缩短停留期限决定书

（____公安局）

缩短停留期限决定书

公（ ）缩字 [  ] 第 号

案由__________________________________________________

违法行为人_____________________________________________

性别__________________________________________________

出生日期_______________________________________________

国籍/地区______________________________________________

证件名称及号码_________________________________________

签证（注）种类及号码___________________________________

入境时间 ______________________________________________

要求离境时间___________________________________________

办案单位_______________________________________________

承办人_________________________________________________

批准人_________________________________________________

填发人_________________________________________________