Page 1 - Nguyen Tram Anh_Osaka Gaigo_T10.2019

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t. LtL : NCI'YEN TRAMANH 2, Eff: VIETNAM
Name Nationality
3. ,f4Eri : FEMALE 4. E+FE 4@+JF aE
Sex Date ofBirth
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Plesent Addfcss
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6. Allfr*: L)A Yes lft No adi&*ii4:
Married status Name of Spouse
'l. ':i:EA : Educational Background

.i:&A frhvb, ftiaqlFl Number of Year Aunede

.;: Ent|y {* Crrduari,
,1. ,',t!
Gia Khanh Binh De ,Gia Khanh, 2000 rF I ll 20)t,it: 5 t
Gia Loc, Hai Duong
tr ?tr- Gia Bui , Gia Khanh,
Gia Khanh ,011+ 9B 20lii 4: .', I
Gia Loc, Hai Duong
Gia Loc 183 Nguyen Che Nghia, Gia Tan, 2015 + 9.8 2014+ i t
Hish school
Gia Loc, Hai Duong
+/:11?li

School, !,1 l!",
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Name of school Location Period M.lluils)/ t.lit)ttu
.\lrurdr" llard/S.lr{uld 11,
131 Nguyen Chi Thanh,
KIM CUONG HDVN 2018F8,q 20ltqr u,l ?6n/ ?6ii rllit
Tan Binh, Hai Duong -
JAPANESE CENTER Year Month Yoar Month
city, Hai DuonE Drovince
13l Nguyen Chi Thanh,
KIM CUONG HDVN 2019+ 4 E
Tan Binh, Hai Duong - 2019+ 0E 150/605 [irB1
JAPANESE CENTER
city, Hai DuonE province Year Month Yeaf Month
L rlltlJli Em ent Record : !6 Yes lft No
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Entry date Departure date Status Address in.T
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Year Nlonrh Day
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Ifyou have more enhies, please write on another piece ofpaper.and attach ,o rhis.
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I hereby declam rhe above staremenr ro be rrue and correct.
l1:h\\. )l tt : 2019 + 0b lJ ls E \ \'3 | : _ NC ULEN TRA_I\I ANH clrair1
Date Year Month Day Signaturc ofApplicant ,t4hl,