APPLICATION FOR A VISA FOR A LONG
STAY IN GREECE
PHOTO
THIS APPLICATION FORM IS FREE OF
CHARGE
1 SURNAME (FAMILY NAME)1 HOSSAIN
2 FIRST NAME(S) (GIVEN NAME(S)2 MD UDOI
3 SURNAME AT BIRTH N/A
4 FORMER FAMILY NAME(S) N/A
DATE OF BIRTH 17 APR 2003
5
(DAY-MONTH-YEAR)
6 PLACE OF BIRTH GAZIPUR
7 COUNTRY OF BIRTH BANGLADESH
8 CURRENT NATIONALITY BANGLADESH
NATIONALITY AT BIRTH, IF DIFFERENT FROM N/A
9
CURRENT:
MALE YES
10 SEX
FEMALE
SINGLE YES
MARRIED
SEPARATED
11 MARITAL STATUS DIVORCED
WIDOW(ER)
OTHER
(PLEASE SPECIFY)
SURNAME N/A
IN CASE OF MINORS - FIRST NAME N/A
12 DETAILS OF PARENTAL AUTHORITY/LEGAL
ADDRESS N/A
GUARDIAN
(IF DIFFERENT FROM APPLICANT'S)
NATIONALITY N/A
NATIONAL IDENTITY NUMBER 4210840049
13
(WHERE APPLICABLE)
ORDINARY PASSPORT YES
DIPLOMATIC PASSPORT
SERVICE PASSPORT
14 TYPE OF TRAVEL DOCUMENT SPECIAL PASSPORT
OFFICIAL PASSPORT
OTHER TRAVEL DOCUMENT
(PLEASE SPECIFY)
15 NUMBER OF TRAVEL DOCUMENT B00673084
16 DATE OF ISSUE OF TRAVEL DOCUMENT 11 JUL 2023
17 TRAVEL DOCUMENT VALID UNTIL 10 JUL 2033
18 TRAVEL DOCUMENT ISSUED BY DHAKA
19 APPLICANT'S HOME ADDRESS AMIR KHANI WORD NO 06, BANIYACHONG-3350, HABIGANJ
20 APPLICANT'S E-MAIL ADDRESS
[email protected]21 APPLICANT'S TELEPHONE NUMBER +88 01787709987
NUMBER OF RESIDENCE PERMI OR N/A
RESIDENCE IN A COUNTRY OTHER THAN THE EQUIVALENT T
22
COUNTRY OF CURRENT NATIONALITY RESIDENCE PERMIT OR EQUIVALENT VALID N/A
UNTIL
23 CURRENT OCCUPATION AGRICULTURE
1
In accordance with the data in the travel document.
2
In accordance with the data in the travel document.
RESIDENCE – FAMILY REUNION
RESIDENCE FOR EMPLOYMENT PURPOSES YES
STUDIES, RESEARCH, PRACTICAL
TRAINING, VOCATIONAL TRAINING
RESIDENCE – COMPANY STAFF
24 MAIN PURPOSE OF THE JOURNEY RESIDENCE – INDEPENDENT FINANCIAL
ACTIVITY – INVESTMENT
ACCREDITATION
OTHER
(PLEASE SPECIFY)
25 INTENDED DATE OF ARRIVAL IN GREECE 10 NOV 2024
26 APPLICANT’S ADDRESS IN GREECE Taki Street no. 19, Athens, Greece,PO BOX 1161
A DATA OF THE INDIVIDUAL RESIDENT IN GREECE IN CASE OF APPLYING FOR A RESIDENCE VISA FOR FAMILY REUNION
SURNAME (FAMILY NAME) OF THE RESIDENT N/A
27
INDIVIDUAL IN GREECE
FIRST NAME(S) (GIVEN NAME(S)) OF THE N/A
28
RESIDENT INDIVIDUAL IN GREECE
DATE OF BIRTH OF THE RESIDENT INDIVIDUAL IN N/A
29
GREECE
NATIONALITY OF THE RESIDENT INDIVIDUAL IN N/A
30
GREECE
NUMBER OF THE RESIDENCE PERMIT OF THE N/A
31
RESIDENT INDIVIDUAL IN GREECE
NUMBER OF PASSPORT OF THE RESIDENT N/A
32
INDIVIDUAL IN GREECE
33 INDIVIDUAL RESIDENT’S ADDRESS IN GREECE N/A
34 INDIVIDUAL RESIDENT’S TELEPHONE N/A
35 INDIVIDUAL RESIDENT’S E-MAIL ADDRESS N/A
SPOUSE N/A
CHILD OF THE INDIVIDUAL RESIDENT N/A
FAMILY RELATIONSHIP CHILD OF HIS/HER SPOUSE N/A
36 (OF THE APPLICANT WITH THE INDIVIDUAL
N/A
RESIDENT IN GREECE)
OTHER (PLEASE SPECIFY)
DATA OF THE EMPLOYER OR THE COMPANY IN CASE OF APPLYING FOR A RESIDENCE VISA FOR EMPLOYMENT PURPOSES, INCLUDING
B
SEASONAL WORK
SURNAME (FAMILY NAME) OF THE EMPLOYER OR KONSTA
37
NAME OF THE COMPANY
FIRST NAME(S) (GIVEN NAME(S)) OF THE GEORGIA
38
EMPLOYER OR NAME OF THE COMPANY
SURNAME (FAMILY NAME) OF THE CONTACT
39
PERSON IN THE COMPANY
FIRST NAME(S) (GIVEN NAME(S)) OF THE
40
CONTACT PERSON IN THE COMPANY
41 EMPLOYER OR COMPANY’S ADDRESS Taki Street no. 19, Athens, Greece,PO BOX 1161
42 EMPLOYER OR COMPANY’S TELEPHONE 00306977261279
43 EMPLOYER OR COMPANY’S E-MAIL ADDRESS [email protected]
GREEK RESIDENCE PERMIT OR GREEK’S IDENTITY -
44 CARD OF THE EMPLOYER OR OF THE CONTACT
PERSON IN THE COMPANY
COMPANY’S GREEK TAX NUMBER 046394131
45
DATA OF THE EDUCATIONAL ESTABLISHMENT OR RESEARCH CENTRE IN CASE OF APPLYING FOR STUDYING OR RESEARCH PURPOSES,
C
PRACTICAL TRAINING OR VOCATIONAL TRAINING
NAME OF THE EDUCATIONAL ESTABLISHMENT OR N/A
46
RESEARCH CENTRE
ADDRESS OF THE EDUCATIONAL ESTABLISHMENT N/A
47 OR RESEARCH CENTRE
TELEPHONE OF THE EDUCATIONAL N/A
48
ESTABLISHMENT OR RESEARCH CENTRE
E-MAIL ADDRESS OF THE EDUCATIONAL N/A
49
ESTABLISHMENT OR RESEARCH CENTRE
INTENDED DATE OF START OF STUDIES OR N/A
50
RESEARCH
INTENDED DATE OF END OF STUDIES OR N/A
51
RESEARCH
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 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)3 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 Greece responsible for processing the data is: Ministry of Foreign
52 Affairs, C4 Directorate, 1 Vas. Sofias Ave. GR 10671 Athens, Tel.:+30.210.3684515, Fax:+30.210.3684180, Email: [email protected]
I am aware that I have the right to obtain notification of the data relating to me recorded in the VIS 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 (Hellenic Data Protection Authority, Kifisias str 1-3, 1st floor, GR – 115 23 Athens, Tel.: +30.210.6475600, Fax:
+30.210.6475628, E-mail: [email protected]} 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.
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 Regulation (EC) No 562/2006 (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.
53 I AM AWARE THAT THE VISA FEE IS NOT REFUNDED IF THE VISA IS REFUSED
54 PLACE NEW DELHI
55 DATE 01 OCT 2024
SIGNATURE
56 (FOR MINORS, SIGNATURE OF PARENTAL AUTHORITY/LEGAL
GUARDIAN
3
In so far as the VIS is operational.
