Application

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Federal Department of Justice and Police

Online visa system

Application for Schengen Visa


This application form is free of charge

Online ID 000807622

For official use only


Date of application : Supporting documents :
Visa application number : Travel document
File handled by : Means of subsistence
Visa decision : Invitation
Issued C LTV A Means of transport
Refused Travel medical insurance
Valid from : until: Other
Number of 1 2 Multiple Number of days :
entries :

Personal data of the applicant


Surname (Family name) AKTER First name(s) JIASMIN
Surname at birth JIASMIN
Previous surname(s) AKTER
Date of birth (dd.mm.yyyy) 25.02.1992 Minor No
Country of birth Bangladesh Place of birth FARIDPUR
Current nationality Bangladesh Nationality at birth Bangladesh
Other nationalities
Gender Female
Marital status Married Further information (marital
status)
National identity number 8243313320
Family relationship with an Yes Guardian Yes
EU, EEA or CH citizen

Personal data of the legal representative


Surname (s) AKTER First name(s) JIASMIN
Nationality Bangladesh

Travel document of the applicant


Type of travel document Passport Further information (travel
document)
Travel document number CB739099 Issued by Switzerland
Date of issue (dd.mm.yyyy) 19.03.2021 Valid until (dd.mm.yyyy) 19.03.2026

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Home address of the applicant
Additional address c/o AUSSTELLUNGSDATUM
ORT-BEHÖRDE 03 05 2022
Zürich ZH GEBURTSORT
Street / No. AUSSTELLUNGSDATUM P.O. Box / P.O. Box No.
ORT-BEHÖRDE 03 05 2022
Zürich ZH GEBURTSORT
Postcode ZIP / Place Zurich GEBURTSORT Canton / region 21631526.8
Country Switzerland
E-mail mdazmainsorker@gmail.com
Number 01859276557 / Mobile phone

Residence regulations of the applicant


Residence regulations in No
other State
Residence permit no. MA0788989 Valid until (dd.mm.yyyy) 17.03.2027

Occupation of the applicant


Occupation Not applicable Further information
(occupation)

Information on the employer and/or training facility of the applicant


Information on the Name (s)
employer/training facility
Additional address c/o
Street / No. P.O. Box / P.O. Box No.
Postcode ZIP / Place Canton / region
Country
E-mail

Planned travel
Purpose of the journey Visit to family or friends
Additional information Spouse
Member State of destination Switzerland State of first entry in the Switzerland
/ Main purpose of the Schengen area
journey
Number of entries 1
Length of stay in days 90 Arrival date (dd.mm.yyyy) 16.09.2023
Departure date 16.12.2023
(dd.mm.yyyy)

Previous Schengen visas


Fingerprints previously No
recorded
Recording date, if known Visa sticker number
(dd.mm.yyyy)

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Entry permit
Issued by Bangladesh
Valid from (dd.mm.yyyy) 19.03.2021 Valid until (dd.mm.yyyy) 19.03.2026

Information on host and/or accommodation


Regulations regarding stay in Switzerland
Surname(s) MAHMUD First name(s) SHAMIM
Company/Organisation SEF- SERV ESTR E
FRONTEIRAD
Surname(s) of the contact MAHMUD First name(s) of the contact SHAMIM
person person
Additional address c/o AUSSTELLUNGSDATUM
ORT-BEHÖRDE 03 05 2022
Zürich ZH GEBURTSORT
Street / No. AUSSTELLUNGSDATUM P.O. Box / P.O. Box No.
ORT-BEHÖRDE 03 05 2022
Zürich ZH GEBURTSORT
Postcode ZIP / Place 4944 Ausweis Canton / region EU/EFTA
Country Switzerland
E-mail mdazmainsorker@gmail.com
Number +8801857863007 / Mobile phone

Travel and living expenses


By the applicant himself / herself

Cash No Credit card No


Traveller's cheques No Prepaid accommodation No
Transport prepaid No Other No

By a host (referred to in field 31 or 32)

Cash No Accommodation provided No


All expenses covered No Transport prepaid No
during the stay
Other No

Other

Cash No Accommodation provided No


All expenses covered No Transport prepaid No
during the stay
Other No

Family members of EU, EEA or CH


Surname(s) MAHMUD First name(s) SHAMIM
Date of birth (dd.mm.yyyy) 30.09.1988
Nationality Bangladesh
Travel document number MA0788989 Issued by Switzerland
Degree of kinship (1) Spouse / registered
partnership
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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 visa application. Any personal data concerning me which appear on the visa 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 visa 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 State
Secretariat for Migration SEM.
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 State concerned. The national supervisory authority of
that Member State (Federal Data Protection and Information Commissioner PDPIC, Feldeggweg 1, 3003 Bern) 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 5(1) of the Schengen Borders Code and am thus refused entry. The prerequisites for entry
will be checked again on entry into the European territory of the Member States.

Place, date Signature

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