Your application is held online for a period of 30 days. During this period, it can be retrieved back any time using the transaction number provided
below:
Your unique transaction number is - 43610912
Visa Details
What type of visa are you applying for? Short Stay (C)
Journey Type: Single
What is the reason for travel? Visit Family/Friend
Purpose of Travel
Passport Type: National Passport
Passport/Travel Document Number: AA1294021
Proposed dates you wish to enter and leave Ireland: From: 12/01/2020 To: 11/04/2020
Personal Details
Surname: Croitoru
Forename: Alina
Other Name:
Date Of Birth: 27/04/1999
Gender: Female
Nationality Moldova
Current Location: Moldova
Current Address:
Address Line 1 Rezina , Stefan cel Mare 25/1
Address Line 2:
Address Line 3:
Address Line 4:
Contact Phone: +37379159715
Contact Email: alinacroitoru20@gmail.com
General Information
Length of residence: No Of Years: 20 No Of Months: 7
Do you have permission to return to that country after your stay in Ireland? Yes
Have you applied for an Irish Visa before? No
Have you ever been issued an Irish Visa? No
Please provide location of application or reference number:
Have you ever been refused an Irish Visa? No
Please provide location of application or reference number:
Have you ever been in Ireland before? No
Do you have family members living in Ireland? No
Have you ever been refused permission to enter Ireland before? No
Have you ever been notified of a deportation order to leave Ireland? No
Have you ever been refused a visa to another country? No
Have you ever been refused entry to, deported from, or otherwise required to leave
No
another country?
If yes to any of the above please give details
Have you any criminal convictions in any country? No
Passport Details
Passport/Travel Document Number: AA1294021
Type of Travel Document: National Passport
Issuing Authority/Type: Moldova
Date of Issue: 19/07/2017
Date of Expiry: 19/07/2024
Is this your first Passport? Yes
Employment/College Details
Are you currently employed in your country of residence? Yes
Current Employer: " Jolly Alon " SRL
Duration Of Employment: No Of Years: 1 No Of Months: 1
Position Held: Cook
What is your work address?
Address Line 1: Chisinau , Maria Cibotari 37
Address Line 2:
Address Line 3:
Address Line 4:
Employer's Phone:
Employer's Email:

Are you currently a student in your country of residence? No

Are you travelling with others
Will you be travelling with any other person? No
Contact / Host in Ireland
Contact details for Contact / Host in Ireland.
If you have no personal contact/host please give accommodation name and address.
Address Line 1: Kildare,Clare Gate street,Clare Gate Court apt.25
Address Line 2:
Address Line 3:
Address Line 4:
Contact Phone: +353 89 251 6388
Is the contact/host in Ireland personally known to you (e.g: family / Friends) Yes
Surname/Family Name(as in passport): Botezat
Forename: Ion
Country of Citizenship: Romania
Occupation: Employed
Relationship To Applicant: girlfriend
Department of Justice Reference number(for non-EEA nationals):
Date Of Birth: 11/06/1992
Email: nelubotezat@gmail.com
Your Family
Personal Status: Single
Spouses/Partners details:
Surname / Family Name(as in passport):
Forenames(as in passport):
Other Name(s)(Maiden or name at birth):
Date of Birth:
Passport Number:
Gender:
In what country does your spouse/partner currently live?
Is your spouse/partner travelling with you?
If yes, on applicant's passport?
Children Details
How many dependant children do you have? 0
Please provide the details of any dependant children.
Child 1
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 2
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 3
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 4
Surname:
Forename:"
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 5
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Child 6
Surname:
Forename:
Date Of Birth:
Gender:
Nationality:
Is this child travelling with you?
If yes, on applicant's passport?
Agency Details
Did you receive any assistance in completing this form from an agent/agency? No