护照遗失经过说明表.docx

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护照遗失经过说明表FORM FOR STATEMENT OF THE LOSS OF PASSPORT外文姓SurnameZHANG外文名Given nameSAN中文姓名Chinese name张三国籍Nationality荷兰性别 Sex男出生日期Date of Birth职业Occupation学生护照号码Passport No.123456入境口岸Port of entry温州机场入境日期Date of entry签证种类Type of visaL在华停留期至Date of expiry此事由Purpose of stay旅游遗失时间Time of the loss遗失原因 cause of the loss丢失遗失物品Items of the Loss护照在温州住址和电话 Telephone No. and Address in Wenzhou温州市鹿城区 XXXXXXX( 136XXXX5689)国外住址Oversea Address无遗失经过详细说明：Statement of the details of the incident:坐公交车不慎丢失！签名：张三Signature: 日期：Date: