KONINKRIJK BELGIË
ROYAUME DE BELGIQUE
KINGDOM OF BELGIUM
ราชอาณาจักรเบลเย ี่ยม
Ambassade te Bangkok
Ambassade à Bangkok
Royal Embassy in Bangkok
สถานทูต ณ กรุงเทพมหานคร
C. 1.2
N°
VM/AH/vs
The Embassy of Belgium in Thailand presents its compliments to the Office of the
Royal Thai Police, Special Branch Bureau, Police Clearance Service Centre, General Staff
Division, 5th Sub-Division, and has the honour to inform the latter that :
Mr /Mrs /Ms _____________________________________________________________,
Born on _____________________, in ______________________________________,
bearer of Thai National Identity Card N° ____________ and Thai passport N° ___________,
has the intention to leave Thailand in order to study / work / get married and to settle down in
Belgium.
The Embassy of Belgium would be obliged if the Special Branch Bureau, Police
Clearance Service Centre, General Staff Division, 5th Sub-Division, could transmit to this
Embassy the record of Mr/Mrs/Ms __________________________________________
for the last five years. This record will be used for the issuance of visa for his/her provisional
stay in Belgium.
The Embassy of Belgium avails itself of this opportunity to renew to the Office of the
Royal Thai Police, Special Branch Bureau, Police Clearance Service Centre, Sub-Division 5, the
assurances of its highest consideration.
Bangkok,
Office of the Royal Thai Police
General Staff Division, Special Branch Bureau,
Police Clearance Service Centre, 5th Sub-Div.,
(Across from “World Trade Centre”)
Rama 1st Road, Pathum Wan, 5th Building,
BANGKOK 10330
Tel. 02-205.21.68 Fax 02-205.21.69
TEL. +66 2 679 54 54
FAX. +66 2 679 54 67
E-MAIL: Bangkok@diplobel.be
WEB: http://www.diplomatie.be/bangkok
Sathorn City Tower, 17th floor
175 South Sathorn Road  10120 Bangkok