Dotazník pro cizince/ Questionnaire bor foreigners
Otec dítěte / Child’s father
Jméno / First name: ................................................... Příjmení / Surname: ........................................................
Rodné příjmení / Surname at birth: .....................................................................................................................
Datum narození / Date of birth:
.....................................................................................................................
Město / City: .............................................................. Stát / State: .....................................................................
Státní občanství / Nationality: ............................................................................................................................
Rodné číslo v ČR / Czech certificate number: ...................................................................................................
Telefon / Telephone contact: ............................................ E-mail: ...................................................................
Trvalé bydliště / Permanent adress: ....................................................................................................................
Matka dítěte / Child’s mother
Jméno / First name: ................................................ Příjmení / Surname: ......................................................
Rodné příjmení / Surname at birth: .....................................................................................................................
Datum narození / Date of birth: ..........................................................................................................................
Město / City: .............................................................. Stát / State: .....................................................................
Státní občanství / Nationality: ............................................................................................................................
Rodné číslo v ČR / Czech certificate number:.....................................................................................................
Telefon / Telephone contact: ............................................ E-mail: ...................................................................
Trvalé bydliště / Permanent adress: ....................................................................................................................
..............................................................................................................................................................................
Datum sňatku / Date of marriage: .......................................................................................................................
Místo sňatku / Place of marriage: .......................................................................................................................
Jména a data narození předcházejících společných dětí / Name(s) and date(s) of birth of previous children of the same parents:
..............................................................................................................................................................................
..............................................................................................................................................................................
Souhlasné prohlášení rodičů o jménu dítěte / Child’s name as declared by parents:
Chlapec / Boy:
Jméno nebo jména / Name or names: ………………………………………………….. ...................................
Příjmení / Surname: ............................................................................................................................................
Dívka / Girl:
Jméno nebo jména / Name or names: ………………………………………………….. ...................................
Příjmení / Surname: ............................................................................................................................................
Podpis otce / Signature of father:
Podpis matky / Signature of mother:
.........................................................................
..................................................................................
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(Dotazník pro cizince