Application for a National Visa PHOTO

This application form is free

1. Surname (Family name) (x) PARTE RESERVADA A LA

ADMINISTRACIÓN

2. Surname at birth (Former family name(s)) (x) Fecha de la solicitud:

Número de la solicitud de
3. First name(s) (Given name(s)) (x) visado:

Expediente gestionado por:

4. Date of birth (day-month-year) 5. Place of birth 7.Current nationality

Documentos presentados:
6. Country of birth Nationality at birth, if different:
□ Documento de viaje
□ Autorización gubernativa
8. Sex 9. Marital status □ Solicitud de autorización
gubernativa
□ Male □ Female □ Single □ Married □ Separated □ Divorced □ Widow(er) □ Medios de subsistencia
□ Other (please specify) □ Prueba de alojamiento
□ Certificado médico
10. In the case of minors: Surname, first name, address (if different from applicant's) and nationality of parental □ Certificado de antecedentes
authority/legal guardian penales
□ Seguro médico de viaje
□ Nota Verbal
□ Otros:

11. National identity number, where applicable

Decisión sobre el visado:
12. Type of travel document
□ Denegado
□ Ordinary passport □ Diplomatic passport □ Service passport □ Official passport □ Special passport
□ Other travel document (please specify) □ Expedido:
Válido desde …………
hasta ………………….
13. Number of travel document 14. Date of issue 15. Valid until 16. Issued by
Número de entradas:

17. Applicant's home address and e-mail address Telephone number(s) □ Una □ dos □ múltiples

Número de días:

18. Residence in a country other than the country of current nationality

□ No
□ Yes. Residence permit or equivalent ………………… No. …………………….. Valid until

* 19. Current occupation

(x) Fields 1-3 shall be filled in in accordance with the data in the travel document.

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20. Main purpose of the journey:

□ Residence without work permit □ Residence – Temporary work (9 months in 1 year)

□ Residence – Family reunion □ Studies
□ Residence – Employee □ Research (within the framework of an agreement signed by a research centre)
□ Residence – Self-employed □ Accreditation

21. Intended date of arrival in Spain 22. Number of entries requested: □ Single entry □ Two entries □ Multiple entries

23. Applicant’s address in Spain

24. Data of the individual resident in Spain in case of applying for a residence visa for family reunion

Surname (Family name) and first name(s) (Given name(s)) of the resident individual in Spain

Family relationship (of the applicant with the individual resident in Spain)
□ dependent direct relative in the ascending line of the individual resident
□ Spouse or the spouse or partner
□ Registered partner □ dependent person when the individual resident holds the parental
□ Child (of the individual resident or the spouse) authority/is the legal guardian

Date of birth Nationality Spanish Alien’s Identity Number (NIE) or number of the Spanish
National Identity Card (DNI)

Individual resident’s address in Spain Individual resident’s telephone

Individual resident’s e-mail address

25. Data of the employer or the company in case of applying for a residence visa for employees, self-employed or temporary work

Surname (Family name) and first name(s) (Given name(s)) of the employer or name of the company and surname (Family name) and first name(s) (Given
name(s)) of the contact person in the company

Employer or company’s address Employer or company’s telephone

Employer or company’s e-mail address

Spanish Alien’s Identity Number (NIE) or number of the Spanish National Identity Card (DNI) of the employer or of the contact person in the company

Company’s Spanish Tax Identification Code (CIF)

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26. Data of the educational establishment or research centre in case of applying for a student or research visa

Name of the educational establishment or research centre

Address of the educational establishment or research centre Telephone of the educational establishment or research centre

E-mail address of the educational establishment or research centre

Intended date of start of studies or research Intended date of end of studies or research

In case of temporary stay of children with the purpose of studying in Spain within the framework of a program of a Public Administration, a non-profit
organisation or a charity or other establishment or persons who do not hold their parental authorities/are not their legal guardians:

Surname (Family name) and first name(s) (Given name(s)) of the person responsible or name of the organisation and surname (Family name) and first
name(s) (Given name(s)) of the contact person in the organisation

Address of the person responsible or organisation Telephone of the person responsible or organisation

E-mail address of the person responsible or organisation

Spanish Alien’s Identity Number (NIE) or number of the Spanish National Identity Card (DNI) of the person responsible or of the contact person in the
organisation

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 are mandatory for the examination of the visa application.
Any personal data concerning me which appear on the visa application form, as well as my
photograph, will be supplied to the relevant authorities 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 will be entered into, and stored in a database. The controller is the Consular
Post at which the visa was applied for. Data shall be accessible to the visa authorities and the
authorities competent for carrying out checks on visas at external borders and in Spain, immigration
and asylum authorities for the purposes of verifying whether the conditions for the legal entry into,
stay and residence on the territory of Spain 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.

I am aware that I have the rights of access, correction and deletion of personal data relating to me
and the right to object to the processing thereof, pursuant to the provisions contained in the Ley
Orgánica 15/1999, de 13 de diciembre, de Protección de Datos de Carácter Personal, by addressing
a request to the Dirección General de Asuntos y Asistencia Consulares of the Ministry of Foreign
Affairs and Coopeartion; calle Ruiz de Alarcón 5, 20871 – Madrid (Spain).

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 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 shall lead to my application being rejected or to the annulment of
a visa already granted.

I am aware that once the visa request has been submitted, a copy of the form, sealed with the
indication of the date and place of reception, shall be returned to the applicant and that arrangements
can be made with the applicant as to the channel to request corrections or the supply of documents or
certificates, as well as to serve notice of summons and to notify the decision adopted in due course.

Notices and requests shall be served by telephone or fax to the contact number provided by the
interested party or his/her legal representative. If they were to prove ineffective, they shall be served
in writing to the domicile set out in the application, which must be located within the consular
district.

Summons and requests served must be complied with within a period not exceeding ten days, unless
personal attendance is required in which case the deadline is fifteen days.

Once all the possibilities of serving a notice have been exhausted, the notice shall be served by
means of an announcement posted at the relevant notice board of the Embassy or Consulate during
ten days.

If no reply is received to a request or summons, the applicant shall be deemed to have withdrawn his
request and the resolution establishing this to be the case shall be notified to him.

Decisions on a visa application shall be notified within one month of the date of the lodging of an
application, except for residence visas without work permit. In this case, decisions shall be notified
within three months, but the request for the residence authorisation that has to be issued by the
competent Delegación or Subdelegación del Gobierno shall interrupt the computation of this period
of time until this authorisation is notified to the Embassy or Consulate.

The visa once granted must be collected within a month, unless it is a visa for family reunion or a
visa for study purposes; in these cases, it must be collected before two months elapse. If a visa is not
collected within the aforesaid period, the applicant shall be deemed to have renounced to the visa
granted and the proceedings shall be filed.

I am aware that the visa fee is not refunded if the visa is refused.

27. Place and date 28. Signature (for minors, signature of parental authority/legal guardian)