Вы находитесь на странице: 1из 3

CEA/23

CEA/23 For Office Use Only Application number Department for Citizenship and Expatriate Affairs 3, Castille Place

For Office Use Only

Application number

Department for Citizenship and Expatriate Affairs 3, Castille Place VALLETTA Application for a residence permit for Non-EU/EEA nationals

(being persons who are not nationals of EU Member States, Iceland, Liechtenstein or Norway)

N. B. This form should be completed by a residence permit holder in respect of family members

1. Details of Residence Permit holder

Surname

Name

Nationality

Residence permit application number

Maltese ID Card number

Address in Malta

Phone

Fax

 

E-mail

2. Details of Person for whom a Residence Permit is required

Surname

Forename(s)

Present Nationality / Nationalities

Birth date

Day

 

Month

 

Year

   

/

   

/

   

Place of birth

Foreign permanent address

Address in Malta

Relationship to residence permit holder:

Former surname

Relationship to residence permit holder: Former surname Maltese ID card number Former Nationality / Nationalities
Relationship to residence permit holder: Former surname Maltese ID card number Former Nationality / Nationalities
Relationship to residence permit holder: Former surname Maltese ID card number Former Nationality / Nationalities

Maltese ID card number

permit holder: Former surname Maltese ID card number Former Nationality / Nationalities Gender Male
permit holder: Former surname Maltese ID card number Former Nationality / Nationalities Gender Male
permit holder: Former surname Maltese ID card number Former Nationality / Nationalities Gender Male
permit holder: Former surname Maltese ID card number Former Nationality / Nationalities Gender Male
permit holder: Former surname Maltese ID card number Former Nationality / Nationalities Gender Male
permit holder: Former surname Maltese ID card number Former Nationality / Nationalities Gender Male

Former Nationality / Nationalities

Gender

Male

Female

Country of birth

Former surname Maltese ID card number Former Nationality / Nationalities Gender Male Female Country of birth
Former surname Maltese ID card number Former Nationality / Nationalities Gender Male Female Country of birth
Former surname Maltese ID card number Former Nationality / Nationalities Gender Male Female Country of birth
Passport number Country of issue Place of issue Date of issue Valid until Day Month
Passport number
Country of issue
Place of issue
Date of issue
Valid until
Day
Month
Year
Day
Month
Year
/
/
/
/
Date/s of previous/current residence in Malta (if any):
From:
To:
From:
To:

3. Application details

Application is being made for:

First Residence Permit Transfer of current Permit to a new passport* Extension of current permit*

*Current Residence permit number

*Current Residence permit number

For the Period

Day

Day Month Year Day Month Year

Month

Day Month Year Day Month Year

Year

Day Month Year Day Month Year

Day

Day Month Year Day Month Year

Month

Day Month Year Day Month Year

Year

/ / 2 0 To / / 2 0
/
/
2
0
To
/
/
2
0

4. Supporting documents

Spouse

Numbers: 1, 2, 3, 4, 5, 6

Minor child

Numbers: 1, 2, 3, 4, 5, 6, 7 and/or 8 (if applicable)

Other family member

Numbers: 1, 3, 4, 5, 6 (others as the case may be)

List of documents:

 

Tick documents enclosed with this application

1

2 x Photographs (two recent coloured passport size photos)

2

Marriage certificate

3

Proof of financial resources

4

Evidence of sickness insurance

5

Passport (or photocopy of passport –part containing details– in case of applications sent by post – authenticated by a police officer)

6

Birth certificate

7

Documentation of parental authority (if parents are divorced/separated)

8

Declaration of consent of father/mother (when minors are not accompanied by both parents)

9

Present residence permit (in case of permit extension or transfer of permit to a new passport)

10

 

11

 

12

 

5. Declaration

I hereby solemnly declare that the information given in this application is true to the best of my knowledge and belief and that no details have been omitted that could be of decisive importance when the application is considered.

Signature:

Date

Form completion instructions for a residence permit application for family members

-‘Applicant’ refers to a Residence Permit holder who is already residing in Malta or to a person who has submitted an application for such a permit.

- Applying for a residence permit in respect of a family member

The Applicant should complete this form:

either in respect of the spouse

or in respect of a child (under 18 years of age)

The fee for a residence permit (valid for 1 year or less) is Lm10, paid at the time of application. FEES ARE NOT REFUNDABLE

Any application that contains omissions or is incorrectly completed will be returned to the Applicant.

- Documentation

All required documents together with photocopies thereof ( + English translations, if applicable) should be presented with an application.

Applicant must attach two recent coloured photographs in respect of the person whose name appears on the application.

- Rules

The passport shall have a validity period at least equivalent to or longer than the validity period of the Residence Permit.

If false information has been deliberately given, or a matter has been concealed which would have led to the rejection of the application, the residence permit will be revoked.

- Data

Information furnished in this application may be forwarded to other Government Departments during the examination of the case.

The information supplied by you (the applicant) in connection with the processing of your application for a residence permit will be registered in the Residence database for which the Maltese Immigration Authorities are responsible. All the relevant information that you supply subsequently in connection with your application for a residence permit will also be registered in the Residence database.

This information will be used when considering issues regarding your residence in Malta and the Police, the Ministry for Justice and Home Affairs as well as other relevant authorities or organizations may receive information about you from the Residence database.

20/12/2006