<text>Application for Schengen Visa</text> <comments>This application form is free</comments> 12225*01 Surname(s) (family name(s)) Surname(s) at birth (earlier family name(s)) First name(s) (given names) Date of birth (year-month-day) ID-number (optional) Place and country of birth Current nationality/ies Original nationality (nationality at birth) Sex Marital status Father's name Mother's name Type of passport Number of passport Issued by Date of issue Valid until If you reside in a country other than your country of origin, have you permission to return to that country? Current occupation Employer and employer's address and telephone number. For students, name and address of school. Main destination Type of visa Visa Number of entries requested Duration of stay (in days) Other visas (issued during the past years) and their period of validity In the case of transit, have you an entrie permit for the final country of destination? Previous stays in this or other Schengen states Purpose of travel Date of arrival Date of departure Border of first entry or transit route Means of transport 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 Who is paying for your cost of travelling and for your costs of living during your stay?
(State who and how present corresponding documentation)
Means of support during your stay. Spouse's family name Spouse's family name at birth Spouse's first name Spouse's date of birth Spouse's place of birth Children (Applications must be submitted separately for each passport)
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 realationship of an EU or EEA citizen 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 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 the annullment of a visa already granted and may also render me liable to prosecution under the law of Schengen state which deals with this application. I undertake to leave the territory of the Schengen states upon 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 Artice 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. Applicant's home address Telephone number Place and date Signature (for minors, signature of custodian/guardian) FOR EMBASSY / CONSULATE USE ONLY Date application: File handled by: Supporting documents: Valid passport Financial means Invitation Means of transport Health insurance Other: Visa: Refused Granted Characteristics of Visa: LTV A B C D D+C Number of entries: 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 EAA citizens have to present documents to prove this relationship.