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Embassy Application for Cyprus Visa
OrФото This application form is free 1 Photo
Consulate

Family members of EU, EEA or CH citizens or of UK nationals who are Withdrawal Agreement beneficiaries shall not fill in fields
no 22, 23, 31, 32 and 33 (marked with *)
Fields 1-3 shall be filled in in accordance with the data in the travel document

FOR OFFICIAL USE

1. Surname (Family name): ONLY

Date of application:
2. Surname at birth (Former family name(s)):

Application number:
3. First name (s) (Given name) (s):

Application lodged
4. Date of birth 5. Place of birth: 7. Current nationality:
at:
(day–month - year):
6. Country of birth: □
Nationality at birth Embassy/consulate
(if different): □ Service provider
□ Commercial
Other nationalities: intermediary
□ Border (Name):

…………………...
8. Sex: 9. Civil status:
□ Other:

Male
Single Married Registered Partnership Separated File handled by:
Female
Divorced Widow(er) Other (please specify):

10. Spouse’s Name: Spouse’s Date of Birth: Supporting

documents:
□ Travel documents
□ Means of
subsistence
11. Parental authority (in case of minors) / legal guardian (surname, first name, address, if □ Invitation
different from applicant’s, telephone no., e-mail address, and nationality): □ TMI
□ Means of transport
□ Other:
12. Children’s Names: Children’s Date of Birth: Visa decision:
□ Refused
□ Issued:
□A
□C
□ LTV

□ Valid:
13. Type of travel document:
From:
Until:
Ordinary passport Diplomatic passport Service passport
Official passport Special passport Number of entries:
□ 1 □ 2 □ Mult
Other travel document (please specify):
Number of days:
14. Number of travel 15. Date of issue: 16. Valid until: 17. Issued by (country):
document:

18. Personal data of the family member who is an EU, EEA or CH citizen or an UK national who is a Withdrawal
Agreement beneficiary, if applicable:

Surname (Family name): First name (s) (Given name (s)):

Date of birth (day-month-year): Nationality: Number of travel document or ID card:

19. Family relationship with an EU, EEA or CH citizen, or an UK national who is a Withdrawal Agreement
beneficiary, if applicable:

spouse child grandchild dependent ascendant

Registered Partnership other

20. Applicant’s home address and e-mail address: Telephone no.:

21. Residence in a country other than the country of current nationality:

No
Yes. Residence permit or equivalent No Valid until 1

*22. Current ocupation: Monthly income:

*23. Employer and employer’s address and telephone number. For students, name and address of educational
establishment:

24. Purpose(s) of journey:

Tourism Business Visiting family or friends Cultural Sports

Official visit Medical reason Study Airport transit Other (please specify):

25. Additional information on purpose of stay:

26. Member State of main destination (and other Member States of 27. Member State of first entry:
destination, if applicable):

28. Number of entries requested:

Single entry Two entries Multiple entries

Intended date of arrival of the first intended stay in the Republic of Cyprus:
Intended date of departure from the Republic of Cyprus after the first intended stay:
29. Fingerprints collected previously for the purpose of applying for a Schengen visa:
No Yes

Date, if known Visa sticker number, if known

30. Entry permit for the final country of destination, where applicable:

Issued by Valid from until

* 31. Surname and first name of the inviting person(s) in the Republic of Cyprus. If not applicable, name of
hotel(s) or temporary accommodation(s) in the Republic of Cyprus:

Address and e-mail address of inviting person(s)/hotel(s) temporary Telephone no:

accommodation(s):

*32. Name and address of inviting company/organization:

Surname, first name, address, telephone no, and e-mail address of contact Telephone no. of
person in company/organisation: company/organisation:

*33. Cost of travelling and living during the applicant’s stay is covered:

by the applicant by a sponsor (host, company, organisation), please specify:

himself/herself referres to in field 30 or 31
other (please specify)
Means of support:
Means of support:
Cash
Traveller’s cheques Cash
Credit card Accomodation provided
Pre-paid accomodation All expenses covered during the stay
Pre-paid transport Pre-paid transport
Other (please specify): Other (please specify)

I am aware that the visa fee is not refunded if the visa is refused.

Applicable in case a multiple-entry visa is applied for:

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.

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 Cyprus responsible for
processing the data is: Ministry of Foreign Affairs, Presidential Palace Ave., 1447, Nicosia, Tel. +357 22651000, fax +357 22661881,
www.mfa.gov.cy.
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 is Data Protection
Authority in Cyprus, Iasonos str. 1, 1082, Nicosia, tel. +357 22818456, fax +357 22304565, e-mail:
commissioner@dataprotection.gov.cy (dpo@mfa.gov.cy) 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 (signature of parental authority/legal guardian, if applicable):