新版领事认证申请表

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1、 中华人民共和国驻外使领馆领事认证申请表Application Form of Consular Legalization of the Embassy/Consulate of the Peoples Republic of China 申请人须如实、完整、清楚地填写本表格，请逐项在空白处用中文或英文大写字母打印体填写，或在口内打J选择。The applicant should fill in this form truthfully,completely and clearly.Please type the answer in capital English letters in the

2、 space provided or tick()the relevant box to select.1、个人申请Applicant(For Individual Use Only)姓名Name出生日期Date of birth(yyyy-mm-dd)身份证件种类Type ofID 工作o机f构em或pl学校名称Name oyer/school家庭住址Home address住宅电话Home phone number国籍Nationality性别出生地点GenderPlace of birth职业Occupation身份证件号码Number of ID Ad工dre作ss机of构e成学校地址

3、mployer/school电子邮箱E-mail address手机Mobile phone number2、企业及其他组织申请Applicant(For Company/Organization Use Only)企业或其他组织名称Name of company/organization 联系地址Address 法定代表人信息Legal Representative of company/organization 姓名Name I 证件种类Typeof ID 3、公证书或其他证明文书证明的事项电话Phone Number 出生日期Date ofbirth yyyy-mm-dd)证件号码Num

4、berof ID Matters Certified by the Notarial Deeds or Other Certificates 口出生证Birth certificate;口结婚证Marriage certificate;口无犯罪记录证明Certificate of non-criminal record;口健康证明Health certificate;口学历证明Diploma;口委托书Authorization letter;口声明书Statement;口商业文件Business documents;口其他（请注明）Others(please specify)4、认证办理目的和

5、文书使用地点Purpose and Destination of Legalization 办理目的Purpose of legalization:口婚姻Marriage;口寄养Fosterage;口房产Real estate;口诉讼Litigation;口签证Visa;口领养Adoption;口商务贸易Business and trade;口其他（请注明）Others(please specify)文书使用地Destination of legalization:5、提交材料及申办认证书的份数Supporting Documents and Copies of Legalization 提交

6、材料Supporting documents 份数Copies 6、办理时间Processing Time 口普通(X个工作日）Regular service for X business days 注：加急和特急服务须经领事官员批准，并将加收费用。口加急(X个工作日）Note:Express and rush service needs approval of consular Express service for X business days officials,and extra fees may apply.口特急(X个工作日）Rush service for X business

7、 day(s)7、代办人Agent代办人姓名1二I国籍Name of agent Nationality 身份证件种类身份证件号码职业Type oflD NumberofID Occupation R与eth申laeti请oano人sohli的icanp关wit系th 联系地址Address 联系电话Ema电子ila邮dd箱n:ss|Phone number 8、申请人代办人声明Declaration of the Applicant/Agent 我保证以上所填内容真实。如有不实之处，本人愿承担一切法律责任。I hereby declare that all the information a

8、bove is true and correct,for which I shall bear all the legal responsibilities.申请人签名：日期：Signature of applicant:Date(yyyy-mm-dd):代办人签名：日期：Signature of agent:Date(yyyy-mm-dd):我声明，我已阅读并理解以下内容：领事认证是指领事认证机构根据自然人、法人或者其他组织的申请，对国外有关文书上的最后一个印鉴、签名的真实性予以确认的活动。领事认证不对公证书或者其他证明文书证明的事项行使证明职能，不对文书内容本身的真实性、合法性负贵，文书内

9、容由文书出具机构负贵。领事官员有权对可能损害国家利益和社会公共利益的和存在不予办理领事认证有关情形的文书不予认证。I hereby declare that I have read and understood the content below:The consular legalization refers to the practice of confinning the authenticity of the last seal or signature on relevant documents issued by other countries,performed by consu

10、lar legalization agencies upon the application of natural persons,legal persons or other organizations.Consular legalization does not undertake the responsibility of certifying the matters certified by the notarial deeds or other certificates,and it is not responsible for the authenticity and validi

11、ty of the documentss content,which shall be the responsibility of the issuing institution.The application will be refused by consular official if the documents may harm the national interests or social public interests or have other circumstances under which consular legalization shall not be perfonned.申请人签名：日期：Signature of applicant:Date(yyyy-mm-dd):以下项目仅供领事官员填写(For Official Use Only):接案人、接案日期：I签署人、签署日期：1复核人（如有）、复核日期：