Power of Attorney Application

Principal’s full name (first, middle, and last) *

Mother's name and surname *

Place of Birth *

Date of Birth *

Husband's name and surname

Passport number *

Issue date *

Expiry date *

Place of registration *

Number of registration *

File number *

Statistical statement number *

The full name of the agent *

Place of birth *

Date of birth *

Place of registration *

Registration number *

City *

Street *

Building *

Phone *

City *

Street *

Building *

Phone *

Mobile *

Fax *

P.O. Box and Emirate *

Personal email *

Professional email

*

Mention the subject of the agency in detail *

Name of the receiving employee

Date of receipt

Serial number

Paid fee

Name of the implementing employee

Family number

Registration number

Individual number

Document number

Implementation date

Image 1 of the Lebanese passport: *

Image 2 of the Lebanese passport: *

Image of the agency document: *

Additional document: *

Subject *

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Specific to Palestinian Refugees

The Agent Detials

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