Surname (Family name)
Surname at birth (Former family name(s))
First name(s) (Given name(s))
Date of birth (day-month-year)
Place of birth
Country of birth
Current nationality
Nationality at birth, if different:
In the case of minors: Surname, first name, address (if different from applicant’s) and nationality of parental authory/legal guardian
National identity number, where applicable
Type of travel document
Official passport
Number of travel document
Date of issue
Valid until
Issued by
Applicant’s home address, e-mail address
Telephone number(s)
Residence in a country other than the country of current nationality
Current occupation
Employer and employer’s address and telephone number. For students, name and address of educational establishment.
Member State(s) of destination
Member State of first entry
Number of entries requested
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 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 accordance with the data in the travel document.
No
Yes. Date(s) of validity from to
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 arrival in the Schengen area 30 Intended date of departure from the Schengen area
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)
*31
Address and e-mail address of inviting person(s)/hotel(s)/temporary
accommodation(s)
Telephone and telefax
*32 Name and address of inviting company/organisation Telephone and telefax of company/organisation
Surname, first name, address, telephone, telefax and e-mail address of contact person in company/organisation
by the applicant himself/herself
Means of support
Cash
Traveller’s cheques
Credit card
Prepaid accommodation
Prepaid transport
Other (please specify)
by a sponsor (host, company, organisation), please
specify
Means of support
Cash
Accommodation provided
All expences covered during the stay
Prepaid transport
Other (please specify)
referred to in field 31 or 32
other (