‫‪Kin‬‬

‫‪ng Fahd University of Petroleum‬‬

‫‪P‬‬ ‫‪& Minerals‬‬ ‫اﻟﻤﻠﻚ ﻓﻬﺪ ﻟﻠﺒﺘﺮوول واﻟﻤﻌﺎدن‬
‫ﺟﺎﻣﻌﺔ ﻚ‬
‫‪Deanship of Faculty & Personnel Affairs‬‬
‫‪A‬‬ ‫ﻋﻤﺎدة ﺷﺆﺆون اﻷﺳﺎﺗﺬة وواﻟﻤﻮﻇﻔﻴﻦ‬
‫‪Faculty & Person‬‬‫‪nnel Services‬‬
‫‪s‬‬ ‫ﺧﺪﻣﺎت اﻷﺳﺎﺗﺬة واﻟﻤﻤﻮﻇﻔﻴﻦ‬
‫ت‬

‫ﻃﻠــــــــــﺐ ﺗـــﺄﺷﻴـــــــﺮة ﺧــــــــــﺮوج ﻧﻬﻬـــﺎﺋﻲ‬

‫‪APPLIICATION FO‬‬
‫‪ORM FOR FINAL EXIT VISA‬‬

‫اﻟﻤﻮﻇﻒ‬
‫ﻒ‬ ‫رﻗﻢ ﺑﻄﺎﻗـــــــﺔ‬ ‫اﻟﻘﺴـــــــــﻢ ‪ /‬اﻟﻮﻇﻴﻔـــــــــــﺔ‬
‫ﻢ‬ ‫إﺳــــــــــــــــﻢ ﺣـــﺎﻣﻞ ﺟﻮاز اﻟﺴـــــــــﻔﺮ‬ ‫ﻹﻗﺎﻣـــــــــﺔ‬
‫رﻗـــــــــﻢ اﻹ‬
‫‪EMPLOYEE’S ID‬‬ ‫‪D#‬‬ ‫‪DEPARTMENT‬‬ ‫‪T / RANK‬‬ ‫‪PASSPORT‬‬ ‫‪T HOLDER’S NA‬‬ ‫‪AME‬‬ ‫‪RESIDENT PER‬‬ ‫‪RMIT (IQAMA) #‬‬

‫ﺗـﺎرﻳـــــــــﺦ اﻟﻤﻐــــــــــــــﺎددرة‬ ‫ﺻﻠــــــﺔ اﻟﻘﺮاﺑــــــﺔ‬ ‫اﻟﺠﻨﺴــــــــــــــــــﻴﺔ‬ ‫ي(‬‫ﺗﺎرﻳﻳـــــﺦ إﻧﺘﻬـــــﺎء اﻹﻗﻗــــﺎﻣـــﺔ )اﻟﻬــﺠﺮي‬

‫‪DA‬‬‫‪ATE OF DEPARTTURE‬‬ ‫‪RELATIONSHIP‬‬ ‫‪NA‬‬‫‪ATIONALITY‬‬ ‫‪RESSIDENT PERMIT‬‬ ‫)‪T EXPIRY (Hijri date‬‬ ‫‪d‬‬
‫‪ ‬‬ ‫‪ ‬‬

‫‪NAME‬‬
‫‪ES OF ACCOMP‬‬
‫‪PANYING CHILD‬‬
‫‪DREN ENDORSE‬‬
‫‪ED ON THE SAM‬‬
‫‪ME PASSPORT‬‬ ‫اﻷول ﻓﻘــﻂ(‬
‫ﻓــــﻰ ﺟـــــــﻮاز اﻟﺴﻔـــــــــــﺮ )اﻻﺳـﻢ ل‬
‫اﺳﻤـــﺎء اﻟﻤــﺮاﻓﻘﻴـــﻦ ﻰ‬
‫ء‬

‫اﻻﺳــــﻢ‬ ‫ﺻﻠـــــــﺔ اﻟﻟﻘﺮاﺑــــﺔ‬ ‫اﻻﺳــــﻢ‬ ‫ﺻﻠــــــــﺔ اﻟﻘﺮاﺑــــﺔ‬

‫‪NAME‬‬ ‫‪RELATTIONSHIP‬‬ ‫‪NAME‬‬ ‫‪RELATION‬‬ ‫‪NSHIP‬‬

‫ارﻗــــــــﺎم اﻟﺘــــــــﻮاﺻﻞ )داﺧــــﻞ اﻟﻤﻤﻠﻜـــــــــﺔ(‬ ‫ﺑـﻴﺎﻧــﺎت ااﻟﺘﻮاﺻـــﻞ )ﺧــﺎرج اﻟﻤﻤﻠﻜــﺔ(‬

‫)‪CONTACT DETAILS (SAUDI ARABIA‬‬ ‫‪CONTAC‬‬ ‫‪CT DETAILS AB‬‬ ‫‪BROAD‬‬

‫‪Telephoone:‬‬ ‫هـــــﺎﺗـﺗـــــــــــﻒ‪:‬‬
‫‪MOBILE:‬‬ ‫ﺟﻮال‪:‬‬
‫‪Mobile::‬‬ ‫ﺟـــــــــــــــــﻮال‪:‬‬
‫‪OFFIC‬‬
‫‪CE:‬‬ ‫ﻣﻜﺘﺐ‪:‬‬
‫‪:‬‬
‫‪Addresss:‬‬ ‫ﻋـــــــــﻨــــﻮان‪:‬‬
‫‪HOME:‬‬ ‫ﻣﻨﺰل‪:‬‬
‫‪Email:‬‬ ‫ﺑﺮﻳﺪ ااﻟﻜﺘﺮوﻧﻰ‪:‬‬

‫ررﺋﻴــــــــــــــــﺲ اﻟﻘﻘﺴـــــــــــــــــﻢ‬
‫‪HEAD OF THE DEPARTMENT‬‬ ‫‪Employee’s Name:‬‬ ‫____‬ ‫ﺳـﻢ‪:‬‬
‫اﻻﺳ‬

‫‪Signature:‬‬ ‫اﻟﺘﻮﻗﻗﻴﻊ‪:‬‬

‫‪Signaature:‬‬ ‫اﻟﺘﻮﻗﻴﻊ‪:‬‬ ‫‪Datte:‬‬ ‫اﻟﺘﺎرﻳﻳﺦ‪:‬‬

 ‫ﺗـــﺄﺷﻴــــــﺮة ﺧـــــــــﺮوج ﻧﻬـــﺎﺋﻲ‬
FINAL EXIT VISA
Please only print the form (first page only) (‫ﻳﺮﺟﻰ ﻃﺒﺎﻋﺔ اﻟﻨﻤﻮذج ﻓﻘﻂ )اﻟﺼﻔﺤﺔ اﻷوﻟﻰ ﻓﻘﻂ‬

1. Please submit this form at least three days before the date of
‫ اﺳﺎﺑﻴﻊ ﻣﻦ ﺗﺎرﻳﺦ اﻟﺴﻔﺮ اﻟﻰ ﻗﺴﻢ ﺧﺪﻣﺎت اﻻﺳﺎﺗﺬة‬٣ ‫ﻳﻘﺪم اﻟﻄﻠﺐ ﻗﺒﻞ‬ .1
travel to Faculty & Personnel Services Department with
:‫واﻟﻤﻮﻇﻔﻴﻦ ﻣﺮﻓﻘًﺎ ﺑﻪ ﻣﺎ ﻳﻠﻰ‬
following documents
 One passport size color picture .‫ ﺻﻮرة ﺷﺨﺼﻴﺔ ﻣﻠﻮﻧﺔ ﺑﺤﺠﻢ ﺻﻮرة اﻟﺠﻮاز‬
 Final Exit Visa Application form
.‫ ﻧﻤﻮذج ﻃﻠﺐ ﺗﺄﺷﻴﺮة اﻟﺨﺮوج اﻟﻨﻬﺎﺋﻰ‬
 Original Passport
.‫ أﺻﻞ ﺟﻮاز اﻟﺴﻔﺮ‬
 Final Clearance Form duty signed and stamped by all
the departments concerned. .‫ ﻧﻤﻮذج إﺧﻼء ﻃﺮف ﻧﻬﺎﺋﻲ ﻣﻮﻗﻊ ﻣﻦ آﺎﻓﺔ اﻷﻗﺴﺎم اﻟﻤﻌﻨﻴﺔ‬
 Original KFUPM ID
.‫ أﺻﻞ ﺑﻄﺎﻗﺔ اﻟﻬﻮﻳﺔ اﻟﺠﺎﻣﻌﻴﺔ‬
 Original resident permit(s)/Iqama(s) of staff and his
‫ إﺻﻞ ﺑﻄﺎﻗﺔ اﻹﻗﺎﻣﻪ ﻟﻠﻤﻮﻇﻔﻴﻦ و اﻟﺘﺎﺑﻌﻴﻦ‬
dependents.

2. Fill in the Final Exit Visa Application form and have it signed ‫إﻣﻸ ﻧﻤﻮذج ﻃﻠﺐ ﺗﺄﺷﻴﺮة اﻟﺨﺮوج اﻟﻨﻬﺎﺋﻲ واﻃﻠﺐ ﻣﻦ رﺋﻴﺲ اﻟﻘﺴﻢ‬ .2

by the department head concerned (for the employee only). .(‫ﺗﻮﻗﻴﻌﻪ )ﻟﻠﻤﻮﻇﻔﻴﻦ ﻓﻘﻂ‬
3. For dependents the Final Exit Visa can be issued online by
."‫ ﻳﻤﻜﻦ اﺻﺪار ﺗﺄﺷﻴﺮاﺗﻬﻢ ﻋﻦ ﻃﺮﻳﻖ ﻧﻈﺎم "أﺑﺸﺮ‬،‫ﻟﻠﺘﺎﺑﻌﻴﻦ‬ .3
the head of the family through (ABSHER system).
4. The original Resident Permit (Iqama) will be submitted at the .ً‫ﻳﺘﻢ ﺗﺴﻠﻴﻢ أﺻﻞ اﻹﻗﺎﻣﺎت ﻓﻰ اﻟﻤﻄﺎر ﻟﻠﻤﻮﻇﻒ و ﻟﻠﺘﺎﺑﻌﻴﻦ أﻳﻀﺎ‬ .4

airport both for employees and dependents. ‫ ﻋﻠﻴﻪ ﻳﺒﻴﻌﻬﺎ و أن ﻳﺘﺄآﺪ أﻧﻪ ﻗﺪ ﺗﻢ ﻧﻘﻞ‬،‫ﻓﻲ ﺣﺎﻟﺔ اﻣﺘﻼك اﻟﻤﻮﻇﻒ ﺳﻴﺎرة‬ .5
5. In case the employee owns a vehicle, he should sell it and
.‫ﻣﻠﻜﻴﺘﻬﺎ ﻟﻠﻤﺎﻟﻚ اﻟﺠﺪﻳﺪ ﻗﺒﻞ ﻃﻠﺐ ﺗﺄﺷﻴﺮة اﻟﺨﺮوج اﻟﻨﻬﺎﺋﻲ‬
make sure that the ownership title is transferred to the new
owner’s name before applying for a final exit visa. ‫ ﻳﺠﺐ اﻟﺘﺄآﺪ‬،‫ ﻋﺎﻣًﺎ أو أآﺜﺮ‬17 ‫إذا آﺎن ﺣﺎﻣﻞ ﺟﻮاز اﻟﺴﻔﺮ ﻳﺒﻠﻎ ﻣﻦ اﻟﻌﻤﺮ‬ .6

6. If the passport holder’s age is 17 year or above, please make ‫ وﻹدﺧﺎل اﻟﺒﺼﻤﺎت‬.‫ﻣﻦ إدراج ﺑﺼﻤﺎﺗﻪ ﻓﻰ ﻧﻈﺎم اﻟﺠﻮازات اﻟﺤﻜﻮﻣﻰ‬
sure that his/her finger prints are available in the Government
.‫إذهﺐ إﻟﻰ ﻣﻜﺘﺐ ﺟﻮازات اﻟﺨﺒﺮ‬
passport system. To enter finger prints go to Jawazat office
in Al-Khobar. ‫ وإذا ﻟﻢ ﻳﻐﺎدر‬.‫ﻋﻠﻰ ﺣﺎﻣﻞ اﻟﺠﻮاز ﻣﻐﺎدرة اﻟﻤﻤﻠﻜﺔ ﻓﻰ اﻟﻤﻮﻋﺪ اﻟﻤﺤﺪد‬ .7

7. The holder of the passport with exit visa must leave the .‫ﻟﺴﺒﺐ ﻣﺎ ﻓﻌﻠﻴﻪ أن ﻳﻌﻴﺪ اﻟﺠﻮاز إﻟﻰ ﻣﻜﺘﺐ ﺧﺪﻣﺎت اﻷﺳﺎﺗﺬة و اﻟﻤﻮﻇﻔﻴﻦ‬
Kingdom on the authorized date. If for some reasons he fails
.‫س‬.‫ ر‬1000 ‫ وإﻻ ﺗﻌﺮض ﻟﻐﺮاﻣﺔ ﻗﺪرهﺎ‬.‫ﻟﺘﺠﺪﻳﺪ أو إﻟﻐﺎء اﻟﺘﺄﺷﻴﺮة‬
to do so, he must return the passport immediately to Faculty
& Personnel Services Department. Otherwise, a penalty of .‫ﺻﻼﺣﻴﺔ اﻟﺘﺄﺷﻴﺮة ُﺗﺤﺴﺐ ﺑﺎﻟﺘﺎرﻳﺦ اﻟﻬﺠﺮي‬ .8

SR1000/- will be imposed for the cancellation / renewal of exit

visa.
8. Hijri Calendar is to be used for validity of the visa.