Harm onised application for m
Application for Schengen Visa
This application form is free
1. Surname (Family name) (x)
FOR OFFICIAL US E ONLY
2. Surna me at birth (Forme r family name(s)) (x)
3. First n ame(s) (Given name(s)) (x)
4. Date of birth (day-month- year)
5. Place of bi rth
6. Countr y of birth
7.Current nation ality
Nationa lity at birth, if different:
8. Sex
□ Male □ Female 9. Marital status
□ Single □ Married □ Separated □ Divorced □
Widow(er) □ Other (pl ease specify)
10. In the case of mi nors: Surname , first na me, addre ss (if diffe rent from a pplicant’s) and na tionality
of paren tal au thority/legal guardian
11. National id entity numbe r, where appli cable
12. Ty pe of travel do cument
□ Ordinar y passport □ Diplomatic passport □ Service passport □ Official passport □ Special passport
□ Other travel document (pl ease specify)
13. Num ber of travel
document
14. Dat e of issue 15. Val id until
16. Issued b y
17. Applican t’s home addr ess and e-mail addr ess
Telephone numb er(s)
18. Resid ence in a countr y other than the countr y of curr ent n ationality
□ No
□ Yes. Residen ce permit or equivalen t ………… ……… No. … ………………….. Valid until
* 19. Current occupation
Date of application:
Visa appl ication
number:
Application lodg ed at
□ Embass y/consulate
□ CAC
□ Service provid er
□ Com mercial
interm ediary
□ Border
Name:
□ Other
File handled by:
Supporting docu ments:
□ Travel docum ent
□ Means of subsistence
□ Invitation
□ Means of tr ansport
□ TMI
□ Other :
Visa decision:
□ Refused
□ Issue d:
□ A
□ C
□ LTV
□ Valid:
From
Until
Number of entr ies:
□ 1 □ 2 □ MultiplePHOT O
EN 1
EN 2* 20. Employer and employer’s address and telephone number. For students, name and address of
educational establishment.
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)
22. Member State(s) of destination
23. Member State of first entry
24. Number of entries requested
□ Single entry…. □ Two entries …. □ Multiple entries25. Duration of the intended stay or transit
Indicate number of days
* The fields marked with * shall not be filled in by family members of EU, EEA or CH citizen s (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.
26. Schengen visas issued during the past three years
□ No
□ Yes. Date(s) of validity from …………………. to
27.Fingerprints collected previously for the purpose of applying for a Schengen visa
□ No ……………………………… □ Yes.
……………………………………. Date, if known
28. Entry permit for the final country of destination, where applicable
Issued by ………………………………..Valid from …………………………until
……………………………………………….
29. Intended date of arri val in the Schengen area
30. Intended date of departure from the
Schengen area
* 31. Surname and first name of the inviting person(s) in the Member State(s). If not applicable, name
of hotel(s) or temporary accommoda tion(s) in the Member State(s)
Address and e-mail address of in viting person(s)/hotel(s)/temporary
accommodation(s)
Telephone and telefax
EN 3*32. Name and address of i nviting company/organisation
Telephone and telefax of
company/organisation
Surname, first name, address, telephone, telefax, a nd e-mail address of contact person in
company/organisation
*33. Cost of travelling and living during the applicant’s stay is covered
□ 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)
34. 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
35. Family relationship with an EU, EEA or CH citizen
□ spouse …………….. □ child …… □ grandchild ……………… □ dependent ascendant
36. Place and date 37. Signature (fo r minors, signature of parental
authority/legal guardian)
EN 4I 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 th e data required by this applic ation form and the taking of my
photograph and, if applicable, the taking of fingerprints, are ma ndatory 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 entere d into, and stored in the Vi sa Information System (VIS)1for 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, st ay and residence on the territory of the Member States are
fulfilled, of identifying persons who do not or who no longer fu lfil these conditions, of examining an asylum application an d
of determining responsibility for such examination. Under certa in conditions the data will be also available to designated
authorities of the Member States and to Europol for the purpos e of the prevention, detection and investigation of terrorist
offences and of other serious criminal o ffences. The authority of th e Member State responsible for processing the data is:
[Office of Immigration and Nationality; Address: H- 1117 Budapest, Budafoki út 60. Tel.: +36 1 4639100].
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 dele ted. At my express request, the authority examining my
application will inform me of the manner in which I may exerci se my right to check the personal data concerning me and
have them corrected or deleted, including the related remedi es according to the national law of the State concerned. The
national supervisory authority of that Me mber State [Authority for Data Protection and Freedom of Information; Address:
H-1125 Budapest, Szilágyi Erzsébet fasor 22/C.; Tel.: +36 (1) 391-1400; Fax: +36 (1) 391-1410; e-mail:
ugyfelszolgalat@naih.hu ; website: www.naih.hu ] 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 Memb er 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 refuse d
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 parent al authority/legal guardian):
1 Insofar as the VIS is operational.