STATE COMMITTEE OF UKRAINE FOR NATIONALITIES AND MIGRATION ORDER. April 09, 2002 city of Kyiv 13

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1 STATE COMMITTEE OF UKRAINE FOR NATIONALITIES AND MIGRATION ORDER April 09, 2002 city of Kyiv 13 On approval of the specimens of certificates of submission by a person of the application for granting to him/her the refugee status, of a person, in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status, of acceptance of a complaint for consideration, and a certificate of petition to court. In order to assure enforcement of the Law of Ukraine On Refugees 2557-III dated 21 June 2001, as per the Article 6 of the said Law and Regulations on the State Committee of Ukraine for Nationalities and Migration approved by the Decree of the President of Ukraine 269/2002 dated 19 March 2002, I order: 1. To approve: 1.1. Specimens of certificates of submission by a person of the application for granting to him/her the refugee status, of a person, in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status, of acceptance of a complaint for consideration, and a certificate of petition to court (hereinafter referred to as the certificates ), which are attached Description of the appearance and manufacturing of the forms of certificates of a person, in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status, certificate of acceptance of a complaint for consideration, and a certificate of petition to court, which is attached. 2. Ju. Buznytskyi, Head of the Department for Migration and Refugees, and E. Goltvyanskiy, Head of the Department of Financial and Economic Support shall assure production of certificate forms and distribution of such forms between the Migration Services in the Autonomous Republic of Crimea, regions, cities of Kyiv and Sevastopol, 3. Heads of the Migration Services in the Autonomous Republic of Crimea, regions, cities of Kyiv and Sevastopol shall provide for keeping in safe custody of the said certificates and determine persons responsible for keeping in custody of such certificates, conformance to established procedure for issue and withdrawal of the certificates. 4. Ju. Sukhov, Deputy Head, shall be responsible for implementation of this Order. G.P. Sereda / signature / Head of the State Committee for Nationalities and Migration SEAL: State Committee for Nationalities and Migration STAMP

2 Supplement 5 APPROVED by the Order No. 13 of the State Committee for Nationalities and Migration of Ukraine dated April 09, 2002 Description of forms of the certificate of submission by a person of the application for granting to him/her the refugee status, certificate of a person, in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status, certificate of acceptance of a complaint for consideration, and a certificate of petition to court The certificate of submission by a person of the application for granting to him/her the refugee status, certificate of a person in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status, certificate of acceptance of a complaint for consideration, and a certificate of petition to court shall be deemed documents issue of which is strictly controlled. The certificates consist of four numbered pages. The number of any certificate shall be printed typographically on its first page. Printing of such forms of the certificates should comply with DSTU Forms of Securities and Strictly Controlled Documents. General Specification. 1. The form of the certificate of submission by a person of the application for granting to him/her the refugee status 1.1. The form of the certificate of submission by a person of the application for granting to him/her the refugee status (hereinafter referred to as the certificate ) is a rightangled paper sheet having the dimensions of 10,5 х 15 cm White paper bearing security feature a green security grid is used to print a form of the certificate The first page of the form of the certificate (front page of the cover) bears the inscription: Certificate on submission by the person of the application for granting to him/her the refugee status On the second page of the form of the certificate, the following columns are placed to be filled: surname, name, patronymic name, date of birth, sex, place of birth, country of citizenship, country of origin, source of information about the person, personal description, height, color of eyes, hair, special peculiarities. In top left corner of the form, the place is marked for the applicant s photograph with a column for signature underneath On the third page of the form of the certificate, the following columns are placed to be filled: case No.; name of the migration service, which has issued the certificate; its address and telephone number; date of certificate issue; term of validity of the certificate; signature of the official, who issued the certificate, and his/her title On the fourth page (the reverse side of the form of the certificate), the excerpt from the Law of Ukraine On Refugees is printed,

3 2. The form of the certificate of a person, in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status 2.1. The form of the certificate of a person, in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status (hereinafter referred to as the certificate ) is a right-angled paper sheet having the dimensions 15 х 21 cm Light-red paper bearing security features iris printing, hologram - is used to print the form of the certificate The first page of the form of the certificate (front page of the cover) bears the inscription: Certificate of a person in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status, downwards the excerpt from the Law of Ukraine On Refugees On the second page of the form of the certificate the following columns are placed to be filled: Case No.; name of the issuing migration service, its address and telephone number; date of certificate issue; term of validity of the certificate; surname, name, patronymic name of the applicant; date of birth; sex; place of birth; country of citizenship; country of origin; source of information about the person; personal description, height, color of eyes, hair; special peculiarities. In the top left corner of the form of the certificate, the place is marked for the applicant s photograph with a column for signature underneath On the third page of the form of the certificate, the following columns are envisaged to be filled: information about juvenile persons under 18 years of age, who are legally represented by the applicant; the source of information about such juvenile persons; signature of the official, who issued the certificate, and his/her title On the fourth page of the form of the certificate, the following columns are placed to be filled: entries on registration with the internal affairs authority and extension of the validity term of the certificate. 3. The form of the certificate of acceptance of a complaint for consideration 3.1. The form of the certificate of acceptance of a complaint for consideration (hereinafter referred to as the certificate ) is a right-angled paper sheet having the dimensions 15x21 cm Light-yellow paper bearing security features iris printing, hologram is used to print the form of the certificate The first page of the form of the certificate (front page of the cover) bears the inscription: Certificate of acceptance of a complaint for consideration, downwards the excerpt from the Law of Ukraine On Refugees On the second page of the form of the certificate the following columns are placed to be filled: Case No., appealed decision; name of the migration service, decision of which is appealed; name of the specially authorized central executive authority for migration, which has issued the document, its address and telephone number; name of the migration service which has issued the certificate, its address and telephone number; date of certificate issue; term of validity of the certificate; surname, name, patronymic name of the applicant; date of birth; sex; place of birth; country of citizenship; country of origin; source of information about the person; personal description, height, color of eyes, hair; special peculiarities. In the top left corner of the form of the certificate, the place is marked for the applicant s photograph with a column for signature underneath On the third page of the form of the certificate, the following columns are

4 envisaged for further filling: information about juvenile persons under 18 years of age who are legally represented by the applicant; the source of information about such juvenile persons; signature of the official, who issued the certificate, and his/her title On the fourth page of the form of the certificate the following columns are placed to be filled: entries on registration with the internal affairs authority, and extension of the validity term of the certificate. 4. The form of the certificate of petition to court The form of the certificate of petition to court (hereinafter referred to as the certificate ) is a right-angled paper sheet having the dimensions 15 х 21 cm Light-gray paper bearing security features - iris printing, hologram is used to print the form of the certificate The first page of the form of the certificate (front page of the cover) bears the inscription: Certificate of petition to court, downwards the excerpt from the Law of Ukraine On Refugees On the second page the following columns are placed to be filled: Case No., appealed decision; name of the migration service subject to appeal; name of the migration service, which has issued the document, its address and telephone number; name of the migration service through which the document has been issued, its address and telephone number; date of the certificate issue; term of validity of the certificate; surname, name, patronymic name of the applicant; date of birth; sex; place of birth; country of citizenship; country of origin; source of information about the person; personal description, height, color of eyes, hair; special peculiarities. In the top left corner of the form of the certificate, the place is marked for the applicant s photograph with a column for signature underneath On the third page of the form of the certificate, the following columns are envisaged for filling: information about juvenile persons under 18 years of age who are legally represented by the applicant; the source of information about such juvenile persons; signature of the official, who issued the certificate, and his/her title On the fourth page of the form of the certificate, the following columns are placed to be filled: entries on registration with the internal affairs authority, and extension of the validity term of the certificate.

5 Supplement No. 1 APPROVED Order of the State Committee for Nationalities and Migration dated No. 13 CERTIFICATE of submission by a person of the application for granting to him/her the refugee status The certificate of submission by a person of the application for granting to him/her the refugee status is a document, which certifies the legitimacy of stay of such person in the territory of Ukraine throughout the validity of the certificate and is valid for exercising of the rights and carrying out of the duties, stipulated by the said Law and other laws. Art. 1 of the Law of Ukraine On Refugees

6 PHOTO Surname Given name Patronymic name Date of Birth Sex Place of birth Country of citizenship Country of origin Case No. Name of the migration service, which has issued the certificate, its address and telephone number Source of information about the person Personal description Height Color of eyes Hair : Special peculiarities Title: Locus Sigilli Date of certificate issue: Certificate is valid until: Entries on registration with the internal affairs authorities:

7 Supplement No. 2 APPROVED Order of the State Committee for Nationalities and Migration dated No. 13 CERTIFICATE of a person, in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status The certificate of a person, in relation to whom the decision was made on execution of the documents addressing the issue of granting to him/her the refugee status is a document that certifies the legitimacy of stay of such person in the territory of Ukraine throughout the validity of the certificate and is valid for exercising of the rights and carrying out of the duties, stipulated by the said Law and other laws of Ukraine. Atr. 1 of the Law of Ukraine On Refugees Case No. Information about juvenile persons under 15 years of age represented by the applicant

8 Name of the Migration Service, which has issued the certificate, its address and telephone number: Date of certificate issue: Certificate is valid until: Surname: PHOTO Given name: Patronymic name: Date of birth: Sex: Place of birth: Country of citizenship: Country of origin: Source of information about the person: Description Height: Color of eyes: Hair: Special peculiarities Photo Surname, given name, patronymic name Source of information about juvenile persons Date of birth Sex : Title:

9 Supplement No. 3 APPROVED Order of the State Committee for Nationalities and Migration dated No. 13 CERTIFICATE of acceptance of a complaint for consideration The certificate of acceptance of a complaint for consideration is a document, which certifies the legitimacy of stay of such person in the territory of Ukraine during the period of consideration of such complaint against the refusal in taking of the application for granting the refugee status or refusal in execution of the document on the decision to grant the refugee status in Ukraine. Such document is valid for exercising of the rights and carrying out of the duties, stipulated by the said Law and other laws. Atr. 1 of the Law of Ukraine On Refugees

10 Case No. Appealed decision Name of the migration service, decision of which is appealed: Name of the specially authorized central executive authority for migration, which has issued the certificate, its address and telephone number: Name of the migration service, which has issued the certificate, its address and telephone number: Date of certificate issue: Certificate is valid until: Surname: PHOTO Given name: Patronymic name: Source of information about the person: Description Height: Color of eyes: Hair: Special peculiarities Date of birth: Sex: Place of birth: Country of citizenship: Country of origin: Photo Surname, given name, patronymic name Source of information about juvenile persons Date of birth Sex

11 Supplement No. 4 APPROVED Order of the State Committee for Nationalities and Migration dated No. 13 CERTIFICATE of petition to court The certificate of petition to court is a document, which certifies the legitimacy of stay of such person in the territory of Ukraine during the period of petition in judicial procedure on the decision on the refusal in acceptance of the application for granting the refugee status, on the refusal in execution of the documents addressing the issue of granting the refugee status, on the refusal in granting the refugee status, on loss of the refugee status, on forfeiting of the refugee status and shall be effective for exercising of the rights and carrying out of the duties, stipulated by the said Law and other laws of Ukraine. Atr. 1 of the Law of Ukraine On Refugees

12 Case No. Appealed decision Name of the migration service, decision of which is appealed: Name of the migration service, which has issued the certificate, its address and telephone number: Name of the migration service through which the document has been issued, its address and telephone number: Date of certificate issue: Certificate is valid until: Surname: PHOTO Given name: Patronymic name: Source of information about the person: Description Height: Color of eyes: Hair: Special peculiarities Date of birth: Sex: Place of birth: Country of citizenship: Country of origin: Information about juvenile persons under 15 years of age represented by the applicant Photo Surname, given name, patronymic name Source of information about juvenile persons Date of birth Sex