Visa Application Form Serbia
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2Fotografija / Photo (3.5 cm x 4.5 cm)
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Zahtev za izdavanje vize*
Visa Application Form*
Diplomatsko-konzularno
predstavništvo Republike Srbije
u ______________________________________________
Diplomatic-Consular Mission
of the Republic of Serbia
in _______________________________________________
1. Prezime
Ispunjava ambasada
1. Surname(s) / family name(s)
odnosno konzulat
For embassy
2. Prezime pri rođenju
/consulate use only
2. Maiden name
3. Ime
Datum prijema:
3. First name(s)
4. Datum rođenja (godina-mesec-dan)
5. ID-broj (podatak nije obavezan)
Odgovorno lice:
4. Date of birth (year-month-day)
5. ID-number (optional)
6. Mesto i država rođenja
6. Place and country of birth
Dodatna dokumenta:
7. Državljanstvo
8. Prvobitno državljanstvo (pri rođenju)
7. Current nationality/ies
8. Original nationality (nationality at birth)
□ Validna PI
9. Pol
□ muški
□ ženski
10. Status:
□ neoženjen/neudata
□ oženjen/udata
□ razdvojen/a
□ Finansijska
9. Sex
Male
Female
10. Marital status:
Single
Married
Separated
sredstva
□ Poziv
□ razveden/a
□ udovac/udovica
□ drugo
□ Način putovanja
Divorced
Widow(er)
Other
□ Putno osiguranje
□ drugo:
11. Ime oca
12. Ime majke
11. Father's name
12. Mother's name
13. Vrsta putne
□ nacionalni pasoš
□ diplomatski pasoš
□ službeni pasoš
□ pasoš za izbeglice i apatride (Konvencija iz 1951
isprave
National passport
Diplomatic passport
Official passport
i 1954)
13. Type of travel
Travel document (1951 and 1954 Convention)
document
□ pasoš za strance
□ pomorska knjižica
□ drugi putni dokument (opis):
Alien's passport
Seamen's document
Other travel document (please specify)
Viza:
14. Broj putne isprave
15. Izdata od
14. Number of passport
15. Issued by
□ Odbijena
16. Datum izdavanja
17. Važi do
16. Date of issue
17. Valid until
□ Izdata
18. Da li posedujete dozvolu za povratak u državu boravka - u slučaju da živite u državi koja nije vaša država po poreklu?
18. If you reside in a country other than your country of origin, do you have permission to return to that country?
□ ne
□ da
Broj i rok važnosti
No
Yes
Number and validity period
Vrsta vize:
19. Trenutna profesija
19. Current occupation
□ A
20. Firma, adresa i telefonski broj poslodavca. Za studente, naziv i adresa obrazovne ustanove
□ B
20. Employer and employer's address and telephone number. For students, name and address of school
□ C
21. Država odredišta
22. Vrsta vize:
□ aerodromska tranzitna
□ za kratkotrajni boravak
23. Viza
□ pojedinačna
□ D
21. Country of destination
22. Type of visa:
Airport transit /A/
Short stay /C/
23. Visa
Individual
□ tranzitna
□ za duži boravak
□ grupna
Transit /B/
Long stay /D/
Collective
Broj ulazaka:
24. Zamoljeni broj ulazaka:
25. Broj dana boravka
24. Number of entries requested:
25. Length of visit
□ 1
□ jedan ulazak
□ dva ulaska
□ višekratni ulasci
Molim za vizu za
dana
□ 2
Single entry
Two entries
Multiple entries
Visa is requested for
days
□ Višekratna
26. Druge vize (koje su izdate u poslednje tri godine) i važnost tih viza
26. Other visas (issued during the past three years) and their period of validity
27. U slučaju tranzita: Da li posedujete dozvolu za ulazak u državu u koju ulazite posle Republike Srbije?
27. In the case of transit, do you have an entry permit for the country you are entering after the Republic of Serbia?
□ ne
□ da, sa važnošću do:
Organ izdavanja:
No
Yes, valid until:
Issuing authority:
28. Prethodni boravci u Republici Srbiji:
28. Previous visits to the Republic of Serbia:
Važi od _________
do ______________
* Obrazac je besplatan
* This application form is free
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