Type of

Household: 

Non-agricultural family

(Non-agricultural corporate) 

Name of Householder: 

xxx

xxx

Household Number: 

  xxxxxxxx

Current residential address: 

No. xxx xxx xxx Road East, xxx District, 

Guangzhou. 

Authorized

supervisor:

Public Security

Authorized

Administrator:

Public Security Sub-Bureau of

Department of

Guang

GuangDong (sealed)

Xxx Road Police Station (sealed)

Registrar:

xxx

Date of Issue:

20^st June 2006

中文名(sealed)

New Address 

Date of registration update 

Registrar 

Name 

Xxx

xxx

Householder him/herself or Relation to the householder 

Householder himself

Former name

(if available) 

Sex 

Male / Female 

Place of birth 

xxxx

Ethnicity 

Han / Manchu / Uigur / Tibetan, etc. 

Ancestral

native place 

xx

Date of birth 

xx^th April xxxx 

Other

residential address in this city (county) 

Religious belief 

Nil 

Citizen ID

card number 

xxxxxxxxxxxxxxxxxx 

Stature 

xxx cm 

Blood group 

B

Educational degree 

Undergraduate 

Marital

status 

Never

married

Military service status 

Nil 

Employer 

xxx 

Occupation 

Commercial personnel

When and from where

immigrated to this city (county) 

Xx Oct xxxx     xxxxx District,xx City, xx Province

When and from where moved

in current residential address 

xx Jun xxxx     xxxxxxxx

Registrar: 

Xxx

Date of register:  

20^th Jun 2006 

xxx

Autborized

Public Security Sub-Bureau of Guangzhou

Administrator:

 Xxx Road Police Station(sealed)