Client Form

DATE

AS PER THE PASSPORT:

SURNAME:
FIRST NAME:

DATE OF BIRTH – DD/MM/YYYY

PLACE OF BIRTH

GENDER

MARITAL STATUS

MOBILE NUMBER – including the country

code

EMAIL ADDRESS

COMPLETE PERMANENT ADDRESS

COUNTRY:
STATE/PROVINCE:
CITY:
POSTCODE:
ADDRESS:
COMPLETE CURRENT ADDRESS
COUNTRY:
STATE/PROVINCE:
CITY:
POSTCODE:
ADDRESS:
CURRENT NATIONALITY

NATIONALITY AT BIRTH - if applicable

PASSPORT NUMBER

PASSPORT VALIDITY
ISSUANCE DATE:
EXPIRY DATE:

PASSPORT ISSUING AUTHORITY

RESIDENCE ID NUMBER

RESIDENCE ID EXPIRATION DATE

VISA FILE NUMBER – for UAE only

VISA VALIDITY
ISSUANCE DATE:
EXPIRY DATE:

CURRENT POSITION/JOB

CURRENT EMPLOYER/COMPANY NAME –

as per the visa sponsorship
CURRENT EMPLOYER COMPLETE ADDRESS
COUNTRY:
STATE/PROVINCE:
CITY:
POSTCODE:
ADDRESS:
EMPLOYER CONTACT DETAILS
PHONE NUMBER
EMAIL ADDRESS
ANY ISSUED SCHENGEN/EU VISA
FOR THE PAST 5 YEARS
SCHENGEN/EU VISA ISSUANCE
DATE – if any
FINGERPRINTS COLLECTED FOR
THE PURPOSE OF APPLYING FOR A
SCHENGEN VISA – if any

“I declare that to the best of my knowledge all information above supplied by me are correct and complete. I am
aware that lodging an application or providing documents containing false personal data or false information, as
well as declaring untruth, concealing the truth, falsifying, counterfeiting, or forging a document in order to use it
as authentic or using it as authentic in a national visa procedure will lead to refusing the national visa or annulling
an issued national visa.”

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APPLICANT’S FULL NAME & SIGNATURE