Application for Schengen Visa

FOTO

This application is free
1. Surname (Family name) (x)

FOR OFFICIAL USE ONLY

2. Surname at birth (Former family name(s)) (x)Date of application:

3. First name(s) (Given name(s)) (x)Visa application number:

4. Date of birth (day-month- year)

8. Sex□ Male5. Place of birth

7. Current nationality

6. Country of birth

Nationality at birth, if different:

9. Marital status□ Single□ Married □ Separated □ Divorced□ Widow(er)□ Other (please specify)□ Female

10. In the case of minors: Surname, first name, address (if different from applicant’s) and nationality ofparental authority/legal guardian

Application lodge at□ Embassy/consulate□ CAC□ em Prestadores de serviços□ em Intermediários comerciais□ na fronteira

Name:□ Other
File handled by:

11. National identify number, where applicable
12. Type of travel document:□ Ordinary passport □ Diplomatic passport □ Service passport□ Other travel document (please specify):□ Official passport

13. Number of travel document

15. Valid until

14. Date of issue

17. Applicant’s home address and e-mail address□ Special passport
16. Issued byTelephone number(s)18. Residence in a country other than the country of current nationality□ No□ Yes. Residence permit or equivalent……………..................................No ...................... Valid until

Supporting documents:□ Travel document□ Means of subsistence□ Invitation□ Means of transport□ TMI□ Other:
Visa decision:□ Refused□ Issued:
□A
□C
□ LVT
□ Valid:
FromUntil
Number of entries:□ 1 □ 2 □ Multiple* 19. Current occupation

Number of days:* 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□ Medical reasons □ Study □ Transit □ Airport transit□ Cultural □ Sports □ Official visit□ 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 entries

25. 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 theirright 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 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 ................................. to ……………………..........
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 and e-mail address of inviting
person(s)/hotel(s)/temporary accommodation(s)Telephone and telefax*32. Name and address of inviting company/organization

Telephone and telefax of comp./organization

Surname, first name, address, telephone, telefax, and e-mail address of contact person in company/organization*33. Cost of travelling and living during the applicant’s stay is covered□ by the applicant himself/herself□ by a sponsor (host, company, organization), please specify□ referred to in field 31 or 32□ others (please specify):

Means of support□ Cash□ Traveller’s cheques□ Credit card□ Prepaid accommodation□ Prepaid transport□ Other (pls. specify):

Means of support□ Cash□ Accommodation provided□ All expenses covered during the stay
□ Prepaid transport□ Other (pls. specify):
34. Personal data of the family member who is an EU, EEA or CH citizen
SurnameFirst 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 (for minors, signature of parental authority/legal guardian):

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 the application form and the taking of my photograph and, if applicable, the taking of fingerprints, are mandatory for the examinationof the visa application; and my 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 Statesand 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)1 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 State for the purposes of verifying whether theconditions 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 fulfill these conditions, of examining an asylum applicationand 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 prevention, detectionand investigation of terrorist offences and of other serious criminal offences. The authority of the Member State responsible for processing the data is the Directorate General for the Consular Affairs and thePortuguese Communities (DGACCP).
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 tome 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[Portuguese Data Protection Commission (CNPD) – Rua de São Bento nº. 148 – 3º, 1200-821 Lisboa – www.cnpd.pt ] 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 alreadygranted 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 theMember 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.

Place and date

Signature (for minors, signature of parental authority/legal guardian):