3a npunpesen npectoj Ips nar: Tiacow na erpancnor ~ npenenento xaj onaacten eyackn npeseaysas HBSRERERO RA Ota _ ZunzoMa 3a sanpiieno oGpaxonanne- npencneHa Kaj oRmaCTEN cy/ACKH Npeneay KAY H 3806} Ynepennja Cepriiuxarnnpencae Kaj opacten cyaicKH mpenenyeass Tea Texoania cocroj6a aa bupwara . OGpaanorxemne aa norpeGuTe on ypaGorynarse Ha crpavtet. * Jloronop 2a npaGorynaive = NOpPeyy boar ‘© Vonoa na poremte 1a crpanetior ~ npeveerto kaj omtacten cynexn npeseaysas fiSabepenONaNGR + Yoepenmte 2a apskavjanierso - npesezeno Kaj osnacten eyackn npeseayoas HigabepevolnaNGTan © oxas aewa ne ce posit xpii ‘kaj onmacreH cysickn mpenea sranka npoTHB CTpaHeuoT O71 MaTH4HaTa seMja On cya ~ peBeneHO peHO HAHOTEP « Jloxas alexa ne e ocyaysan_crpaneuor on MarHunaTa seMja om cys - npeBeneHo Kaj OBsIacTeM cy;I¢KH npewexynay WJanepexo Ha Hota ‘© Cpeaersa 3a xnmectie ~ orosop 3a Kupitja te nlostat oat Gaparbero © Cpeacroa 3a wsapaynarve ~ TeKostla cocroj6a M orosop sa paGora nomefy Hero M dupmata © 4 Gororpapun oa crpanenor 3 x 3.5 em on horocryano ‘© 3apancrseno ocurypysaise 3a crpaneuor (acriTumaunja, KHMUIKa) — Oo HeKoja OcHTypHTenHa KyKa Ho Fenresija 20KOnKY HeMa CTPaHickO sapawcTseHo OCUTypYBaIvE-TaTHHYKO OCHTYpyBAIbe * TIpwjasa 2a npecroj xa crpaneuor (Kapronieto) ~ botoxonnja * Bapare 3a nsnanaine 203801 3a npispeen npectoj—TIOTONIHETA ATWIMKALIMJA !!! co narena yriaruiua PAT-50 aenapH. Ynaatunuun sa Fpampemen [Ipectoj Llen na 2oanaka “aamant.rakea 3a o6paxenor 3a Gapatbero 3a npHapemen mpectoj, usnoc “50 apu, Hasna H ceamuTe va npxMasor “Byuer ma PM“, Gauka wa npiwanot “HBPM“, ‘TpantcaxuneKa emersa “100000000063095", cweTka ta GyuetcKH KopHeHiax “0600100124 631 12%, npuxoana wnppa m mporpana “724122 20%, waits “2*) Len Ha J03HaKa “aaMuNraKea 3a OOpasenor 4a TosHOAATA 3a MpHBpeMen MpecToj", HsH0C “190 xenapm', Hasna 1 ceamure Ha npaMasior “Byuer ua PM“, Gaiika tia npnwasor “HBPM*, ‘rpaneaxunesa ewerxa “100000000063095", cwerka Ha GyuercKH KopHcHitk “0600100124 631 12%, Inpuxoania wnippa 1 nporpasta “724122 20%, nasunt “2") et Ha aoavaKa “ANMMTaKea 3A HBAABAIKE Ha TOsBOAIA 3a MpMBpemeH mpecToj*, wHoC “1S enpa, Has v ceamurre Hla npuwavor “Tpesopeka emerka", Ganka Ha npawaor “HBPM,cwerka 1000000063095, ynzarua cmerxa “840 115 03161", npxxoaxa umibpa « nporpama “722313 00" en Ha osHaKa “AAMIRMETpATHBHa TaKea 3a onOGeHNe 3a MpHBpemen mpecroj*, HsH0c “20 cupa xe. nporuspeanoct*,ceamuite Ha npuMasor “Tpesopeka emerka%, Ganka Ha npuMasior “HBPM*,cmerca 1000000063095", ynarxa cmerka “840 115203161, npuxoaxa unpa u nporpama “722313 00"fO6paseu Gp. 2 Hasne wa opranot ao Koj ce nogMecysa GaparseTo Fpnemen wrem6un (Name of the receiving authority) (Stamp of receipt) BAPAIbE 3A OfOBPYBAHE/NPODOMKYBAHE NPMBPEMEH NPECTOI (APPLICATION FOR GRANTING/EXTENSION OF TEMPORARY RESIDENCE) pso wsqasawe C NpoROMKYBaIbE Ha AOZBONATA 3a NPMBPEMeEHHOT NPECTO} (First issue) (Extension of the temporary residence permit) Tipeaume (Surname) NopakewHo/poneHo npesmme (Previous surname/surname given at birth) Vime (Given Name) = = Mon (sex): mauixo (male) meHcKo (femal Mime Ha poqurenute (Names of parents) ther) majxa (mother a, MECTO M Ap'aBa Ha pafatee (Date, place and country of birth) Dpxasjancrao (Nationali Marka ncnpasa Ha noqHocuTenot Ha Gapatbero (Travel document of the applicant): Haanemes oprat Koj ja w3aan naTHata Menpasa (The issuing competent authority) Mecto m fatym Ha w3nasatbe (Place and date of issue) 5poj (Number) sani Ao (valid until) Pow Ha Baxelbe Ha nocneako Apumennuo (Period of validity o W3aaneHo onoGpenne 3a npectoj, AoKONKy e the last issued residence permit, if plicable} Darym na snes Bo Peny6nuxa Cesepa Makegonnja (Date of entry into the Republic of North Macedonia) a) o6apcka 3a noceayearve susa (visa requirement): 3 aa (yes): © He(no) 6) Bu3a 6poj (visa number) sax ao (valid until) _ wsqaqaena of (issued by) ~ 3anwmatse (Profession) > Bpawa cocroj6a (Marital status) HeKeHeT/Hemanena (single) © MeHeT/mankena (married) 5 Bgoseu/eqosnua (widowed) 5 paseener/passenena (divorced)Aapeca 80 Peny6nnka Cesepna Maxenonnija (Address in the Republic of North Macedonia): Anpeca 80 crpancrao (Address abroad) LMC RoR Uenure nepuonor 3a wou ce 6apa nossonata 3a npuspemen npectoj (The reasons and the period for which temporary residence permit is requested): Flonaroun 32 nayero eps ocHoRa Ka wu cratyc Bo Peny6nnKa Cesepna Maxenonnja ce 6apa noasona 3a npwspemen npecroj (Information about the person on the basis of whose status the temporary residence permit in the Republic of North Macedonia is requested), 2) Mpeswme w nme (Surname and given name) ©) Bary, mecto u apwasa va pafarse (Date, place and country of birth) 8) Apxasjancrao (Nationality) ‘1 Crarye na senor Wa cemejnara saeannua (Status of the family member) © Cemejna aaequnua (family union) © Barym na cunyuysarse Ha 6} Cemejnn ogmocu (Family re PaKor (date of conclusion of marriage) lationship) i Craryc ce Gapa aossona 3a npuspemen CoecTOl MMa ABYT PerMerpApaH BpaveN APyrap CO Koj Beke muse 80 Pemyenmn Cesena Maxenonnja? (Does the person based on whose status the temporary residence permit is requested has another registered spouse with whom s/he already lives in the Republic of North Macedonia?) 0 aa (yes) 2 we (no) f) Bann ponwrenckoro npaso Ha Aereto 2a Koro ce Gapa uajasaibe Ha noseona 3a MpwBpeme npectoj € noneneHo? (Is the parental right to the child for which ‘temporary residence permit is requested shared?) c a (yes) c He (no) ©) Mogaroux oa natwara wenpaea a apnasjannn Ha Peny6nuKa Cesepna Makenonnja/erpaney oj wma perynupan cratye 80 Peny6auka Cesepna Maxenonuja (Data from the passport of the citizen of the Republic of North Macedonia/alien who has a regulated status in the Republic of North Macedonia): 5poj Ha narHa vcnpasa (number of passport) AaTym wa wapazaibe (date of issue) CO pox Ka Bamwiocr Ao (valid until) %*) Anpeca a ApMasjaHnn Wa Peny6nuKa Cesepwa Maxegounia /cpaHey 80 Peny6nuka Ceeepna Makenonuja (Address of the citizen of the Republic of North Macedonia/alien in the_-~—-Republic._~—of_—sNorth Macedonia) npujasen on (Registered from): 3) Bo caysaj Wa Henocroeibe Ha saeqHiuKa agpeca Ha KHBeeibe, Be MonMMe Aa rH waBeneTe npnuniire. (If there is no common permanent residence, please specify the reasons), —s) Nogaroun 3a 3aKoHcKMoT npecTo] Ha crpaHeyor |p3 ocHoBa Ha 4Kj craryc ce Gapa A0380na 3a npuBpemen npecroj (Data on the legal residence of the alien based on whose status temporary residences permit is requested): 4) Nogatoun 3a noctoeie Ha cpeacTea 3a w3Apysaiee Ha CrpaNeUor eps OcHOBa a nj cratyc ce apa aos8ona 3a Npuspemen npectoj (Data on the existence of ‘means for subsistence the alien on the basis of whose status a temporary res Permit is required): j) Mogaroun 3a 3apascrseno ocHrypysarse Ha cTpaHeuoT 8p3 OcHoBa Ha uj craTyc ce Gapa qo3sona 3a npHepemex npectoj (Health insurance data of the alien based on whose status a temporary residence permit is required): = MogaToun 3a noceaysaise cpegcrea 3a w3ApyKysatbe Ha NoAHOCHTeNOT Ha 6apareero (Information regarding subsistence means of the applicant}: = Mogaroun 3 o6e36eneHo cmecTysaive 80 PenyGnnka CesepHa Makenonja win eka wma cpeacrsa 3a cmecrysaise (Information regarding accommodation in the Republic of North Macedonia or possession of means for accommodation): ~ Mopatous 3a sapaactaeno ocurypysaise (Information regarding health insurance): - Mlogaroun exa rm HcnonHysa ycnosHTe 32 ogo6pysatse npuBpemen npectoj 3apagy pasnvynn npusMHn cornacHo 3aKoHOT 32 crpanum (*) (Information on fulfilment of conditions provided for separate types of temporary residence permit in accordance with the Law on Aliens): = Kon Gapavero ra npunomysam cnequuTe Roxymenti (I enclose the following documents to the application): Bug Ha O6pa3z0sanne (Type of education) ~ Mpeasnpeno tpaeise Ha npecrojor (Period of intended stay): oalfrom ao(until): - Mpwunna 3a noaNecysaise Ha Gapatsero (Reasons for application): ~ 3aspwna wajasa (Final statement): a) Co 08a notepaysam qeKa cHTe nofaToyn HaBeAeHM BO TONKMTe 1-24 ce YenocHH, BMCTAHMTH M OproBapaaT Ha NOAaTOUMTe BO NPHNOMeHHTe AOKYMeHTH. MloTEPAUTe KOM ce Ha Apyr ja3Hk, npunomenn ce Ha MaKeaoHcKH npesoa, (Hereby I confirm that all information given under items 1-24 are complete, they are true and correspond to the data contained in the documents attached. Certificates made in a foreign language are attached in their Macedonian translation.)6) Co ova ce o6spaysam qeka cexoja nomena Ha nuYHUTe NoAaTOUMTe, NPEA BNeIOT BO Peny6nuxa Cesepna Maxenonuja Ke rm qocrasam Ha HajnemKHuTe opraHH Bo Peny6nuKa Cesepna Maxenonija, npexy ANNnOMATCKOTO, DAHOCNO KOHIYNApHO NpecTaBHHUITEO Ha Peny6nnxa Cesepa Maxenonsija. (Hereby | undertake, that | will communicate any change of my personal data to the Macedonian competent authorities through diplomatic or Nsular missions of the Republic of North Macedonia before entering the Republic of North Macedonia.) 8) ViasBecten cym qeKa MOwTe AMNHM noAaTOUK, co Yen CocraBysarbe Ha 3aNICHAK M apxnanparbe Ke Gugat undopmatwuKn OGpaGoren. (I take note that my personal data are electronically processed for the purpose of making minutes and filing,) 1) Mazecren cy eka 3apaAH HENOTHONHW MAK HeTONK NOAATOUM MOeTO Bapatbe MOME Aa Sueno. (| have been advised that my application may be refused on account of Guae o) incomplete and inaccurate data, Bo (i Wa en Morne Ha noqnocurenor wa Gaparbero (Signature of the applicant) Mecro 3a hotorpaduja 3x3,5cm Photo ONHYBa NOMKUMCKHOT CAYKGEHHK Ha OpraHoT AO Koro @ nogHeceHo Gaparsero (To be ed out by the Police Officer of the receiving authority} Kako peuieHo Gaparsero (Reply to the request) _ Bpoj Ha pewennero 3a onoGpysaise Ha npHapemen npecroj (Number of decision on grant of temporary residenc Ao xo} gaTym e onoGpen npuepemennor npectoj (The period of temporary residence is granted until). 2 Zany arse /NpoAOMKyBaE Ha OAOSpeHeTO 3a npHEpemeH npectoj (Data of issue/extension of the temporary residence) Tlonuyncin caym6ennx Police Officer)