Harmonised application form
Application for Schengen Visa
This application form is free
Family members of EU, EEA or CH citizens or of UK nationals who are Withdrawal Agreement beneficiaries shall not
fill in fields no.21, 22, 30, 31 and 32 (marked with*).
Fields 1–3 shall be filled in in accordance with the data in the travel document.
1. Surname (Family name) FOR OFFICIAL USE ONLY
ABDULSALAM
2. Surname at birth (Former family name(s)) Date of application:
3. First name(s) (Given name(s)) Application number:
BASHIRU ADEOLA
4. Date of birth 5. Place of birth 7. Current nationality Application lodged at:
(DD-MM-YYYY)
OTA NIGERIAN Embassy/consulate
25-09-1994 6. Country of birth Nationality at birth, if different Service provider
NIGERIA NA Commercial intermediary
Other nationalities Border (Name):
NA
8. Sex 9. Civil status Other:
Male Single Married Registered Partnership
Female Separated Divorced Widow(er) File handled by:
Other Other (please specify)
10. Parental authority (in case of minors) /legal guardian (surname, first name, address, if different from Supporting documents:
applicant’s, telephone no., email address, and nationality) Travel document
NA Means of subsistence
Invitation
TMI
11. National identity number, where applicable Means of transport
51504711135 Other:
12. Type of travel document
Ordinary passport Diplomatic passport Service passport Official passport
Special passport Other travel document (please specify) Visa decision:
13. Number of travel document 14. Date of issue 15. Valid until 16. Issued by (country) Refused
B51350740 04-12-2024 03-12-2034 ABEOKUTA Issued:
17. Personal data of the family member who is an EU, EEA or CH citizen or an UK national who is a A
beneficiary of the EU-UK Withdrawal Agreement, if applicable C
Surname (Family name) First name(s) (Given name(s)) LTV
NA NA
Date of birth (DD-MM-YYYY) Nationality Number of travel document or ID card Valid:
NA NA NA From:
18. Family relationship with an EU, EEA or CH citizen or an UK national who is a beneficiary of the Until:
EU-UK Withdrawal Agreement, if applicable
Spouse Child Grandchild Dependent ascendant
Registered Partnership Other (please specify) NA Number of entries:
19. Applicant's home address and email address Telephone no. 1
2
HOUSE 5, OKIKI ILU TOWN OFF LEMOMU STREET ATAN 09167240753
Multiple
OTTA OGUN STATE. ABDULOLA563@GMAIL.COM Number of days:
20. Residence in a country other than the country of current nationality
No
Yes Residence permit or equivalent No. Valid until
*
21. Current occupation
DATA ANALYST
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1
*
22. Employer and employer’s address and telephone number. For students, name and address of
educational establishment
JAGI COMMUNICATIONS. 4, ADEBIYI STREET SOMOLU LAGOS STATE.
23. Purpose(s) of the journey
Tourism Business Visiting Family or Friends Cultural
Sports Official visit Medical reasons Study
Airport transit Other (please specify)
24. Additional information on purpose of stay
NA
25. Member State of main destination (and other Member States of 26. Member State of first entry
destination, if applicable)
SWEDEN SWEDEN
27. Number of entries requested
Single entry Two entries Multiple entries
Intended date of arrival of the first intended stay in the Schengen area 14-06-2025
Intended date of departure from the Schengen area after the first intended stay 23-06-2025
28. Fingerprints collected previously for the purpose of applying for a Schengen visa
No Yes Date, if known
Number of the visa, if known
29. Entry permit for the final country of destination, where applicable
Issued by Valid from until
NA NA NA
*
30. Surname and first name of the inviting person(s) in the Member State(s). If not applicable, name of
hotel(s) or temporary accommodation(s) in the Member State(s)
APARTDIRECT HAMMARBY SJOSTAD
Address and email address of inviting person(s)/hotel(s)/temporary Telephone no.
accommodation(s)
120 33, Hammarby Fabriksväg 93, Stockholm 46858886340
*
31. Name and address of inviting company or organisation
NA
Surname, first name, address, telephone no., and email address of contact Telephone no. of company
person in company or organisation or organisation
NA NA
*
32. Cost of travelling and living during the applicant’s stay is covered
by the applicant himself/herself by a sponsor (host, company, organisation), please specify
referred to in field 30 or 31
Means of support other (please specify)
Cash Means of support
Traveller’s cheques Cash
Credit card Accommodation provided
Pre-paid accommodation All expenses covered during the stay
Pre-paid transport Pre-paid transport
Other (please specify) Other (please specify)
33. Surname and first name of the person filling in the application form, if different from the applicant Telephone number
NA NA
Address and email address of the person filling in the application form
NA
I am aware that the visa fee is not refunded if the visa is refused.
Applicable in case a multiple-entry visa is issued:
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I am aware of the need to have an adequate travel medical insurance for my first stay and any
subsequent visits to the territory of Member States.
2
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 and, if applicable, the taking of fingerprints, are mandatory for
the examination of the application; and any personal data concerning me which appear on the
application form, as well as my fingerprints and my photograph will be supplied to the relevant
authorities of the Member States and processed by those authorities, for the purposes of a decision
on my application.
Such data as well as data concerning the decision taken on my application or a decision whether to
annul, revoke or extend a visa issued will be entered into, and stored in the Visa Information System
(VIS) for a maximum period of five years, during which it will be accessible to the visa authorities and
the authorities competent for carrying out checks on visas at external borders and within the
Member States, immigration and asylum authorities in the Member States for the purposes of
verifying whether the conditions for the legal entry into, stay and residence on the territory of the
Member States 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. Under certain conditions the data will be also available to designated authorities of the
Member States and to Europol for the purpose of the prevention, detection and investigation of
terrorist offences and of other serious criminal offences. The authority of the Member State
responsible for processing the data is: The Swedish Migration Agency, 601 70 Norrköping, Sweden,
www.migrationsverket.se.
I am aware that I have the right to obtain, in any of the Member States, notification of the data
relating to me recorded in the VIS and of the Member State which transmitted the data, and to
request that data relating to me which are inaccurate be corrected and that data relating to me
processed unlawfully be deleted. At my express request, the authority examining my application will
inform me of the manner in which I may exercise my right to check the personal data concerning me
and have them corrected or deleted, including the related remedies according to the national law of
the Member State concerned. The national supervisory authority of that Member State (contact
details: Swedish Authority for Privacy Protection, Box 8114, 104 20 Stockholm, Sweden,
www.imy.se) will hear claims concerning the protection of personal data.
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 will lead to my application being rejected or to the annulment of
a visa already granted and may also render me liable to prosecution under the law of the
Member State which deals with the application.
I undertake to leave the territory of the Member States before the expiry of the visa, if granted. I have
been informed that possession of a visa is only one of the prerequisites for entry into the European
territory of the Member States. The mere fact that a visa has been granted to me does not mean that
I will be entitled to compensation if I fail to comply with the relevant provisions of Article 6(1) of
Regulation (EU) No 2016/399 (Schengen Borders Code) and I am therefore refused entry. The
prerequisites for entry will be checked again on entry into the European territory of the
Member States.
Place and date Signature of applicant: (signature of parental authority/legal guardian,
if applicable)
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