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SOCIALIST REPUBLIC OF VIETNAM
INDEPENDENCE – FREEDOM – HAPPINESS
HO CHI MINH CITY
HOUSEHOLD REGISTRATION BOOK
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: …………………….
Full Name of Householder: ……………………
House No.
Street
Ward, Village
District, Town
:
:
:
:
No. ……………………
……………………
……………………
……………………
……………………
…………………
On Behalf of ……………………………………..
……………………
(Signed and Sealed)
…………………………………..
. ……………………
1/2
RELATION WITH THE HOUSEHOLDER: …………
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: …………………….
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)
…………………………………..
. ……………………
…………………
On Behalf of ……………………………………..
……………………
(Signed and Sealed)
…………………………………..
. …………………
2/2
