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Write in Latin block letters



НазваниеWrite in Latin block letters
Дата конвертации22.11.2012
Размер155.42 Kb.
ТипДокументы
источник



VISA APPLICATION

DENMARK


Write in Latin

BLOCK LETTERS





Remove Adhesive Label and Place Photo



Official Stamp

of the Mission


Sticker No.




Embassy or Consulate Application No.


 


  


 




Danish Alien No. or CPR No.


          

Reply to be Sent to


 




^

Information about Applicant


Surname


                                     

Given Name(s)


                                    

Surname at Birth



                                    

Main Nationality

Code


                                 

 

Nationality 2

Code


                                 

 

Nationality 3

Code


                                 

 

Previous Nationality

Code


                                 

 

Place of Birth (City and Country)

Code


                                 

 

Date of Birth

Sex (Male=M; Female=F)










  










Type of Passport or Travel Document



                                    

No. of Passport or Travel Document

Code


                                 




Issuing Country or Organization

Code



                                 

 

Issuing Date (dd-mm-yyyy)

Valid until (dd-mm-yyyy)








  








  


















Planned Date of (First) Entry into Schengen (dd-mm-yyyy)

Planned Date of (Last) Exit from Schengen (dd-mm-yyyy)

Type of Visa











  











  










Planned Entries:

Duration of Stay (Days)

One (1)




Two (2)




Several













Purpose of Stay

0 – medical reasons

1 – business reasons

2 – cultural reasons

3 – family reasons

4 – invitation

5 – official, political reasons

7 – sports competition

8 – training course

9 – tourism and transit



















Employment or Profession

Code


                                 



Employer/School/Organization Name


                                    

Employer/School/Organization Address and Telephone Number


                                    


                                    

Marital Status

Married




Single





Widow / Widower





Separated





Divorced







Main Destination in Schengen (City)

Code


                                 

 

Border of Entry


                                    

Permanent Address


                                    

Permanent Address ZIP-code


        




Permanent Address City


                                    

Permanent Address Country

Code


                                 

 

Means of Support During Your Stay (Select Only One)

Cash



(Traveller’s) Cheques




Credit Cards




Accommodation




Insurance




Health Insurance







Reference type

Person




Company



Organisation







Indicate Reference Family Relationship


Child





Brother / Sister





Parent





Spouse





Engaged/Boy-/ Girlfriend





Other







If other, State Relationship


                                    

Reference Surname / Company


                                    







Reference Given Name/Attention Person


                                    

Address of Reference


                                    

Reference Address ZIP Code


                                    

Reference Address City


                                    

Reference Address Country


                                    

Reference Telephone Number

                                    

Reference Fax Number or E-mail Address

                                    

Address During Your Stay in Denmark or Main Destination Country


                                    


                                    

Spouse’s Surname


                                    

Spouse’s Given Name(s)


                                    

Spouse’s Date of Birth (dd-mm-yyyy)








  



Spouse’s Place of Birth (City)

Code


                                  

 

Spouse’s Surname at Birth


                                    

Spouse’s Nationality

Code


                                 


 

Spouse’s Sex (Male=M; Female=F)

Spouse Accompanying

Accompanying Children Entered in Applicants Passport or Travel Document


















^

If You Have Permission to Return to a Country of Residence other than Your Native Country


Residence Permit

No.

Valid until (dd-mm-yyyy)








        









  




Re-entry Permit

No.

Valid until (dd-mm-yyyy)








        









  



^

Previous Stay(s) in Schengen


Dates of Previous Stay in Schengen: From (yyyy-mm-dd)

to (dd-mm-yyyy)







  












  



^

In Case of Transit or Airport transit


Country of Destination

If You Have an Visa or Entry Permit for the Country of Destination, Please State Issuing Authority


             

                     

If yes:

Type

No.

Valid until (dd-mm-yyyy)


       


        








  



^

Previous Applications for Schengen Visa


Date (dd-mm-yyyy)

Embassy / Consulate








  

                            

Date (dd-mm-yyyy)

Embassy / Consulate







  


                            

Signature


I hereby declare, under penalty of the law laid down in section 163 of the Danish Criminal Code and sections 59 and 60 of the Danish Aliens Act, that all the information given by me on this application form is truthful and complete.

I also consent to, in connection with the processing of my application, the relevant authorities requesting information on my personal affairs from other Danish and foreign authorities, including police authorities.

At the same time, I consent to, in connection with the processing of my application, the passing on of my personal information to the above-mentioned authorities.

Date of Signature

Place of Signature

Applicants Personal Signature










The information you have given in connection with your application for a visa will be registered on the Internal Visa Register, which the Danish Immigration Service is responsible for.

The information will be used to deal with questions regarding your stay in Denmark, and the Danish Ministry of Foreign Affairs, the police and the Danish Ministry of the Interior will be able to receive the information that is held about you.

You are required to provide the information necessary to assess your eligibility for a visa. If you do not provide all relevant information you risk a fine or detention, and you risk not being granted a visa. You have the right to access the information held about you. For inquiries on this right please contact the Danish Immigration Service.
^

For Use of Embassy / Consulate


Enclosure Checked

Declaration of Guarantee

Submission Suggested













 


 


 




Reason for Suggested Submission


                                    

Urgency

Schengen Urgency


                 

                

Submission Date








  




Comments



                                    



                                    



                                    



                                    




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