《Word版申根签证申请表》由会员分享，可在线阅读，更多相关《Word版申根签证申请表（4页珍藏版）》请在金锄头文库上搜索。
1、Application for Schengen Visa This application form is freePHOTO1. Surname (Family name) (x)FOR OFFICIAL USE ONLY Zhang2. Surname at birth (Former family name(s) (x)Date of application:Visa application number:3. First name(s) (Given name(s) (x) SanApplication lodged at Embassy/consulate CAC4. Date o
2、f birth (day-month-year)01 JAN 20005. Place of birth BEIJING6. Country of birth CHINA7.Current nationality CHINANationality at birth, if different: Service provider Commercial intermediary BorderName:8. Sex Male Female9. Marital status Single Married Separated Divorced Widow(er) Other (please specif
3、y) OtherFile handled by: Supporting documents: 10. In the case of minors: Surname, first name, address (if different from applicants) and Travel document nationality of parental authority/legal guardian11. National identity number, where applicable 11010820000101222212. Type of travel document Ordin
4、ary passport Diplomatic passport Service passport Official passport Special passport Other travel document (please specify) Means of subsistence Invitation Means of transport TMI Other:Visa decision: Refused Issued: A C13. Number of travel documentG1234567814. Date of issue 15. Valid until16. Issued
5、 by LTV Valid: From Until17. Applicants home address and e-mail addressTelephone number(s)Room XXX, No. XXX, XXX Road Haidian District, Beijing, China Number of entries: 1 2 MultipleNumber of days:18. Residence in a country other than the country of current nationality No Yes. Residence permit or e
6、quivalentNoValid until* 19. Current occupationFarmer31 DEC 2021Exit 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 th
7、e 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)1 for a maximum period of five years, during w
8、hich 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, s
9、tay 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 de
10、signated 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: FPS Home Affairs, Foreigners Department, Cha
11、usse dAnvers 59b, 1000 Bruxelles Belgium.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 an
12、d 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 accordin
13、g to the national law of the State concerned. The national supervisory authority of that Member State (Commission for the Protection of Privacy - 139, rue Haute, 1000 Brussels) will hear claims concerning the protection of personal data.I declare that to the best of my knowledge all particulars supp
14、lied 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
15、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
16、 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.Place and date Beijing 01 APR 2013Signature (for minors, signature of parental authority/legal guardian):
