Application For Schengen Visa - English/arabic (Page 4 of 4) in pdf

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 visa application; 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 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)

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 Member State responsible for processing the data is: FPS

Foreign Affairs, Foreign Trade and Development Cooperation rue des Petits Carmes 15 1000 Brussels 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 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 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 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 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.

ٔ ‫أخز انًؼهٕيبد انًطهٕثخ فٙ ْزِ االسزًبسح، أخز طٕسح شخظٛخ نٙ ٔ إٌ نضو أخز ثظًبرٙ، دٛش كم رنك إنضايٛب نذساسخ‬

ٙ‫إَُٙ ػهٗ ػهى ثًب ٚهٙ ٔ يٕافك فّٛ ػهٗ يب ٚه‬

‫انجٓبد انًخزظخ نهذٔنخ‬

ٗ‫فذض ؽهت انزؤشٛشح، ٔ أٌ يؼهٕيبرٙ انشخظٛخ ٔ انًذَٔخ فٙ اسزًبسح ؽهت انزؤشٛشح ٔ كزا ثبنُسجخ ثظًبرٙ ٔ طٕسرٙ سٛسبس إنٗ رجهٛغٓب إن‬

‫انؼؼٕ ٔ سٛزى يؼبنجزٓب يٍ لجم رهك انجٓبد نغشع ارخبر انمشاس ثشؤٌ ؽهجٙ نهزؤشٛشح‬

‫ٔ رخضُٚٓب فٙ َظبو انزؤشٛشاد‬

‫ٔ إٌ ْزِ انًؼهٕيبد ٔ كزا انمشاس انز٘ سٛزخز ثشؤٌ ؽهجٙ أٔ انمشاس انخبص ثئنغبء ٔ سذت ٔ رًذٚذ انزؤشٛشح انًًُٕدخ سٛسبس إنٗ إدخبنٓب‬

ٙ‫ًٚكٍ انٕطٕل إنٛٓب يٍ لجم انجٓبد انًخزظخ ثغٛخ ػجؾ انزؤشٛشاد ػُذ انذذٔد انخبسجٛخ ٔ فٙ انذٔل األػؼبء ٔ جٓبد انٓجشح ٔ انهجٕء ف‬

ٔ ،‫سُٕاد‬

‫خالل فزشح‬

)

( 1

‫ش انًسزكًهٍٛ نٓب أٔ نى‬

ٛ‫خبص غ‬

‫انذٔل األػؼبء ثمظذ انزذمك يٍ أَٓب يسزكًهخ نششٔؽ انذخٕل ٔ انزٕاجذ ٔ اإللبيخ انمبََٕٛخ فٙ أساػٙ انذٔل األػؼبء ٔ انزؼشف ػهٗ األش‬

‫فٙ دبالد يؼُٛخ ًٚكٍ أٚؼب انشجٕع إنٗ انًؼهٕيبد انًذَٔخ يٍ لجم‬

‫ٚسزٕفٕا ْزِ انششٔؽ ٔ كزا ثبنُسجخ نذساسخ ؽهجبد انهجٕء ٔ رذذٚذ انًسؤٔنٛخ ػٍ ْزِ انذساسخ‬

ِ‫ٔ أٌ انجٓخ انًسئٕنخ ػٍ يؼبنجخ ْز‬

ٖ‫خ إسْبثٛخ ٔ جشائى خطٛشح أخش‬

ُ‫انجٓبد انًسئٕنخ ثبنذٔل األػؼبء ٔ انششؽخ األٔسٔثٛخ ثغٛخ انزفبد٘ ٔ انكشف ٔ انجذش ػٍ ج‬

‫ثهجٛكب‬

‫ثشٔكسم‬

‫شبسع‬

ٙ‫انزجبسح انخبسجٛخ ٔانزؼبٌٔ اإلًَبئ‬

‫لٕح دًبٚخ انًُشآد‬

ٌٕ‫سٛك‬

‫انًؼهٕيبد كًب ْٕ انذبل ثبنُست حنجهجٛكب‬

15 1000

Petits Carmes

‫دٔنخ ػؼٕا انمٛبو ثئػاليٙ ثبنًؼهٕيبد انزٙ رخظُٙ ٔانًذخهخ فٙ َظبو انزؤشٛشاد ٔ يٍ انذٔنخ انؼؼٕ انزٙ لبيذ ثُمهٓب ٔأٚؼب‬

‫ٔأَّ صبثذ نذ٘ ثؤَّ ٚذك نٙ أٌ أؽهت يٍ أٚخ‬

‫ظب‬

ٛ‫ٔفٙ دبل ؽهت رنك خظ‬

ََٕٙ‫انمٛبو ثطهت رؼذٚم رهك انًؼهٕيبد انشخظٛخ غٛش انذلٛمخ ٔشطت انًؼهٕيبد انزٙ رخض شخظٙ ٔانزٙ جشٖ انزؼبيم يؼٓب ثشكم غٛش لب‬

‫ٔ انمٛبو ثزؼذٚهٓب أٔ إنغبئٓب‬

ُٙ‫فئٌ انجٓبد انزٙ رمٕو ثذساسخ ؽهجٙ سزؼهًُٙ ثبنطشٚمخ انزٙ ًٚكُُٙ يٍ خالنٓب يًبسسخ دمٙ فٙ انزذمك يٍ انًؼهٕيبد انشخظٛخ انزٙ رخظ‬

‫شبسع‬

139

–

‫نجُخ نذًبٚخ انخظٕطٛخ‬

ٙٓ‫ف‬

‫ثهجٛكب‬

‫فٙ دبل‬

(

‫ٔ دٕل ؽشق رمذٚى انطؼٌٕ انزٙ ٚزؼًُٓب انمبٌَٕ انًذهٙ نهذٔنخ انًؼُٛخ ٔ انجٓبد انٕؽُٛخ انًششفخ‬

Haute

‫سزمٕو ثزهجٛخ انشكبٖٔ انزٙ رخض دًبٚخ انًؼهٕيبد انشخظٛخ‬

)

‫ثشٔكسم‬

1000

ٔ‫ب نشفغ ؽهجٙ أ‬

‫ٔ إَُٙ ػهٗ ػهى ثبٌ كبفخ األلٕال غٛش انظذٛذخ ًٚكٍ أٌ ركٌٕ سجج‬

‫ٔ إَُٙ أطشح دست ظُٙ ثبٌ كبفخ انًؼهٕيبد انًمذيخ يٍ لجهٙ ْٙ طذٛذخ ٔ كبيهخ‬

‫إنغبء انزؤشٛشح انزٙ يُذذ نٙ ٔ ًٚكٍ انزمبػٙ ػذ٘ شخظٛب ؽجمب نزششٚغ انذٔنخ انؼؼٕ انزٙ لبيذ ثمجٕل ؽهجٙ نإلجشاء‬

‫ل ألساػٙ أٔسٔثب انزبثؼخ‬

ٕ‫ٔ لذ جشٖ إػاليٙ ثبٌ دٛبصح رؤشٛشح نٛس ْٕ انششؽ انٕدٛذ نهذخ‬

ٙ‫ٔ إَُٙ أرؼٓذ ثًغبدسح أساػٙ انذٔل األػؼبء لجم اَزٓبء انزؤشٛشح انزٙ رًُخ ن‬

‫لبٌَٕ دذٔد‬

(

2006

562

‫، يٍ َظبو انًجًٕػخ األٔسٔثٛخ سلى‬

‫نهذٔل األػؼبء ٔ أٌ يُذٙ رؤشٛشح ال ٚؼُٙ اَّ نذ٘ انذك ثزؼٕٚغ نٕ خبنفذ ثُٕد انًبدح انخبيسخ، انفمشح‬

‫نذٔل األػؼبء‬

‫إٌ اسزكًبل ششٔؽ انذخٕل سٛزى انزذمك يُّ ػُذ دخٕل أساػٙ ا‬

ٙ‫ٔ ٚشفغ نزنك دخٕن‬

)

ٍ‫شُف‬

‫انًكبٌ ٔ انزبسٚخ‬

)

‫رٕلٛغ ٔنٙ األيش ثبنُسجخ نهمظش‬

(

‫انزٕلٛغ‬

Place and date

Signature (for minors, signature of

parental authority/legal guardian):

‫لذس يب ٚسًخ ثّ ػًم َظبو انزؤشٛشاد‬

)

( 1

In so far as the VIS is operational

Application For Schengen Visa - English/arabic Page 4

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