ࡱ> BDA% bjbj%% &:GGl$,ZJ^I I I $H hrI I I I I I bI 4%%> B06RVF%%*0Z%% INCLUDEPICTURE \d "P:\\Carlos\\Ministrio das Relaes Exteriores_files\\transp.gif" \* MERGEFORMATINET   INCLUDEPICTURE \d "P:\\Carlos\\Ministrio das Relaes Exteriores_files\\ae.gif" \* MERGEFORMATINET  REPBLICA FEDERATIVA DO BRASIL MINISTRIO DAS RELAES EXTERIORES POSTO FORMULRIO DE AUTORIZAO PARA VIAGEM DE MENOR Authorization Form for Persons under 18 years travelling to Brazil (Preencher a mquina ou em letra de forma) Autorizo(amos) o(a) menor __________________________________________________, ____________________ I (We) authorize the minor nome completo (first and family name) , n do passaporte (passport n) _________________________ , _________/__________/_________, natural de ________________________________ rgo expedidor (issuing office), data de expedio (date of issue) place of birth cidade e pas (city and country) nascido(a) em _______/________/_______, a viajar em qualquer poca para o Brasil, dentro do date of birth dia (day) ms (month ano (year) to travel on any occasion to and within the territrio brasileiro e para todos os pases com os quais o Brasil mantm relaes territory of Brazil and to all countries with which Brazil maintains diplomatic relations, diplomticas, bem como a retornar para o pas de residncia desacompanhado(a) ou sob as well as to return to the country of residence, unaccompanied or under the a responsabilidade de _________________________________________________________________ responsibility of nome completo da pessoa que acompanha o(a) menor (full name of the person accompanying the minor) __________________________, _________________________, ___________________, residente em nacionalidade (nationality) estado civil (maritus status) profisso (profession) resident at ______________________________________________________________________ portador(a) da identidade/passaporte endereo completo (full address) bearer of identity card/passport # n _____________________ emitido(a) por ____________________________________ . issued by nome do rgo expedidor (name of issuing office) ___________________________________ Nome (Name) ___________________________________ Grau de parentesco (father/mother) ___________________________________ Identidade e nmero(Identity & #) ___________________________________ rgo expedidor (Name of issuing office) ___________________________________ Assinatura (Signature) ___________________________________ Nome (Name) ___________________________________ Grau de parentesco (father/mother) ___________________________________ Identidade e nmero (Identity & #) ___________________________________ rgo expedidor (Name of issuing office) ___________________________________ Assinatura (Signature) _________________________, _____ de ______________ de ______ Local ( place) dia (day) ms (month) ano(year) Assinaturas reconhecidas diretamente pela autoridade consular se os pais forem de nacionalidade brasileira e comparecerem na Repartio consular. If both parents are Brazilian nationals, signatures must be authenticated before the Consular Officer at the Consulate. Se os genitores forem estrangeiros devero reconhecer previamente suas assinaturas em tabelio. If the guardians are foreign nationals, signatures must be authenticated by Notary Public before submitting to this Consulate.  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