Form T Mv Sr 11-055 - Application For Visa Of The Slovak Republic

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Stamp of embassy or consulate
Application for visa of the Slovak Republic
Photo
This application form is free
1. Surname(s) (family name(s))
For embassy/consulate
use only
2. Surname(s) at birth (earlier family name(s))
Dátum prijatia žiadosti:
3. First name(s) (given name(s))
4. Date of birth (year-month-day)
5. ID number (optional)
Spis spracoval:
6. Place and country of birth
7. Current nationality/ies
8. Original nationality (nationality at birth)
Podporné doklady:
9. Sex
10. Marital status:
platný cestovný doklad
male
female
single
married
separated
finančné prostriedky
divorced
widow(er)
other
pozvanie
dopravný prostriedok
11. Father’s name and surname
12. Mother’s name, surname and earlier name
zdravotné poistenie
ďalšie/iné:
13. Type of passport:
national passport
diplomatic passport
service passport
travel document (1951 Convention)
alien’s passport
seaman’s passport
other travel document (please specify):
.......................................................................................................................................................................
14. Number of passport:
15. Issued by
16. Date of issuance
17. Valid until
18. If you reside in a country other than your country of origin, have you permission to return to that
country?
no
yes,
Vízum:
(number and validity)............................................................................................
odmietnuté
* 19. Current occupation
udelené
* 20. Employer and employer’s address and telephone number. For students, name and address of school.
Charakteristika víza:
21. Country (place) of destination
22. Type of visa
23. Visa
A
airport transit
transit
individual
B
C
shortstay
longstay
collective
D
24. Number of entries requested
25. Duration of stay
single entry
two entries
Visa is requested for: ______ days
multiple entries
26. Other visas (issued during the past three years) and their period of validity
Počet vstupov:
1
2
27. In the case of transit, have you an entry permit for the final country of destination?
viac (multi)
no
yes, valid until:
Issuing authority:
Platnosť od........................
* 28. Previous stays in the Slovak Republic
Platnosť do........................
Doba pobytu......................
...........................................
*
The questions marked with * do not have to be answered by family members of citizens of the Slovak Republic (spouse, child or dependent ascendant).
Family members of citizens of the Slovak Republic have to present documents to prove this relationship.
T MV SR 11-055
XI/2003

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