Serbia Visa Application Form - Visa Center Order Form (Page 7 of 7) in pdf

29. Svrha putovanja

Ispunjava ambasada

29. Purpose of travel

odnosno konzulat

For embassy

□ turizam

□ poslovna poseta

□ poseta rođaku ili prijatelju

□ kultura/sport

□ službena poseta

/consulate use only

Tourism

Business

Visit to family or friends

Cultural/Sports

Official

□ zdravstveni

□ drugi razlozi (molimo da ih navedete):

razlozi

Other (please specify):

Medical reasons

30. Planiran datum dolaska u Republiku Srbiju

31. Planiran datum odlaska iz Republike Srbije

30. Intended date of arrival in Republic of Serbia

31. Intended date of departure from Republic of Serbia

32. Granični prelaz pri ulasku u Republiku Srbiju

33. Prevozno sredstvo

32. Border post of first entry or transit route

33. Means of transport

34. Ime lica ili naziv firme, koja vas poziva. U slučaju firme, ime kontakt osobe. U slučaju turističke posete, ime i adresa hotela ili privremena adresa u Republici

Srbiji

34. Name of host or company in the Republic of Serbia and contact person in host company. If not applicable, give name of hotel or temporary address in the

Republic of Serbia

Ime

Telefon i faks

Name

Phone and telefax

Potpuna adresa

E-mail

Full address

E-mail

35. Ko snosi troškove vašeg putovanja i boravka?

Navedite ko i kako i priložite odgovarajuće dokaze o tome

35. Who is paying for your travel and living costs?

State who and in what way, and present corresponding documentation

□ molilac za vizu

□ osoba koja poziva

□ firma koja poziva

Myself

Host person(s)

Host company

36. Novčana sredstva za izdržavanje

36. Means of support during your stay

□ gotovina

□ putnički čekovi

□ kreditne kartice

□ smeštaj

□ drugo:

Cash

Traveller's cheques

Credit cards

Accommodation

Other:

□ putničko ili zdravstveno osiguranje. Važi do:

Travel and/or health insurance. Valid until:

37. Prezime supružnika

38. Prezime supružnika pri rođenju

37. Spouse's family name

38. Spouse's maiden name

39. Ime supružnika

40. Datum rođenja supružnika

41. Mesto i država rođenja supružnika

39. Spouse's first name

40. Spouse's date of birth

41. Spouses's place and country of birth

42. Deca (Za svaki pasoš mora da se ispuni poseban formular)

42. Children (Application must be submitted separately for each passport)

Prezime

Ime

Datum rođenja

Surname

First name

Date of birth

43. Slažem se da se lični podaci u ovoj molbi pošalju odgovarajućim organima Republike Srbije, u slučaju kada je to potrebno za izdavanje vize.

Izjavljujem da su gornji podaci tačni i potpuni.

Svestan/na sam, da će zbog moguće lažne izjave moja molba za vizu biti odbijena, odnosno, da će već izdata viza biti poništena.

Obavezujem se da ću napustiti teritoriju Republike Srbije do isteka važnosti, u slučaju izdavanja vize.

Upoznat sam da je izdavanje vize samo jedan od preduslova za ulazak na teritoriju Republike Srbije.

43. I am aware of and consent to the following: any personal data concerning me which appear on this visa application form will be supplied to the relevant

authorities in the Republic of Serbia and processed by those authorities if a visa is required.

I declare that to the best of my knowledge all particulars supplied by me are correct and complete.

I am aware that my false statements will lead to my application being rejected or to the cancellation of a visa already granted.

I undertake to leave the territory of the Republic of Serbia 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 territory of the Republic of Serbia.

44. Adresa molioca

45. Telefon, E-mail

44. Applicant's home address

45. Phone, E-mail

46. Mesto i datum

47. Potpis (za maloletne, potpis roditelja

46. Place and date