Photo	Application for Schengen Visa

This application form is free	Stamp Embassy
or Consulate
1. Surname(s) (family name(s))	FOR EMBASSY/
CONSULATE USE ONLY
2. Surname(s) at birth (earlier family name(s))	Date application:
3. First names (given names)
4. Date of birth (year-month-day)	5. ID-number (optional)	File handled by:
6. Place and country of birth
Supporting documents:
7. Current nationality/ies	8. Original nationality (nationality at birth)	Valid passport
Financial means
9. Sex	10. Marital status	Invitation
Single
Married
Separated
Divorced
Widow(er)	Means of transport
Male
Female
Other	Health insurance
11. Father’s name	12. Mother’s name	Other:
13. Type of passport:
National passport
Diplomatic passport
Service passport
Travel document (1951 Convention)
Alien’s passport
Seaman’s passport
Other travel document (please specify):
14. Number of passport	15. Issued by
16. Date of issue	17. Valid until
18. If you reside in a country other than your country of origin, have you permission to return to that country?
No
Yes, (number and validity)	To
* 19. Current occupation	Visa:
Refused
* 20. Employer and employer’s address and telephone number. For students, name and address of school	Granted
Characteristics of Visa:
21. Main destination	22. Type of visa	23. Visa
Airport transit
Transit
Individual
Collective
Short stay
Long stay
24. Number of entries requested	25. Duration of stay
Single entry
Two entries
Multiple entries	Visa is requested for:	days.	Number of entries:
26. Other visas (issued during the past three years) and their period of validity	1 2 Multiple
Valid from
27. In the case of transit, have you an entry permit for the final country of destination?
No
Yes, valid until	Issuing authority:	To
* 28. Previous stays in this or other Schengen states	Valid for
* The questions marked with * do not have to be answered by family members of EU or EEA citizens (spouse, child or dependent ascendant). Family members of EU or EEA citizens have to present documents to prove this relationship.
10479 (Godkj. 01-2003) Elektronisk utgave	Side 1/2
29. Purpose of travel	FOR EMBASSY/
Tourism
Business
Visit to Family or Friends
Cultural/Sports
Official
Medical reasons	CONSULATE USE ONLY
Other (please specify):
* 30. Date of arrival	* 31. Date of departure
* 32. Border of first entry or transit route	* 33. Means of transport
* 34. Name of host or company in the Schengen states and contact person in host company. If not applicable, give name of hotel or temporary address in the Schengen states
Name	Telephone and telefax
Full address	E-mail address
@
* 35. Who is paying for your cost of travelling and for your costs of living during your stay?
Myself
Host person(s)
Host company (State who and how and present corresponding documentation)
* 36. Means of support during your stay
Cash
Traveller’s cheques
Credit Cards
Accommodation
Other
Travel and/or health insurance. Valid until:
37. Spouse’s family name	38. Spouse’s family name at birth
39. Spouse’s first name	40. Spouse’s date of birth	41. Spouse’s place of birth
42. Children (Application must be submitted separately for each passport)
Name	First name	Date of birth
1
2
3
43. Personal data of the EU or EEA citizen you depend on. This question should be answered only by family members of EU or EEA citizens.
Name	First Name
Date of birth	Nationality	Number of passport
Family relationship
of an EU or EEA citizen
44. I am aware of and consent to the following: any personal data concerning me which appear on this visa application form will be supplied to the relevant authorities in the Schengen states and processed by those authorities, if necessary, for the purposes of a decision on my visa application. Such data may be input into, and stored in, databases accessible to the relevant authorities in the various Schengen states.

At my express request, the consular authority processing 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 altered or deleted, in particular, should they be inaccurate, in accordance with the national law of the state concerned.

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 Schengen state which deals with the application.

I undertake to leave the territory of the Schengen states upon 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 Schengen 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 the Schengen Implementing Convention and am thus refused entry. The prerequisites for entry will be checked again on entry into the European territory of the Schengen states.
45. Applicant’s home address	46. Telephone number
47. Place and date	48. Signature (for minors, signature of custodian/guardian)
10479 (Godkj. 01-2003) Elektronisk utgave	Side 2/2

LTV

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B

C

D

D+C

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SignForm

2005-05-21