Application For Schengen Visa - Embassy Of Italy

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Embassy of Italy
Harmonised application form
PHOTO
Application for Schengen Visa
This application form is free
1. Surname (Family name) (x)
F
OR OFFICIAL USE ONLY
Date of application:
2. Surname at birth (Former family name(s)) (x)
Visa application number:
3. First name(s) (Given name(s)) (x)
Application lodged at
□ Embassy/consulate
□ CAC
□ Service provider
4. Date of birth (day-month-year)
5. Place of birth
7.Current nationality
□ Commercial
intermediary
6. Country of birth
Nationality at birth, if different:
□ Border
8. Sex
9. Marital status
Name:
□ Male □ Female
□ Single □ Married □ Separated □ Divorced □ Widow(er)
□ Other (please specify)
□ Other
10. In the case of minors: Surname, first name, address (if different from applicant's) and nationality of parental
File handled by:
authority/legal guardian
Supporting documents:
□ Travel document
11. National identity number, where applicable
□ Means of subsistence
□ Invitation
□ Means of transport
□ TMI
12. Type of travel document
□ Other:
□ Ordinary passport □ Diplomatic passport □ Service passport □ Official passport □ Special passport
□ Other travel document (please specify)
13. Number of travel document
14. Date of issue
15. Valid until
16. Issued by
Visa decision:
□ Refused
□ Issued:
17. Applicant's home address and e-mail address
Telephone number(s)
□ A
□ C
□ LTV
18. Residence in a country other than the country of current nationality
□ Valid:
□ No
From
□ Yes. Residence permit or equivalent ………………… No. …………………….. Valid until
Until
* 19. Current occupation
Number of entries:
□ 1 □ 2 □ Multiple
Number of days:
1

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