Harmonised application form

Application for Schengen Visa

This application form is free

Family members of EU, EEA or CH citizens or of UK nationals who are beneficiaries of the EU-UK Withdrawal
Agreement shall not fill in fields No. 21, 22, 30, 31 and 32 (marked with*).

Fields 1–3 shall be filled in in accordance with the data in the travel document.

1. Surname (Family name): FOR OFFICIAL USE ONLY

2. Surname at birth (Former family name(s)):

Date of application:

3. First name(s) (Given name(s)):

Application number:

4. Date of birth (day 5. Place of birth: 7.Current nationality: Application lodged at:
month year):

6. Country of birth: Nationality at birth, if □ Embassy/consulate

different:
□ Service provider
Other nationalities:
□ Commercial intermediary

8. Sex: 9. Civil status: □ Border (Name):

□ Male □ Single □ Married □ Registered Partnership □

□ Female Separated □ Divorced □ Widow(er) □ Other (please ………………………………………
□ Other specify):
□ Other:

10. Parental authority (in case of minors) /legal guardian (surname, first name, File handled by:
address, if different from applicant’s, telephone no., e mail address, and nationality):

11. National identity number, where applicable: Supporting documents:

□ Travel document

□ Means of subsistence

12. Type of travel document: □ Invitation

□ Ordinary passport □ Diplomatic passport □ Service passport □ Official passport □ TMI

□ Special passport □ Other travel document (please specify):
□ Means of transport

□ Other:

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13. Number of 14. Date of issue: 15. Valid until: 16. Issued by Visa decision:
travel document: (country):
□ Refused

□ Issued:
17. Personal data of the family member who is an EU, EEA or CH citizen or a UK
national who is a beneficiary of the EU-UK Withdrawal Agreement, if applicable
□A

□C
Surname (Family name): First name(s) (Given name(s)):
□ LTV

Date of birth Nationality: Number of travel □ Valid:

(day-month-year): document or ID card:
From:

Until:
18. Family relationship with an EU, EEA or CH citizen or a UK national who is a
beneficiary of the EU-UK Withdrawal Agreement, if applicable:

□ spouse □ child □ grandchild □ dependent ascendant □ registered partnership

□ other:

19. Applicant's home address and email Telephone no.:

address:

20. Residence in a country other than the country of current nationality:

□ No

□ Yes.
Residence permit or equivalent……………
No. ……………
Valid until……………

21. *Current occupation: Number of entries:

□ 1 □ 2 □ Multiple

22. *Employer and employer’s address and telephone number. For students, name
and address of educational establishment: Number of days:

23. Purpose(s) of the journey:

□ Tourism □ Business □ Visiting family or friends □ Cultural □ Sports □ Official visit

□ Medical reasons □ Study □ Airport transit □ Other (please specify):

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24. Additional information on purpose of stay:

25. Member State of main destination (and 26. Member State of first entry:
other Member States of destination, if
applicable):

27. Number of entries requested:

□ Single entry □ Two entries □ Multiple entries

Intended date of arrival of the first intended stay in the Schengen area:

Intended date of departure from the Schengen area after the first intended stay:

28. Fingerprints collected previously for the purpose of applying for a Schengen visa:

□ No □ Yes.

Date, if known ……………………..

Visa sticker number, if known …………………………………………………………

29. Entry permit for the final country of destination, where applicable:

Issued by ………………………………..
Valid from ……………………until ……………………

30. *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 and email address of inviting Telephone no.:

person(s)/hotel(s)/temporary
accommodation(s):

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31. *Name and address of inviting company/organisation:

Surname, first name, address, telephone no., Telephone no. of

and e-mail address of contact person in company/organisation:
company/organisation:

32. *Cost of travelling and living during the applicant’s stay is covered:

□ by the applicant: □ by a sponsor (host, company,

organisation), please specify:

Means of support:
…….□ referred to in field 30 or 31
…….□ other (please specify):
□ Cash
□ Traveller’s cheques
□ Credit card
□ Pre-paid accommodation Means of support:
□ Pre-paid transport
□ Other (please specify): □ Cash
□ Accommodation provided
□ All expenses covered during the
stay
□ Pre paid transport
□ Other (please specify:

Surname and first name of the person filling in the application form, if different from
the applicant:

Address and email address of the person filling Telephone no.:

in the application form:

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

Applicable in case a multiple-entry visa is issued:

I am aware of the need to have 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 application;
and any personal data concerning me which appear on the 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 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) 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 Ministry of Foreign Affairs of Denmark or the Danish
Immigration Service. Read more about the responsible of data and the processing of personal data at
www.newtodenmark.dk/visa_personaldata.

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 Member State concerned. The national supervisory authority of that Member State [the Danish
Data Protection Agency, Carl Jacobsens Vej 35, DK-2500 Valby, 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 6(1) of Regulation (EU) 2016/399 (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 of applicant:

(signature of parental authority/legal guardian, if applicable):

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