声    明    书

声明人：林*（曾用名：林**），男，一九八二年九月三日出生，公民身份号码：35****19820903****。

现我特在此郑重声明如下：

本人原中华人民共和国护照号码为:G392*****，现使用中华人民共和国护照号码为：E175*****。

本人保证上述声明完全真实，如有不实，愿承担一切法律责任。

声明人：                      

                    （林*）       

日期：二〇一五年八月十一日

Statement

Declarant: Lin * (previous name: Lin **), male, born on September 3, 1982, ID card number: 35****19820903****.

Now I hereby solemnly declare as follows:

The original number of the passport of the People’s Republic of China is: G392***** and now the new number of the passport of the People’s Republic of China is: E175*****.

I guarantee that the above statement is completely authentic and if there is any false, I am willing to take all legal responsibilities thereof.

     Declarant: Lin * (Signature)

(Lin *)

Date: August 11, 2015