Microsoft Word - How to fill-Schengen Visa Form-DNK

Harmonised application form (1)

Application for Schengen Visa

This application form is free.

Photo

1 Surname (Family name) (x) Write your last name as mentioned on your passport

2 Surname at birth (Former family name(s)) (x) N/A

3 First name(s) (Given name(s)) (x) Write your first name as mentioned on your passport

Date of birth (day-month-year)

Place of birth

Current nationality

Write your date of birth in day-month-year

order. Example: 25-01-1900

Write your place of birth as mentioned on

your passport

Nationality at birth, if different:

Write Your passport Nationality

Country of birth

Write the name of your country

Sex

9 Marital status

Male

Female

Single

Married

Separated

Divorced

Widow(er)

Other (please specify)

Specify your Gender

Specify your Marital status

10 In the case of minors: Surname, first name, address (if different from applicant's) and nationality of parental authority/legal guardian

Write the legal guardian Name, Address and Nationality. This section is applicable for Minor applicant (below 18 years).

11 National identity number, where applicable

N/A

12 Type of travel document

Ordinary passport

Diplomatic passport

Service passport

Official passport

Special passport

Other travel document (please specify)

Specify the type of your passport

Number of travel document

14 Date of issue

15 Valid until

16 Issued by

Write your passport number as

mentioned on your passport

Ex:01-12-1900

Ex:01-12-1905

Specify the authority that issued the passport

and the place of issue. Ex: DIP/DHAKA

Applicant's home address and e-mail address

Telephone number(s)

Write your current address and Email ID Write your mobile no

18 Residence in a country other than the country of current nationality

Yes. Residence permit or equivalent No.

Valid until

* 19 Current occupation

Write your Designation

* 20 Employer and employer's address and telephone number. For students, name and address of educational establishment.

Write Office /Educational institute Name & Address where you are working /studying

21 Main purpose(s) of the journey:

Tourism

Business

Visiting family or friends

Cultural

Sports

Official visit

Medical reasons

Study

Transit

Airport transit

Other (please specify)

OR OFFICIAL USE ONLY

Date of application:

Visa application number:

Application lodged at

Embassy/consulate

CAC

Service provider

Commercial intermediary

Border

Name:

Other

File handled by:

Supporting documents:

Travel document

Means of subsistence

Invitation

Means of transport

TMI

Other:

Visa decision:

Refused

Issued:

LTV

Valid:

From

Until

Number of entries:

Multiple

Number of days:

Select the box that describes the purpose of your trip

(1) No logo is required for Norway, Iceland and Switzerland.

Member State(s) of destination

Member State of first entry

WRITE THE NAME OF SCHENGEN STATE OF YOUR MAIN

DESTINATION

AS PER THE TICKET (Only Schengen state considered)

Number of entries requested

Duration of the intended stay or transit

Single entry

Two entries

Indicate number of days

Multiple entries

Total number of the day in Schengen State(s)

Mark the box corresponding to your desired number of entries

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.

(x) Fields 1-3 shall be filled in in accordance with the data in the travel document.

Schengen visas issued during the past three years

Yes. Date(s) of validity from……………………………………

Specify the box if you have obtained the Schengen visa during the last three years

Fingerprints collected previously for the purpose of applying for a Schengen visa

Please specify the box

Yes

Date, if known

28 Entry permit for the final country of destination, where applicable

Applicable for Transit visa case

Issued by

Valid from

until

29 Intended date of arrival in the Schengen area

30 Intended date of departure from the Schengen area

Write your expected arrival date in the Schengen area.

Example: 01-05-2000

Write your departure date from the Schengen area.

Example: 10-05-2000

* 31 Surname and first name of the inviting person(s) in the Member State(s). If not applicable, name of hotel(s) or temporary

accommodation(s) in the Member State(s)

Write the name of the person who invited you (Visiting Friends & Family), or Name of the Hotel

Address and e-mail address of inviting person(s)/hotel(s)/temporary

Telephone and telefax

accommodation(s)

Contact Number

Hotel address

*32 Name and address of inviting company/organisation

Telephone and telefax of company/organisation

Inviting Company name

Contact Number

Surname, first name, address, telephone, telefax, and e-mail address of contact person in company/organisation

Invitee person name and Company address

*33 Cost of travelling and living during the applicant's stay is covered

Select the appropriate box’s

by the applicant himself/herself

Means of support

Cash

Traveller's cheques

Credit card

Pre-paid accommodation

Pre-paid transport

Other (please specify)

by a sponsor (host, company, organisation), please specify

referred to in field 31 or 32

other (please specify)

Means of support

Cash

Accommodation provided

All expenses covered during the stay

Pre-paid transport

Other (please specify)

Personal data of the family member who is an EU, EEA or CH citizen

Surname

First name(s)

Date of birth

Nationality

Number of travel document or ID card

Family relationship with an EU, EEA or CH citizen

spouse

child

grandchild

dependent ascendant

Place and date

37 Signature (for minors, signature of parental authority/legal guardian)

Dhaka-01-01-1900

Signature of the applicant / If it’s for Minor (below

18year) Parents or Guardian signature is required.

I am aware that the visa fee is not refunded if the visa is refused.

Applicable in case a multiple-entry visa is applied for (cf. field no 24):

I am aware of the need to have an adequate travel medical insurance for my first stay and any subsequent visits to the territory of Member States.

I am aware of and consent to the following: the collection of the data required by this application form and the taking of my photograph and, if

applicable, the taking of fingerprints, are mandatory for the examination of the visa application; and any personal data concerning me which appear on

the visa application form, as well as my fingerprints and my photograph will be supplied to the relevant authorities of the Member States and processed

by those authorities, for the purposes of a decision on my visa application.

Such data as well as data concerning the decision taken on my application or a decision whether to annul, revoke or extend a visa issued will be

entered into, and stored in the Visa Information System (VIS) (1) for a maximum period of five years, during which it will be accessible to the visa

authorities and the authorities competent for carrying out checks on visas at external borders and within the Member States, immigration and asylum

authorities in the Member States for the purposes of verifying whether the conditions for the legal entry into, stay and residence on the territory of the

Member States are fulfilled, of identifying persons who do not or who no longer fulfil these conditions, of examining an asylum application and of

determining responsibility for such examination. Under certain conditions the data will be also available to designated authorities of the Member States

and to Europol for the purpose of the prevention, detection and investigation of terrorist offences and of other serious criminal offences. The authority of

the Member State responsible for processing the data is the Danish Immigration Service, Ryesgade 53, DK-2100 Copenhagen Ø, Denmark, e-mail:

[email protected].

I am aware that I have the right to obtain in any of the Member States notification of the data relating to me recorded in the VIS and of the Member State

which transmitted the data, and to request that data relating to me which are inaccurate be corrected and that data relating to me processed unlawfully

be deleted. At my express request, the authority examining my application will inform me of the manner in which I may exercise my right to check the

personal data concerning me and have them corrected or deleted, including the related remedies according to the national law of the State concerned.

The national supervisory authority of that Member State (the Danish Data Protection Agency, Borgergade 28, 5, DK-1300 Copenhagen K, Denmark, e-

mail: [email protected]) will hear claims concerning the protection of personal data.

I declare that to the best of my knowledge all particulars supplied by me are correct and complete. I am aware that any false statements will lead to

my application being rejected or to the annulment of a visa already granted and may also render me liable to prosecution under the law of the Member

State which deals with the application.

I undertake to leave the territory of the Member States before the expiry of the visa, if granted. I have been informed that possession of a visa is only one of

the prerequisites for entry into the European territory of the Member States. The mere fact that a visa has been granted to me does not mean that I will be

entitled to compensation if I fail to comply with the relevant provisions of Article 5(1) of Regulation (EC) No 562/2006 (Schengen Borders Code) and I am

therefore refused entry. The prerequisites for entry will be checked again on entry into the European territory of the Member States.

Place and date

Signature (for minors, signature of parental authority/legal guardian):

Dhaka-01-01-1900

Signature of the applicant / If it’s for Minor (below 18year) Parents

or Guardian signature is required.

(1) In so far as the VIS is operational