Type of Household: 

Non-agricultural family

(Non-agricultural corporate) 

Name of Householder: 

Zhang San 

（张三） 

Household Number: 

Current residential address: 

No. 888, X Road, 

Dongcheng District, Beijing 

Authorized supervisor: 

Public Security Bureau of Beijing (sealed) 

Authorized 

Administrator: 

X Road Police Station (sealed) 

Registrar: 

Wang Wu (sealed) 

Date of Issue: 

1^st January 2000 

New Address 

Date of registration update 

Registrar 

Name 

Zhang San 

（张三） 

Householder him/herself or Relation to the householder 

Householder himself / herself; 

Son / Son’s wife, etc. 

Former name (if available) 

Sex 

Male / Female 

Place of birth 

Beijing 

Ethnicity 

Han / Manchu / Uigur / Tibetan, etc. 

Ancestral native place 

Bazhou, Hebei Province 

Date of birth 

1^st October 1949 

Other residential address in this city (county) 

Religious belief 

Nil 

Citizen ID card number 

110000491001888 

Stature 

175 cm 

Blood group 

O 

Educational degree 

Master of Laws 

Marital status 

Married 

Military service status 

Nil 

Employer 

X Corporation Limited 

Occupation 

General Manager 

When and from where immigrated to this city (county) 

When and from where moved in current residential address 

18 Aug 2005 

No. 7, Z Road, Xicheng District, Beijing 

Registrar: 

(sealed) 

Date of register: 

15^th Sept 2000 

Updated item 

Updated content 

Date of Update 

Registrar 

ID card No. 

110000194910018889 

1999-04-20 

(sealed)