Annex no. 9 to Minister of Interior Decree no.9/2024 (of II.29.
National Directorate-General for
Aliens Policing
Országos Idegenrendészeti
Főigazgatóság
Application form for a residence permit
For completion by the authority.
The authority receiving the application:
__________________
Date of receipt of the application:
______ year ______ month ____ day
Area designated for the
placement of a facial
photograph
[Handwritten signature specimen of the applicant (legal
representative)]
✓
The signature must be inside the box in its entirety.
PLEASE COMPLETE THE FORM LEGIBLY, IN LATIN BLOCK LETTERS.
✓ First time issuance of a residence permit: Border crossing point as place of entry, date of entry: Budapest , 2024 year
8 month 23 day
Extension of a residence permit: Document number of the residence permit, date of expiry: , year
month day
Telephone number: +994 (70) 595 56 78 Email address: mahdi.mirzayev@gmail.com
Delivery of the document (in case the application is submitted by the applicant, unless the application is for a residence permit
for the purpose of training or for a residence permit for the prupose of studies):
The applicant requests delivery of the document by way of post.
Postal delivery address: place of accommodation of the applicant contact address of the attorney-in-fact
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✓ The applicant will collect the document at the issuing authority.
1. Personal data of the applicant
surname (as shown in the passport): forename (as shown in the passport):
Mirzayev Mahdi
surname at birth: Mirzayev forename at birth: Mahdi
mother’s surname at birth: Mammadova mother’s forename at birth: Mirzayeva
sex: ✓ male female marital status: ✓ unmarried widow(er) married divorced
date of birth: 2003 year 08 month 02 place of birth (locality): Bilasuvar country: Azerbaijan
day
citizenship: Azerbaijani nationality/ethnicity (nonmandatory data):
professional qualification(s): educational attainment: primary occupation before arriving in
secondary Hungary:
Finance Student, Part time auditor
✓ tertiary
2. Particulars of the applicant’s passport
passport number: C04077368 date and place of issuance: 2023 year 10 month 08 day,
Azerbaijan
passport type: ✓ ordinary service/official diplomatic other date of expiry: 2033 year 10 month 08 day
3. Particulars of the applicant’s place of residence in Hungary
parcel postal code: locality: name of the public place:
identification/land
register reference
number (topographical
LOT no.):
type of the public place (i.e. street number: building: stairway: floor: door:
street, road, square, etc.):
legal title of residence in the place of accommodation: owner (sub)tenant family member courtesy user of
accommodation other, specifically:
4. Condition of full health insurance
Do you have full health insurance for the duration of your stay in Hungary?
based on an employment relationship I have funds to cover the costs
I have full health insurance ✓ other, specifically: Provided by scholarship
5. Conditions for return or onward travel
When your legal stay expires, which country will you return or travel onwards to? By which means of transport?
Azerbaijan Air
Do you have the necessary passport? visa? ticket(s)? financial coverage?
✓ yes yes ✓ yes ✓ yes, amount: Stipendium Hungaricum
no ✓ no no no +2000 usd
6. Applicant’s dependent spouse, child, parent
name/degree of place and date of citizenship: legal title of residence: residence visa
relationship: birth: visa permanent residence permit
Kamala Mirzayeva, 01.06.1979 Azerbaijan residence permit national permanent
Mother interim permanent residence residence permit
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permit immigration permit
EC permanent residence EU Blue Card
permit
Residence document number:
interim residence card
EU residence card
✓ does not reside in Hungary
national residence card
other, specifically:
name/degree of place and date of citizenship: legal title of residence: residence visa
relationship: birth: visa permanent residence permit
residence permit national permanent
interim permanent residence residence permit
permit immigration permit
EC permanent residence EU Blue Card
permit
Residence document number:
interim residence card
EU residence card
national residence card
does not reside in Hungary
other, specifically:
name/degree of place and date of citizenship: legal title of residence: residence visa
relationship: birth: visa permanent residence permit
residence permit national permanent
interim permanent residence residence permit
permit immigration permit
EC permanent residence EU Blue Card
permit
Residence document number:
interim residence card
EU residence card
national residence card
does not reside in Hungary
other, specifically:
name/degree of place and date of citizenship: legal title of residence: residence visa
relationship: birth: visa permanent residence permit
residence permit national permanent
interim permanent residence residence permit
permit immigration permit
EC permanent residence EU Blue Card
permit
Residence document number:
interim residence card
EU residence card
national residence card
does not reside in Hungary
other, specifically:
7. Other details
Permanent or habitual place of residence (prior to your arrival in Hungary):
Country: Azerbaijan Locality: Sumgait Name of the public place: Saray
Are you a holder of a valid residence permit document in another Schengen Member State? yes ✓ no
type and number of the permit:
date of expiry: year month day
Have you ever had a rejected application for a residence permit before?
yes ✓ no
Have you ever been sentenced for a crime before? If yes, in which country and when, for what crime, and what was your punishment,
sentence?
yes ✓ no
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Have you ever been expelled from Hungary, if yes, when?
yes ✓ no
year month day
To your knowledge, do you have any of the contagious diseases of HIV/AIDS, or tuberculosis, hepatitis B, syphilis/lues, leprosy,
typhoid fever that require medical treatment, or are you a carrier of the infectious agent of HIV, hepatitis B, typhoid or paratyphoid
fevers in your body?
yes ✓ no
If you suffer from any of the diseases specified above, or if you are contagious or a carrier of infectious disease pathogens, do you
receive compulsory and regular medical treatment with regard to the said diseases?
yes ✓ no
8. I hereby declare that the minor child of mine indicated in my passport is travelling to Hungary together with me.
yes ✓ no
Please note that if your minor child indicated in your passport is travelling to Hungary together with you, Appendix ”A” must
be attached to/enclosed with your application.
9. Planned duration of stay and reasons
Until when are you applying for a residence permit? 2026 year 07 month 30 day
I hereby declare that the reason for my stay in Hungary is:
Guest self-employment (Appendix no. 9.2)
Guest investor (Appendix no. 9.3)
Seasonal employment (Appendix no. 9.4)
Employment for the purpose of investment (Appendix no. 9.5)
Employment (Appendix no. 9.6)
Residence permit for guest workers (Appendix no. 9.7)
Hungarian Card (Appendix no. 9.8)
EU Blue Card (Appendix no. 9.9)
Intra-corporate transfer (Appendix no. 9.10)
Research or (long-term) mobility of researchers (Appendix no. 9.11)
National Card (Appendix no. 9.12)
✓ Pursuing studies or student mobility (Appendix no. 9.13)
Seeking a job or starting a business (Appendix no. 9.14)
Training (Appendix no. 9.15)
Traineeship (Appendix no. 9.16)
Official (Appendix no. 9.17)
White Card (Appendix no. 9.18)
Posted work (Appendix no. 9.19)
Medical treatment (Appendix no. 9.20)
Voluntary service (Appendix no. 9.21)
Residence permit for reasons of Hungarian national interest (Appendix no. 9.22)
Family reunification (Appendix no. 9.23)
10. I hereby declare that all data indicated in this application and in the appendix/appendices
attached/enclosed are true and correct. I understand that submission of false data or information shall result in the refusal of
the application.
Date: ..................................................... Signature: .....................................................
11. I hereby declare that I undertake voluntarily departure from the territory of the Member States of the European Union
in case a final decision is made on my application case for a residence permit. (to be completed if the application is submitted in
Hungary)
Date: ..................................................... Signature:.....................................................
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12. I undertake to leave the territory of the Member States of the European Union and other Schengen States within 8 days of
the date on which my residence permit ceases to be valid.
In this context, I declare that I am going to undertake voluntary departure and fulfil my obligation to leave to
as a country which is considered a safe country of origin or a safe third country for me, where I will not be
at risk of persecution on grounds of race, religion, nationality, membership of a particular social group or political opinion, or
as defined in Article XIV(3) of the Fundamental Law of Hungary.
The country of expulsion is:
a state where I have my habitual place of residence and that I am allowed to enter with the following permit:
type and number of the permit: ,
the/a state of my citizenship,
a state that I am allowed to enter with the following permit:
type and number of the permit: ,
It is known to me that if I do not comply with the provisions of the decision of expulsion by the deadline specified in the
decision, the immigration authority will carry out the expulsion under law enforcement escort and impose a ban on my entry
and stay.
Date: ..................................................... Signature: .....................................................
Transaction number of payment if made by an electronic payment instrument or by a bank deposit:
For completion by the authority.
If the application is approved
I hereby approve the applicant’s residence in Hungary for the purpose of _________________________ until ______ year ____
month ___ day.
Date: ......................................... Signature, stamp: .....................................................
Document number of the residence permit issued and handed over: ______________________________
I received the residence permit.
Date: ......................................... Signature of the applicant: ..........................................
In case of extension, the document number of the residence permit withdrawn: ______________________________
If the application is refused
Number of the resolution on refusal: ______________________________
Date of the refusal: ______ year _____ month ___ day
Legal basis of the refusal:
If the procedure is terminated
The number of the decision of termination: ______________________________
Date of the decision: ______ year _____ month ___ day
Legal basis of the decision: ______________________________
