Letter Of Proxy Form-Embassy Of Japan In The Netherlands

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Letter of proxy
To the Embassy of Japan in the Netherlands,
I, ______________________________________,
Address:
__________________________________________
Tel:
___________________________________________
Date of Birth: __________________________________________
Passport nr.: ___________________________________________
hereby declare that I have authorized to apply/to pick up my visa
application to enter Japan to :
Name:
___________________________________________
Address:
___________________________________________
Tel:
__________________________________________
Passport / I.D.nr.: ______________________________________
(attached: copy of Passport/I.D. card)
Date:
/
/
Signature:

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