APPLICATION FOR SCHENGEN VISA THIS …

1 1 The fields marked with * shall not be filled in by family members of EU, EEA or CH citizens (spouse, child or dependent ascendant) while exercising their right to free movement. Family members of EU, EEA or CH citizens shall present documents to prove this relationship and fill in fields no 34 and 35. * )*( ( / - - ) 43 43 . APPLICATION FOR SCHENGEN visa THIS APPLICATION FORM IS FREE 1.

2 Surname (Fami ly name) (x) 1- (x) FOR OFFICIAL USE ONLY 2. Surname at bi rth (Former fami ly name(s)) (x) 2- (x) Date of appli cati on: Vi sa appli cati on number: Appli cati on lodged at Embassy/consulate CAC Service provider Commercial intermediary Border Name: Other Fi le handled by: Suppor ti ng docum ents: Travel document Means of subsistence Invitation Means of transport TMI Other: Vi sa deci si on: Refused Issued: A C LTV Valid: From Unti l Number of entri es: 1 2 Multiple Number of days: 3. Fi rst name(s) (Gi ven name(s)) (x) 4- (x) 4. Date of bi rth ( day-month-year) 3- ( - - ) 5. Place of bi rth 3- 6.

3 Country of bi rth 6- nati onali ty 7- Nati onali ty at bi rth, i f di ffe rent: 8. Sex 8- Male/ Female/ 9. Mari tal status 9- Si ngle/ Married/ Separated/ Di vorced/ Wi dow(er)/ Other (please s peci fy)/ ( ) 10. In the case of mi nors: Surname, fi rst name, address (i f di fferent from appli cant s) and nati onali ty of parental authori ty/legal guar di an 11- : ( ) 11. Nati onal i denti ty number, w here appli cable 11- 12.

4 Type of travel docum ent 12- : Ordinary passport/ Diplomatic passport/ Service passport/ Official passport/ Special passport/ Other travel document (please specify)/ ( ) 13. Number of trav el document 14- 14. Date of i ssue 13- 15. Vali d unti l 13- 16. Issued by 16- 17. Appli cant's home address and e-mai l address 17- Telephone num ber(s) 18. Resi dence i n a country other than the country of current nati onali ty18- No / Yes.

5 Residence permit or equivalent/ No.. Valid until/ 1 19. Current occupati on *19- * 20. Employer and em ployer's address and telephone num ber. For students, name and address of educati onal establi shment. 22- )*( . 21. Mai n purpose(s) of the journey: 21- : Tourism/ Business/ Visiting family or friends/ . Cultural/ Sports/ Official visit/ Medical reasons/ Study/ Transit/ Airport transit/ Other (please specify)/ ( ) x Fields 1-3 shall be filled in in accordance with the data in the travel document 1 4 (x) PHOTO 1 The fields marked with * shall not be filled in by family members of EU, EEA or CH citizens (spouse, child or dependent ascendant) while exercising their right to free movement.

6 Family members of EU, EEA or CH citizens shall present documents to prove this relationship and fill in fields no 34 and 35. * )*( ( / - - ) 43 43 . 22. Member S tate(s) of desti nati on 22- 23. Member S tate of fi rst entry 24- 24. Number of entri es requested 23- Single entry /.

7 Two entries /. Multiple entries / 25. Durati on of the i ntended s tay or transi t 23- : Indi cate num ber of days 26. SCHENGEN vi sas issued duri ng the pas t three years 26- No / Yes. Date(s) of validity from .. to .. /.. ngerpri nts collected previ ously for the purpos e of applyi ng for a SCHENGEN vi sa 27- No /.. Yes /.. Date, if known / 28. Entry permi t for the fi nal country of des ti nati on, w here appli cable 28- ( ) Issued by / ..Vali d from /.

8 Until /.. 29. Intended date of arri val i n the SCHENGEN ar ea 29- 30. Intended date of depar ture from the SCHENGEN area 41- *31. Surname and fi rst name of the i nvi ti ng person(s) i n the Mem ber S tate(s). If not appli cable, nam e of hotel(s) or tem porary accommodati on(s) i n the M ember State(s) *41- Address and e-mai l address of i nvi ti ng person(s)/hotel(s)/temporary accommodati on(s) Telephone and telefax *32. Name and addr ess of i nvi ti ng company/organi sati on *42- Telephone and telefax of company/or gani sati on Surname, fi rst name, address, telephone, telefax, and e-mai l addr ess of contact person i n company/or gani sati on : - - - - - *33.

9 Cost of travelli ng and li vi ng duri ng the appli cant's stay i s covered *44- : by the applicant himself/herself / Means of support / Cash / Traveller's cheques / Credit card / Pre-pai d accommodation / Pre-pai d transpor t / Other (please specify) ( )/ by a sponsor (host, company, organi sati on), please speci fy ( ) referred to in field 31 or 32 41 42 other (please speci fy) ( ) Means of support / Cash / Accommodation provided All expenses cover ed duri ng the stay Pre-pai d transpor t / Other (pleas e speci fy) ( ) 34.

10 Personal data of the fami ly member w ho i s an EU, EEA or CH ci ti zen 43- 1 The fields marked with * shall not be filled in by family members of EU, EEA or CH citizens (spouse, child or dependent ascendant) while exercising their right to free movement. Family members of EU, EEA or CH citizens shall present documents to prove this relationship and fill in fields no 34 and 35. * )*( ( / - - ) 43 43.