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Ity), portador do documento de viagem n. (numero de passaporte/passport number), requerente de visto (tipo de visto/type of visa), autorizo, nos termos da al nea d) do n. 1 do art. 12. do Decreto Regulamentar 84/07 de 5 de Novembro, a consulta pelo Servi o de Estrangeiros e Fronteiras do meu registo criminal portugu s. Assinatura/Signature.

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