Ходатайство о транзите в соответствии со статьей 15 соглашения между правительством российской федерации

Ходатайство о транзите в соответствии со статьей 15 Соглашения между Правительством Российской Федерации и Правительством Королевства Дания о реадмиссии

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Annex 6 to the Agreement between the Government of the Russian Federation and the Government of Iceland on readmission

[Emblem of the Russian Federation]                      [Emblem of Iceland]

...................................       .................................

...................................               (Place and date)

___________________________________

(Designation of the competent
of the requesting State)


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...................................

...................................

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___________________________________

(Designation of the competent
of the requested State)

                        TRANSIT APPLICATION

               pursuant to Article 15 of the Agreement

         between the Government of the Russian Federation

         and the Government of Iceland and on readmission
. Personal details                                     ------------------

. Full name (underline surname):                       ¦                ¦

...........................................             ¦                ¦

. Maiden name:                                         ¦   Photograph   ¦

...........................................             ¦                ¦

                                                      ¦                ¦

. Date and place of birth:                             ¦                ¦

...........................................             ------------------

.  Sex  and  physical  description  (height, color of eyes, distinguishing
etc.):

...........................................................................

.  Also  known  as  (earlier  names,  other  names used/by which known, or
):

...........................................................................

. Nationality and language:

...........................................................................

. Type and number of travel document:

...........................................................................
. Special circumstances relating to the transferee

. State of health

(E.g.  possible reference to special medical care; latin name of contagious
):

...........................................................................

. Indication of particularly dangerous person

(e.g. suspected of serious offence; aggressive behaviour):

...........................................................................
. Transit operation

. Type of transit

¬            -¬            -¬
by air     L- by sea     L- by land

. State of final destination

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. Possible other States of transit

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.  Proposed  border  crossing  point,  date, time of transfer and possible


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...........................................................................

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.  Admission  assured in any other transit State and in the State of final
(Article 14 (2) of the Agreement between the Russian Federation
Iceland on readmission)

¬           -¬
yes       L- no

.  Knowledge of any reason for a refusal of transit (Article 14 (3) of the
between  the  Government  of  the  Russian  Federation  and  the
of Iceland on readmission)

¬           -¬
yes       L- no
. Observations

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(Signature of the competent authority of the requesting State) (Seal/stamp)