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APPLICATION FOR A BORDER ZONE ACCESS PERMIT - WITH TRAVEL DOCUMENT (foreign citizens)

APPLICATION FOR A BORDER ZONE ACCESS PERMIT - WITH TRAVEL DOCUMENT (foreign citizens)

I request the issuance of the access permit to the border area, in my own name

Surname:

Given Name:

Born on:

domiciled in the country

and I have a passport series Passport No.

valid until the date

I attach the photocopy of the passport that I have:

upload

during the period of

in the locations

I declare on my own responsibility that: I have no unbroken criminal record, I have not previously violated the legislation of the Republic of Moldova regarding the state border.

Pursuant to Article 8 of Law no. 133/2011 on the protection of personal data, I express my consent for the processing of personal data concerning me for the purpose of issuing the access permit in the border area.

I have taken note of the rules of the legislation in force, and during my stay in the border area I undertake to respect them.

Upon request, I attach: a copy of the document attesting to the legal activity in the border area, other documents (in the case of carrying out activities that require a special authorization)
(optional

upload

Personal contacts

Phone

E-mail

I also request a permit for the floating means in my possession: