Naziv tijela kojemu se zahtjev podnosi OBRAZAC 18 Name of the authority to which the application is submitted Ge IT PRIJAMNI PECAT STAMP OF RECEIPT ZAHTJEV ZA IZDAVANJE: APPLICATION FOR ISSUANCE OF: 1. Odobrenja za privremeni boravak Approval for temporary stay 2. Odobrenja za staini boravak O approval for permanent stay 3. Odobrenja za autonomni boravak Approval for autonomous stay Prvoizdavanje —_—_—Produzenje Firstissuance [] Extension [] + Prosime PAVE CU) Stina: a 2. Bivse, odnosne rodeno prezime: 2 7AM EN LOY) O Former rman sumame: BAR A 2. Ine Wen name(s) 4 Spo COMusKo gy Zensho B® RBS 3 1G AS 8x: fale © Female “upisuje se ukolka je dodielin / to be entered if issued 5. Imo rote tee HL ee eS Bete Shera ot paren: Fale 7 Real SrA ICD OT ake MIRADA STAM ENOL Neher : VE ie 6. Datum, mjostoidrva rodenjar 2S. 5.0903. MIE - SPB/GA Bator lacs and Stats of bt 7. Drdavijanstvo S RPS Ko Nationality: © Maniat status neaterjon/eudana -izvanbratna zajedrica yp oterien /udana rudovae/ udovica _—rastvjen(l creeensaae Cleommontawmarage tamed = CM Sisowen’® CIgiateal®) 2. Poses ode —— ean _ isoviniiren: = GD, > STAM sys 1) Ie, prezme: GU IAT 7 CX Le V1 re eumama Tara ae ? Datum, mjesto, crtava rodenjadravjanstvs, “5 0 AT wid ~ SRRIDA Date, place, state of birth and nationality: 2). Ime, prezime: Name, surname: Datum, mjesto, dr2ava rodenja i drzavjanstvo: Date, place, state of birth and nationality: 9) Ime, prezime: Name, surname: Datum, mjesto, dr2ava rodenja i dreavijanstvo: Date, place, state of birth and nationality: 4). Ime, prezime: Name, surname: Datum, mjesto, dr2ava rodenja i drzavjanstvo: Date, place, state of birth and nationality: Naziv i mjesto skole: Name and place of schoo!