sex
what country you emigrated)
M
F
9. Russian institution or organization to be visited (name and address,
phone, fax number, E-mail (if known), name of contact person)
8. Purpose of visit
official
tourism
medical
business
private
cultural
sports
other, please specify
**10. Itinerary (places to be visited)
11. Date of entry (DD/MM/YY)
12. Date of departure (DD/MM/YY)
13. Number of entries
1
2
multiple
14. Passport number
Passport issued by
Date of issue
Valid until
15.Type of passport
diplomatic
official
tourist
seaman’s passport
alien’s travel document
other (please specify)
**16. Name and reference number of the tourist group
**17. Do you have а medical insurance policy valid in Russia (please specify)?
18. Who will pay for your trip to and stay in Russia?
19. Marital status
мarried
single (never married)
divorced
separated
widowed
20. Spouse’s full name (even if divorced or separated, please indicate maiden name if applicable)
21.Spouse’s date of birth (dd/mm/yy)
22. Spouse’s place of birth
**23. Your father’s full name
**24. Your mother’s full name
25. Have you ever been issued a Russian visa?
Yes
When?
Where?
No
**26. Have you ever lost your passport or had one stolen?
Yes
No
**27. List all countries you have visited in the last ten years and indicate the year of visit
**28. List all countries which have
previously issued you a passport
**29. List your last two places of work, excluding the current one
1. Name
Phone number
Address
Your supervisor’s full name
Your position
Dates of employment
2. Name
Phone number
Address
Your supervisor’s full name
Your position
Dates of employment
**30. List all educational institutions you ever attended, except high schools
1. Name
Address and phone number
Course of study
Dates of admission and graduation
2. Name
Address and phone number
Course of study
Dates of admission and graduation
**31. List all professional, civil and charity organizations which you
**32. Do you have any specialized skills, training or experience related to
are (were) a member of, or contribute (contributed) to, or work
fire-arms and explosives or to nuclear, biological or chemical activities? If
(worked) with
«Yes», please explain
**33. Have you ever performed military service? If «Yes», indicate the country, branch of service, rank, military occupation and dates of
s ervice
**34. Have you ever been involved in an armed conflict, either as a member of the military service or a victim? If «Yes», please explain
35. Are any of your relatives mentioned below staying in Russia now? Is he (she) a permanent resident or citizen of Russia? If «Yes», indicate
that person’s full name, address and status in Russia (citizen of Russia, permanent or temporary resident, visiting, studying, working, etc.)
Husband/Wife
Father/Mother
Brother/Sister
Bridegroom/Bride
Son/Daughter
36. IMPORTANT! EACH APPLICANT MUST READ AND GIVE ANSWERS TO THE FOLOWING QUESTIONS
A visa may not be issued to persons belonging to specific categories, defined by the Law as undesirable, except in cases
when a waiver has been obtained in advance.
Have you ever been arrested or convicted for any offence?
Yes
When?
Where?
No
Have you ever been sick with a communicable disease of risk for the public or suffered a dangerous physical or mental disorder?
Have you ever abused drugs or been a drug-addict?
Yes
No
Have you ever been refused a Russian visa?
Yes
When?
Where?
No
Has your Russian visa ever been canceled?
Yes
When?
Where?
No
Have you ever tried to obtain or assisted others to obtain a Russian visa or enter Russia by providing misleading or false
information?
Yes
No
No
Have you ever overstayed your Russian visa or stayed unlawfully in Russia?
Yes
Have you ever been deported from Russia?
Yes
When?
Where?
No
While an affirmative answer does not automatically mean ineligibility for a visa, if you answered «Yes»
you will have to appear in person before a Consular officer.
37. Your permanent address, phone, fax number and E-mail address
40. Has anyone assisted you in
completing this application form? If
«Yes», have the assisting
person complete item 41
Yes
No
38. Place of work or study (name, address, phone and fax number,
41. Application completed by
Place for
E-mail address)
Name
photograph
Relationship to applicant
Address
39. Name, address and phone number of person or hotel in Russia
that you plan to stay with
Applicant’s signature, Date
Signature of person
completing the form,Date

Download Russian Visa Application Form - Consulate General of the Russian Federation in San Francisco - City and County of San Francisco, California

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