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UNDERTAKING

I,

the

undersigned,

Mr

/

Mrs ………………………………… confirm being aware that,

Passport number …………………………

if I am issued a Schengen visa for a longer period than applied for, then during all my future travels into Schengen territory, I

shall be obliged to possess an insurance for the entire period of stay similar to the one I obtained during my initial travel.

This shall also apply to any children / dependents who may be accompanying me in the said Schengen territory.

Date:

Signature