Form for granting Power of Attorney

I hereby authorize the following person to act as an agent on my behalf in relation to my visa
application and to represent me in discussions with the Swedish Migration Board on my AuPair permit in Sweden.

Surname, first name of your agent (name of the person you authorize to act on your behalf)

SCANDINAVIAN AU-PAIR CENTER SWEDEN

JON HJALMARSSON / VIKTORIJA KARAPETIAN
The agents address: (contact address)

ULTUNAGATAN 62
Telephone

+46 42 20 44 02

Mobile phone

Postal code

Place / country

25667

HELSINGBORG

E-mail

Fax

scandinavian@aupair.se

+46 42 32 82 39

Information about yourself (person granting the power of attorney):

Surname, first name

Date of birth

Case number / reference number (if you have it available)

Place and date

Signature