passport information sheet

REPUBLIQUE DU BENIN
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MINISTERE DES AFFAIRES ETRANGERES,
DE L’INTEGRATION AFRICAINE, DE LA
FRANCOPHONIE ET DES BENINOIS DE
L’EXTERIEUR
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SECRETARIAT GENERAL DU MINISTERE
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AMBASSADE DU BENIN A COPENHAGUE
PASSPORT INFORMATION SHEET
DIPLOMATIC
SERVICE
New
Renewal
Extension
SURNAME ……….……………………………………………………………………………………………
GIVEN NAMES ……………………………………..……………………………………………….………
DATE AND PLACE OF BIRTH …………………………………………………………………………..
SEX …………………………………………………………………………………………………………….….
OCCUPATION …………………………………………………………………………………………………
ADDRESS IN BENIN……….………………………………………………………………………………..
ADDRESS IN COUNTRY OF RESIDENCE ……………………………………………………………
…………………………………………………………………………………………………………………..….
HEIGHT ………………………. EYES ……………………………. HAIR ……………………..…………
SPECIAL MARKS …………….…………………………………………………………………………..….
He/She is issued a passport pursuant to Decree
No. ……………………………………………………………………
……………………………………………………………………………
section ………………….paragraph……………………………
………
The Director of Consular Affairs
Done in ……………….... on ……………………
Signature of applicant
Skelvej 2 – 2900 Hellerup – DANEMARK
Tél: (+45) 39 68 10 30 Fax: (+45) 39 68 10 32
E-mail: [email protected]