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SOCIALIST REPUBLIC OF VIETNAM INDEPENDENCE – FREEDOM – HAPPINESS HO CHI MINH CITY HOUSEHOLD REGISTRATION BOOK Full Name of Householder: ……… House No.. Place of Residence before Arrival:

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SOCIALIST REPUBLIC OF VIETNAM INDEPENDENCE – FREEDOM – HAPPINESS

HO CHI MINH CITY

HOUSEHOLD REGISTRATION BOOK

Full Name of Householder: ………

House No : ………

Street : ………

Ward, Village : ………

District, Town : ………

No ………

HOUSEHOLDER Full Name : ………

Codename : ………

Date of Birth : ……… Male/Female

Place of Birth : ………

Native Place : ………

Ethnic Group : ……… Religion: ………

Occupation : ………

Working Place : ………

ID Card Number : ………

Date of Issue : ……… Place of Issue:…………

Date of Arrival : ………

Place of Residence before Arrival: ………

………

On Behalf of ………

………

(Signed and Sealed) ………

………

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RELATION WITH THE HOUSEHOLDER: …………

Full Name : ………

Codename : ………

Date of Birth : ……… Male/Female

Place of Birth : ………

Native Place : ………

Ethnic Group : ……… Religion: ………

Occupation : ………

Working Place : ………

ID Card Number : ………

Date of Issue : ……… Place of Issue:…………

Date of Arrival : ………

Place of Residence before Arrival: ………

………

On Behalf of ………

………

(Signed and Sealed) ………

………

RELATION WITH THE HOUSEHOLDER: …………

Full Name : ………

Codename : ………

Date of Birth : ……… Male/Female

Place of Birth : ………

Native Place : ………

Ethnic Group : ……… Religion: ………

Occupation : ………

Working Place : ………

ID Card Number : ………

Date of Issue : ……… Place of Issue:…………

Date of Arrival : ………

Place of Residence before Arrival: ………

………

On Behalf of ………

………

(Signed and Sealed) ………

………

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