fisa Application Form of thePeople'sRepubLr'c of C h a

-. #T#SkA&Q8 / Section 1. Information about Yourself $73?S@/Reset Forn

1.1 91.2$$;8/ FullName:
R#IPhoto
j$ / Surname: lq 4 1Middle Name:
*% 1 %%%!HE*
;% 1 Given Name: 1 1.2 tkjg 1Sex: X. &4i$W%B(I%.$ZPI

--

1.3 A$$& I Chinese Name if Applicable:

passport swle color photo,
with full face, front v j e q
1.5 $4 4 @, $$JR & / Other or Former Name:
fi@t badpound.
I
1.7 $j & U / Date of Birth(YY-MM-DD) 1.8 & &=&,&(@. % I $ ) / Place (ProvincelState, Country) of Birth:

1.9 *%@& I
9l.& / Diplomatic [7 Q$. % g 1 Service or Official [7 $4 / Regular
Passport Type n
# ~ < E # ( i & i ~ Q1 Other
) (Please specify):
1.10 @ % 963 / Passport Number: 1.11 2 H 9 1 Date of Issue(YY-MM-DD):

1.12 %2&,&(%l$W H 8 )/ Place (ProvincelState, Country) of Issue: 1.13 #@ El 1 Expiration Date(YY-MM--DD)

1.14 3 %l@,& (q$&) / Your Current Occupation(s):

--
1 Businessman &jq. & I Teacher or Student .f$ 1 Government Official
%&,A9
/ Crew Member of Airlines, Trains or Ships $Ji(4f i & A .f$ 1 Staff of Media
- ijl / Member of Parliament, Congressman or Senator %%A+ 1 Clergy
- # %(ftijd a ) /other (Please specify):

=, &&j&q&fi
/ Section 2. Your Visit to China
2.1
~.
$j-& 9 &%$& (q&&) 1 Major Purpose(s) of Your Visit@)to China:
.- -

,&I$$I Tourism #!,$'j*$+ / A s Crew Member of Airlines, Trains or Ships

. #$% / Visiting Relatives .. iZ$f '#g/ A s Resident Journalist
@j$$ / Business Trip -. iZ$f I]$ @%i$/ A s Journalist for Temporary News Coverage
.. transit . 3l.25. @$ZfTj!$+@% / A s Resident Diplomat or Consul in China
1 / Study '@ 3?$I.7 1 Official Visit
$$' & @ & 1 Commercial Performance -f2P,X&1 Employment
'
$&%(i$ijd%)1 other (Please specify):

-&A&i$%& (3 +a &&&) 1 Single entry valid for 3 months;

2.2 it24 A*%&&1 .. s & A $ j f % % @ (6 &%a)/Double entry valid for 6 months;
Intended Number of Entries * q & $&A ti:%$j@ I Multi-entry valid for 6 months;
-$& $&A 1 Multi-entry valid for 12 months.

2.3 $$&?JEjai&@ U 1 Date of Your First Possible Entry into China (YY-MM-DD)

2.4 ~ i t { $ - & & + @ @/Your

' & ~Longest
~ j ?Intended
& Stay in China Days

2.5 %@@j@fifiPiBa-f$i$S.7+U$5%,& ($X

$/ ) / Please list Counties/Cities and
Provinces to visit in China in a time sequence:
2.6 B E 4 I @U , ? .. .
1) / Express for 2-3 working days;
kpg.(2-3
&@g&;b~$@,#&.@.$ 1 Normally, visa
processing takes 4 working days. Do you request . . #2.(l+II@ El)/Rushfor 1 workingday.
express or rush service by paying extra fee?
 1. %%#%!kW& 1?A#IN R7%fi/ Section 3. Your Health Condition and Previous O v e m Tour
3.1 f % j i 6 ~ B & t E % R j ?U~ g M ? 8 /No WrYes
Have you ever been refused a visa for China?
3.2 I$%?5~k2-&#Z%~A3~j$_%&j q U? 5 /No &/Yes
Have you ever been rehsed entry into or deported from China?
3.3 f$&tpH$$$1&U A % B % @ S o Z S ? 5 /No &/Yes
Do you have any criminal record in China or any other country?
3.4 {%a&% 5 ,%,% T{??-@ &%/ Do you suffer from any of the following diseases?
$51 Mental Diseases @K~lBf$&$@l Open Tuberculosis
3 /No WNes
@lk$5lVenereal Diseases @&% HIV $T&@/HIV Positive or AIDS
@%n@~l Leprosy @#%.lf@#&$5/ Other infectious diseases
..
3.5 E B $$?$ c)iqq U N a v e you ever visited China before? %/No - &Nes
I

3.6 jt.J-[q% 3.1-3.4 &# "%" # F & s $ @ * g i E , iffijC8fli$&l1%a/ If you select Yes to any question
from 3.1 to 3.4, you do not lose eligibility for visa application. Please give detailed reasons for your answer.

E?J. 4% #4%% 75 &I Section 4. Your Contact Information

4.1 {$&L@2${3$,%@$$$ /Name of Your Employer or School: 4.2 U 1'87 aiif / Daytime PhoneNumber:

4.3 {$& ~fi&&fh$$k&%& /Address of Your Employer or School: 4.4 &lq &<if / Nighttime Phone Number:

4.5 I$& &&f$& 1 Your Home Address: 4.6 $$& & +g$$/ Your Email:

4.7 &*%if$, % % k % ~ & & { & & % & % % ? $ & b $ P $ %/ N a m e of 4.8F$$~@,iif/Pl1oneNumberofYourContact:

Inviter, Contact or Your Relative in China:

4.9 &q-%$j- %% % $,&%3f I& i, & 1 Address of

@ 4.10 @,3%@1 Email of Your Contact:
Inviter, Contact or Your Relative in China:

f 88 1$F% I Section 5.Other Declmtion

3,#f%
&$i$#z,$*p 88 f %, *.G~;&IGVI
/ If there is more information to declare, please give the information below.

f i . %hRg $ *Zk / Section 6.Application Form Completed by Another Person

&&#z,A*.I$w 549+$&,-iff-j@$j.% kXT;tZ EJ / If this application was completed by another person on behalf of
you, please have that person complete this section.
6.1 I%$&h$&& Name of Person Completing the Form: 6.2 -f 3 / Relationship to the Applicant:

6.3 f?,gAi&&R@,% /Address and Phone Number of that Person: 6.4 ( t g A g $ /Signature of that Person:

-I;. Sg$% I Section 7 .Important

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9%&4%F&W, 1%.E-51;$.
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ii-~+.~w.* m ~ f i&8i5&zaik+;~d~,~
fi
~%%%X~F~%ZS~-%T%%&&~~E.PM%%&&L%~A+~.
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I have read and understood all the questionsin is application. I shall be filly responsible for the answers and the photo,
which are true and correct. I understand that qpe of visa, number of entries and duration of each stay rvi/l be decided by
consuls, and any fdse,misleadiog or incomplete statement may result in the refis& o f a visa for or denid of entry into China.

$ *A@& 1 Apptioant' s Signature: El aDate(W-MM-DD):

. China Tourist Visa, Chinese Tourist Visa Application Page 1 of 1

L Visa (Tourist Visa)

.. Required Documents
1. Your valid and actual passport with blank visa pages and at least 6-month
period of validity (counting from the day you submit the application);
2. Fill in the Visa Application Form (QI), attached with 2-inch passport photo
(black & white or colored are all accepted);
3. If you were born in China and then join the foreign nationality, for the first
time you apply for the visa, the original Chinese passport (original or the
copy) should be required.

If you apply for multiple-entry L visa, the written explanation for your multiple
visits should be provided. The foreign Chinese people may apply multiple-
entry visa available for two years.

Note: Please fill in the visa application form faithfully, completely and clearly,
or possibly your visa application will be refused and accordingly make your
oversea trip protracted.

Transact Way
The applicant can handle the visa personally, or entrust other people, travel
agency and visa handling agency to transact the visa he wants according to
different consular jurisdiction of the embassies or consulate-general.

1. Make an appointment ahead of time is NOT needed.

2. Visa application by mail is not accepted, but the postal service back to
you is provided.
3. The normal processing time for handle the visa generally is 4 working
days. If you need urgent service, 30 US dollars will be added as the
additional fee for 1 working day processing while 20 US dollars for 2 to 3
working days processing.

Visa Expense, Validity and Duration of Stay

..

1. VISA, Mastercard, Money Order, Cashier's check, Company's Check and

Cash are all accepted (based on the written stipulation), but TCG suggests
you'd better pay for the visa expense by cash due to the actual experience.
2. The charging standard of visa expense are different as follows:

For Citizens of Other

Entry Times For US Citizens Countries

Single Entry 100 US dollars 30 US dollars

Double Entry 100 US dollars 45 US dollars
Multiple Entry for 6 Months 100 US dollars 60 US dollars
Multiple Entry for 12 Months 100 US dollars 90 US dollars
Multiple Entry for 24 Months 100 US dollars 90 US dollars

4. The period of validrty of F visa (single or double entry) is 3 to 6 months;

the duration of stay generally is 30 days, counting from the first day after
your arrival in China. The visa issuing officials may properly extend the
duration time according to the applicant's request and need.