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LIXiulan
HouseholdNumber
Domicile
Room2,Unit3Building2,NO.18Huanhualu.
QingyangDistrict.Chnegdu
ProvincialPublicSecurityOrganPermanentResidenceRegistrationOrgan
SpecialSealforResidentialRegistrationSpecialSealforResidentialRegistration
SichuanMunicipalPublicSecurityDepartmentChengduMunicipalPublicSecurityBureauQingyang
(SpecialSealforHukou)PoliceSub-Bureau(SpecialSealforHukou)
StampofOperator:
XiaoYuan(Seal)Issuedon:
12/09/2013
DomicileAlterationRegistration
DomicileafterAlteration
DateforAlteration
StampofOperator
RegistrationCardforPermanentResident
Name
XiaoTa
HouseholderorRelationshipwithHouseholder
Sun
NameEverUsed
Sex
Male
PlaceofBirth
Chengdu,SichuanProvince
Nationality
Han
NativePlace
Wuhan,HubeiProvince
DateofBirth
08/07/1973
OtherDomicileintheCity(County)
Religion
Resident’sIDCardNo.
510106197307080088
Stature
183
BloodType
O
Education
BachelorofEngineering
MaritalStatus
Married
MilitaryService
PlaceofService
Chengdu
government
Profession
governmentofficials
Whenandfromwheretothiscity(county)
Whenandfromwheretothisdomicile
21/12/2012FromRoom8,Unit2Building4,NO.88Yipidajie.
JinniuDistrict.Chnegdu
Registeredon:
21/11/2013
Daishengping(Seal)
ChengduMunicipalPublicSecurityBureauQingyangPoliceSub-Bureau(SpecialSealforHukou)
AlterationandCorrectionRecordofRegisteredItems
Items
AfteralterationandCorrection
DateofAlteration
SealandSignatureofUndertaker
Name
LiXiulan
Householderherself
LiKeyu
Female
Shanghai
15/12/1956
510106195612153456
168
Undergraduate
Retired
Fanglinlucommunity
07/11/2008Retiredfrom
chengdumilitarygeneralhospital
Registeredon:
10/02/2014
Hebing(Seal)