Conslondra.esteri.it

Surname at birth (Former family name(s)) (x) 10. In the case of minors: Surname, first name, address (if different from applicant's) and nationality of parental authority/legal guardian 11. National identity number, where applicable Other travel document (please specify)………………………. 18. Residence in a country other than the country of current nationality From: ………………….………… Residence permit or equivalent ………………… No. …………………Valid until……………. *20. Employer and employer's address and telephone number. For students, name and address of * 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. Tourism Business Visiting family or friends 25. Duration of the intended stay or transit Single entry Two entries Multiple entrie 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 Yes. Date, if known ……………………………………………………………. 28. Entry permit for the final country of destination, where applicable Issued by ……………………………….Valid from …………………………until………………………………………………. 29. Intended date of arrival 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 accommodation(s) in the Member State(s) Address of inviting person(s)/hotel(s)/temporary accommodation(s) *32. Surname, first name, address, telephone, telefax, and e-mail address of contact person in company/organisation *33. Cost of travelling and living during the applicant's stay is covered by a sponsor (host, company, organisation), please specify: 34. Personal data of the family member who is an EU, EEA or CH citizen Surname First name(s) Date of birth 35. Family relationship with an EU, EEA or CH citizen 37. Signature (for minors, signature of parental authority/legal guardian) * 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. 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)i 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:
Ministry of Foreign Affairs, Piazzale della Farnesina n.1, 00194 Roma.
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
(Garante per la protezione dei dati personali, Piazza Montecitorio n. 121, 00187 Roma) 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.
(for minors, signature of parental authority/legal guardian):

Source: http://www.conslondra.esteri.it/NR/rdonlyres/3F1E85FC-3DBC-4295-BAD5-B0F7FB532FD6/0/Applicationform_new.pdf