Standard form for determining the State responsible for examining an application for asylum (Text adopted by the Council on 20 June 1994)
Date: 1994-06-20
Institutions: Council of the European Union
Subjects: administrative formalities, admission of aliens, liability, political asylum













EUR-Lex - 31996Y0919(13) - EN






Avis juridique important




|



31996Y0919(13)

Standard form for determining the State responsible for examining an application for asylum (Text adopted by the Council on 20 June 1994)  


Official Journal C 274 , 19/09/1996 P. 0044 - 0048 





ANNEX III.5STANDARD FORM FOR DETERMINING THE STATE  RESPONSIBLE FOR EXAMINING AN APPLICATION FOR ASYLUM (Text adopted by the Council on 20 June 1994) > START OF GRAPHIC>Photo File number Personal particulars of applicant 1. Surname (*).Maiden name.2. Forename(s).3. Does the applicant use/has he /she used other names?   Yes   NoWhat are/were they?.4. Date of birth.5. Place of birth.District/region.Country.6.  Nationality(-ies) (indicate all).(a) current.(b) previous.(c) none/stateless.7. Sex  Male    Female8. Name of father.9. Name of mother.10. Marital status  Single   Married   Widowed   Divorced  11. Address.- current.. - in country of origin.12. Language(s) of origin.(*) In block capitals Personal particulars of family members 13. Spouse:Surname (*), maiden name, forename(s), sex, date of birth, place of residence (If the spouse is seeking asylum, a separate form should be completed) . . 14. Children:Surname (*), forename(s), sex, date of birth, place of birth, place of residence (indicate all children; a separate form should be completed for children over 16 years of age if  asylum is sought) (a) . (b) . (c) . (d) . (e) . 15. Place and date of the application for asylum in the country of residence . . Previous asylum procedures 16. Has the asylum applicant ever previously applied for asylum or recognition of refugee status in  the country of residence or in another country?  Yes   NoWhen and where?..Was any decision taken on  the application?  No   Not known   Yes, refusedWhen was the decision taken?.Identity papers17.  National passport  Yes   No Number. Issued on.By.Valid until.18. Document replacing passport  Yes    No Number. Issued on.By.Valid until.19. Other document  Yes   No Number. Issued on.By.Valid  until.20. In the absence of documents: (specify whether they may have contained a valid visa or residence permit and, if so, indicate the issuing authority and date of issue as well as the period of validity)  Departed   Lost   Stolen Without documents (When, where? . .)   Other reasons (Which? .) .(*) In block capitals Residence documents/visas21. Does the asylum applicant possess a residence document/visa for the  country of residence?  Yes   NoType Residence permit  Entry visa Transit visaIssued on.by.Valid  until.22. Does the asylum applicant possess a residence document/visa for another EU Member State?  Yes  NoWhich State?.Type Residence permit  Entry visa Transit visaIssued on.By.Valid until.23. Does  the asylum applicant possess a residence document/visa for a non-member country? Yes  NoWhich  country?.Type Residence permit  Entry visa Transit visaIssued on.By.Valid until.Travel route24.  Country in which the journey was begun..(country of origin or of provenance).- Route followed from  country where journey was begun to point of entry into country in which asylum is requested..-  Dates and times of travel.- Crossed border on.- At the authorized crossing point, or.- Avoided  border controls (entered illegally) at.- Means of transport used Public transport (what form? .)  Own vehicle Other means (how? .)25. Did the asylum applicant enter via another European Union  Member State? No  Yes- Which was the first EU Member State entered?. .- Crossed border at authorized crossing point, or. .- Avoided border controls at.- When?.Residence in another EU Member State26. Residence in another  EU Member State or States after leaving country in which journey was begun (country of  origin/provenance) No  Yes- In which State or States?.- From - to.- Place/exact address.- Residence was  Authorized   Unauthorized- Period of validity of residence permit.- Purpose of residence..Residence in third  countries (non-members of EU)27. Residence in third country or countries after leaving country in  which journey was begun (country of origin/provenance)  No  Yes- In which third country or countries?.- From - to.- Place/exact address.  Hotel/boarding house    Private accommodation  Camp   Other(Where? .)- Residence was  Authorized   Unauthorized- Period  of validity of residence permit..- Purpose of residence..- Was the asylum applicant in danger of  being expelled/removed?  Yes   No- To which country?.- Why?.- Reasons for continuing  journey.Particulars of family members living in EU Member States or in third countries28. (a) Is  any member of the family recognized in a Member State or in a third country as having refugee  status and as being legally resident there?  Yes   No- Name of family member - State - Address in that State. . . . . .(b) Do any of those concerned object to the examination of the application for asylum in that  Member State or third country?  Yes   No>END OF GRAPHIC>