Professional Documents
Culture Documents
1
Operator de date cu caracter personal notificat sub numrul 5285, 5286, 5287
AMBASADA ROMNIEI LA _____________
CONSULATUL GENERAL AL ROMNIEI LA _________
Nr. _______/_______
CERERE
pentru efectuarea de servicii consulare 1
Subsemnatul(a) __________________________________nscut/ la
data de ________________, n localitatea_____________________,
Romnia, avnd documentul de identitate_____________________,
cu domiciliul n Romnia, n localitatea________________________,
strada_____________________, nr.______,bl.______, sc.__, ap.__,
jude/sector____________________, aflat temporar n ___________,
localitatea_________________________, strada_______________ ,
nr._____, telefon____________________, rog s mi se aprobe
efectuarea urmtoarelor servicii consulare:
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
________________________
Sunt de acord cu prelucrarea datelor prezentate n conformitate cu Legea 677/2001.
I agree with processing of data presented according with Law no. 677/2001.
Data______________
Semntura,
____________________