Application for Schengen Visa PHOTO

This application form is free

1. Surname (Family name): FOR OFFICIAL USE ONLY

OYESANMI

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

ADEWALE

3. First name(s) (Given name(s)): Visa application number:

KAFAYAT

4. Date of birth (day-month-year): 5. Place of birth: 7.Current nationality: Application lodged at

28/12/1990 LAGOS NIGERIA
□ Embassy/consulate
□ Service provider
6. Country of birth: Nationality at birth, if different: □ Commercial intermediary
NIGERIA □ Border (Name)

Other nationalities: ……………………..............

.
8. Sex: 9. Marital status: ……………………………..
.
□ Male  Female □ Single  Married □ Registered Partnership □ Separated □ Other
□ Divorced □ Widow(er) □ Other (please specify)

10. In the case of minors: parental authority/legal guardian (surname, first name, address, if different from applicant's,
telephone number, e-mail address and nationality): File handled by:

Supporting documents:

11. National identity number, where applicable: □ Travel document

80056115418 □ Means of subsistence
□ Invitation
12. Type of travel document: □ Means of transport
□ TMI
 Ordinary passport □ Diplomatic passport □ Service passport □ Official passport □ Special passport □ Other:
□ Other travel document (please specify)

13. Number of travel document: 14. Date of issue: 15. Valid until: 16. Issued by (country): Visa decision:
B50578716 06/10/2023 05/10/2033
□ Refused
□ Issued:
17. Personal data of the family member who is an EU, EEA or CH citizen: □A
□C
Surname (Family name): First name(s) (Given name(s)): □LTV

□ Valid:
From……………………
Until…………………….
Date of birth (day-month-year): Nationality: Number of travel documents or ID card:
Number of entries:
□ 1 □ 2 □ Multiple

18. Family relationship with an EU, EEA or CH citizen: Number of days:

□ spouse □ child □ grandchild □ dependent ascendant □ registered partnership □ other

1
19. Applicant's home address and e-mail address: Telephone number(s):
86, GASKIYA ROAD, BADIYA LAGOS STATE

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

No
□ Yes. Residence permit or equivalent ……………………..………… Number……….…………………….. Valid until …………………………….

* 21. Current occupation:

EMPLOYEE

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

23. Main purpose(s) of the journey:

 Tourism □ Business □ Visiting family or friends □ Cultural □ Sports □ Official visit

□ Medical reasons □ Study □ Airport transit □ Other (please specify)

24. Additional information on purpose of stay:

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

27. Number of entries requested:

Single entry □ Two entries □ Multiple entries

Intended date of arrival of the first intended stay in the Schengen area:

Intended date of departure from the Schengen area after the first intended stay:

28. Fingerprints collected previously for the purpose of applying for a Schengen visa: □ No □ Yes.

Date, if known………………………..……...Visa sticker number, if known………………………………………………

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

Issued by ……………………………………………..Valid from …………………………until……………………………

* 30. Surname and first name of the inviting person(s) in the Member State(s). If not applicable, name of hotel(s) or temporary accommodation(s) in the
Member State(s)

Address and e-mail address of inviting Telephone number:

person(s)/hotel(s)/temporary accommodation(s): (34) 916312510
SERCOTEL POZUELO ASCEND HOTEL
COLLECTION

*31. Name and address of inviting company/organisation:

Surname, first name, address and e-mail address of contact Telephone number of company/organisation:
person in company/organisation:

*32. Cost of travelling and living during the applicant's stay is covered:

2
 by the applicant □ by a sponsor (host, company, organisation), please specify:
□ referred to in field 30 or 31
himself/herself. Means of support: □ other (please specify)………………………………….
Cash
□ Traveller's cheques Means of support:
□ Credit card □ Cash
□ Pre-paid accommodation □ Accommodation provided
□ Pre-paid transport □ All expenses covered during the stay
□ Other (please specify) □ Pre-paid transport
□ 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 (cf. field no 27):

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; and 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.
In Spain, the authority responsible for processing the data is the consular post at which the visa was applied for.

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 [in the Spanish case, the Agencia Española de Protección de Datos; calle Jorge Juan, número 6 (C.P.28001)
–https://www.aepd.es/es/derechos-y-deberes/conoce-tus-derechos/derechos-schengen, 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 (EC) No 399/2016 (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 (for minors, signature of parental authority/legal guardian):

LAGOS - 28/03/2024

*Family members of EU, EEA or CH citizens shall not fill in fields number 21, 22, 30, 31 and 32 (marked with *).
* Fields 1-3 shall be filled in in accordance with the data in the travel document.