OD1 Referencenumber: 6761842
Application for EU residence document
For internal official use
Signature                                  No digital signature
Submit date                                24-08-2021 14:15
Information about you the applicant
Given name(s)                              Emma
Surname                                    Lissova
Nationality                                Slovakia
Date of birth (dd-mm-yyyy)                 11-12-2001
Country of birth                           Slovakia
Place of birth (city)                      Trstená
Gender                                     Female
Do you have children?                      No
Maritial status                            Unmarried
When did you enter and begin your          22-08-2021
current stay in Denmark? (dd-mm-yyyy)
Telephone number                           50208113
Email address                              emmaliss001@gmail.com
Address in Danmark (street, number, floor Vejrupsgade 24,2
and side)
Postal code                                6000
City                                       Kolding
Last address abroad before entering        S.Furdeka 190/14
Denmark (street, number, floor and side)
Postal code                                02801
City                                       Trstena
Country                                    Slovakia
Danish Agency for International Recruitment and Integration – newtodenmark.dk   Page 1/2
OD1 Referencenumber: 6761842
Information about your passport or national ID card
Which type of ID are you using?               National ID card
Passport number/ID card number                HE015971
Date of issue (dd-mm-yyyy)                    24-11-2016
In which country was the passport or ID       Slovakia
card issued?
Why are you applying for an EU residence document?
On which grounds are you applying for an      I am studying in Denmark
EU residence document?
Do you already have an EU residence           Yes
document and are you applying to change
your grounds for residence?
Sworn declaration and information
I hereby consent to let the Danish Agency     Chosen
for International Recruitment and
Integration (SIRI) share information about
me with my sponsor (family member) to
this greater extent in order to ease the
processing of this application.
I confirm by my signature that I have         Chosen
provided correct information in the
application form and that I have read and
accepted the contents of section A of the
sworn declaration. I also confirm that I
have made a decision regarding whether
or not to consent to share information to a
greater extent. I also understand that the
information I have provided or will provide
will be recorded in SIRI's registers.
Sworn declaration
Signature                                     ..pdf
Submit application
Email address                                 emmaliss001@gmail.com
Has all required documentation been           Yes
attached digitally to this application?
Danish Agency for International Recruitment and Integration – newtodenmark.dk   Page 2/2