Form V.2011a - Visa Application Form Of The People'S Republic Of China Page 4

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Form V.2011A

4.8

4.3

4.7

If you answered “Yes” to any of questions 4.3 to 4.7, please give details below.

Section 5: Relevant declaration

5.1

(Form V.2011B) Please also complete

the Supplementary Visa Application Form (Form V.2011B) if you are not a U.S. citizen, or if you are applying for work visa or student visa, or if you

will be accompanied by anyone who shares the same passport with you.

5.2

Please use the space below or a separate sheet for

additional information / declaration / statement other than already provided in this application.

Section 6: Signature

6.1

I have read and understood all the

questions in this application. I declare that the information provided above is true and accurate. I shall take all responsibilities for any false

information.

6.2

I understand that the decision on whether to issue a visa, validity/ type of visa, number of entries, and duration

of each stay will be decided by consular officers, and that any false, misleading or incomplete information may result in the refusal of a visa or denial of

entry into China.

Applicant’s signature:

Date (yyyy-mm-dd):

Note: Parent or guardian may sign on behalf of an applicant aged under 18.

Section 7 If the application form is completed by another person on the applicant’s behalf, please fill out

the following:

7.1

7.2

Name of the person completing

Relationship to the

this form on the applicant’s behalf

applicant