MINISTERUL AFACERILOR INTERNE Nr.

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Nr. Data cerere:
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Data progr.:
Serviciul pentru Imigrari al Judetului Ilfov
Operator de date cu caracter personal nregistrat sub nr. 6052 CNP:

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Profesia (Profession): PONTATOR Cod COR: 431301

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Localitatea STEFANESTII DE JOS Strada FLORILOR
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Localitatea BUCURESTI Strada SOS COLENTINA
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FORMULARUL SE VA COMPLETA CU MAJUSCULE

THE APPLICATION SHALL BE FILLED IN CAPITAL LETTERS
LE FORMULAIRE SERA COMPLETE EN MAJUSCULES
 'HFODUDLL Statements
'HFODUSHSURSULDUVSXQGHUHFORFXLHVFvQPRGHIHFWLYODDGUHVD I declare, at my own risk, that I live at the address mentioned in
FRPSOHWDWSHFHUHUH the form
'HFODUFDDPOXDWODFXQRWLQDLVXQWGHDFRUGFD,QVSHFWRUDWXO Declare that I took note and I agree that the General Inspectorate
*HQHUDOSHQWUX,PLJUULvQUHJLVWUDWFDRSHUDWRUGHGDWHFX for Immigration (registered as personal data operator under no.
FDUDFWHUSHUVRQDOVXEQUVSUHOXFUH]HGDWHOHFXFDUDFWHU 6052) processes my personal data, including my biometric data,
personal pe care le-am furnizat, inclusiv datele mele biometrice, in order to apply the legal provisions in the field of migration,
SHQWUXUHJOHPHQWDUHDVWDWXWXOXLPHXSHWHULWRULXO5RPkQLHLL asylum, social integration of the aliens and free movement of
HPLWHUHDGRFXPHQWXOXLGHFOWRULHHOHFWURQLFSHUPLVXOXLGH citizens of the Member States of the European Union and the
HGHUHHOHFWURQLFSHQWUXDSOLFDUHDSUHYHGHULORUOHJDOHGLQ European Economic Area on the Romanian territory.
GRPHQLXOPLJUDLHLD]LOXOXLLQWHJUULLVRFLDOHDVWULQLORUOLEHUHL I am aware that the refusal of providing requested data, necessary
FLUFXODLLSHWHULWRULXO5RPkQLHLDFHWHQLORUVWDWHORUPHPEUHDOH to General Inspectorate for Immigration in order to pursue its
8QLXQLL(XURSHQHL6SDLXOXL(FRQRPLF(XURSHDQ attributions given by law, will determine the impossibility of
'HDVHPHQHDFXQRVFFQHIXUQL]DUHDDFHVWRULQIRUPDLLFDUHVXQW regularization of my stay on the Romanian territory having the
QHFHVDUH,QVSHFWRUDWXOXL*HQHUDOSHQWUX,PLJUULSHQWUX consequence impossibility to be issued the document request.
vQGHSOLQLUHDDWULEXLLORUOHJDOHSRDWHGXFHODQHUHJOHPHQWDUHD I am aware that the registered information are destinate to be
UHJLPXOXLPHXSHWHULWRULXO5RPkQLHLLDUHGUHSWFRQVHFLQ used by the General Inspectorate for Immigration and could be
imposibilitatea de a-mi fi emis documentul solicitat. transmitted, according with Romanian legislation, to the central
&XQRVFIDSWXOFLQIRUPDLLOHvQUHJLVWUDWHVXQWGHVWLQDWHXWLOL]ULL or local public authorities, to Romanian diplomatic missions, to
GHFWUH,QVSHFWRUDWXO*HQHUDOSHQWUX,PLJUULLSRWIL the judicial authorities, to the local health services or to the
FRPXQLFDWHGXSFD]vQFRQGLLLOHOHJLLDXWRULWLORUSXEOLFH banking authorities, as well as to the other institutions which
centrale sau locale, reprezentantelor diplomatice ale Romniei, General Inspectorate for Immigration cooperate with, in light to
DXWRULWLORUMXGHFWRUHWLVHUYLFLLORUORFDOHGHVQWDWHVDX practicing the competences according to the law.
VRFLHWLORUEDQFDUHSUHFXPLDOWRULQVWLWXLLFXFDUH,QVSHFWRUDWXO I am aware and I agree that my personal data are transmitted to
*HQHUDOSHQWUX,PLJUULFRODERUHD]vQYHGHUHDH[HUFLWULL General Direction of Passports- National Unique Center for the
DWULEXLLORUFHOHVXQWGDWHvQFRPSHWHQSULQOHJH Personalization of Electronic Passports/ National Center for
&XQRVFIDSWXOLVXQWGHDFRUGFDGDWHOHPHOHVSRDWIL Managing Databases regarding the Persons Records in order to
WUDQVPLVHFWUH'LUHFLD*HQHUDOGH3DDSRDUWH&HQWUXO personalize, according to the law, the residence permits/the
1DLRQDO8QLFGH3HUVRQDOL]DUHD3DDSRDUWHORU(OHFWURQLFH identity documents and travel documents issued to the
&HQWUXO1DLRQDOGH$GPLQLVWUDUHD%D]HORUGH'DWHSULYLQG aliens/residence cards.
(YLGHQD3HUVRDQHORUvQYHGHUHDSHUVRQDOL]ULLGXSFD]D I know that biometric data collected is stored in the database of
SHUPLVHORUGHHGHUHGRFXPHQWHORUGHLGHQWLWDWHLGRFXPHQWHORU the National System of Records of Aliens and production
GHFOWRULHFDUHVHHOLEHUHD]VWULQLORUFULORUGHUH]LGHQ databases.
&XQRVFIDSWXOFGDWHOHELRPHWULFHSUHOHYDWHVHVWRFKHD]vQ I know that, after customizing documents and send them to the
ED]DGHGDWHD6LVWHPXOXL1DLRQDOGH(YLGHQD6WULQLORULvQ competent authority to issue, biometric data stored in production
ED]HOHGHGDWHGHSURGXFLH databases are cleared by automatic procedure.
&XQRVFIDSWXOFGXSSHUVRQDOL]DUHDGRFXPHQWHORUL I know that digital impressions stored in the database of the
WUDQVPLWHUHDDFHVWRUDODDXWRULWDWHDFRPSHWHQWVOHHOLEHUH]H National System of Records Aliens are deleted by automatic
GDWHOHELRPHWULFHVWRFDWHvQED]HOHGHGDWHGHSURGXFLHVHWHUJ procedure immediately after removal of the documents, and if
SULQSURFHGXUDXWRPDW them are not raised at the scheduled time for their release - not
&XQRVFIDSWXOFLPSUHVLXQLOHGLJLWDOHVWRFDWHvQED]DGHGDWHD later than the end of a period of three months from this time.
6LVWHPXOXL1DLRQDOGH(YLGHQD6WULQLORUVHWHUJSULQ I know that at the documents raise benefit by right to request
SURFHGXUDXWRPDWLPHGLDWGXSULGLFDUHDGRFXPHQWHORULDU checking of electronic date stored in electronic store area in
GDFQXDXIRVWULGLFDWHODGDWDSURJUDPDWSHQWUXHOLEHUDUHD adequate conditions of security and privacy.
acestora, cel trziu la mplinirea unui termen de 3 luni de la I am aware that according to Law no. 677/2001- on the
DFHDVWGDW Protection of Individuals with Regard to the Processing of
&XQRVFIDSWXOFODULGLFDUHDGRFXPHQWHORUEHQHILFLH]GHGUHSWXO Personal Data and the Free Movement of Such Data, amended
de a solicita verificarea datelor stocate n mediul de stocare and completed, I benefit from the right to access to data, the right
HOHFWURQLFvQFRQGLLLFRUHVSXQ]WRDUHGHVHFXULWDWHL of intervention upon the data, the right to object, the right of not
FRQILGHQLDOLWDWH be the subject to an individual decision and the right to address to
&XQRVFIDSWXOFEHQHILFLH]vQFRQGLLLOH/HJLLQU a court law.
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Data (Date) 6HPQWXUD6LJQDWXUH

Nr. solicitare Portal 22050