34. Personal data of the family member who is an EU, EEA or CH citizen
ate of birth
mber of travel document or ID card
5. Family relationship with na EU, EEA or CH citizen
6. Place and date
or minors, signature of parental authority/legal guardian):
I am aware that the visa fee is not refunded if the visa is refused.
Applicable in case a multiple-entry visa is applied for (cf. field No 24):
I am aware of the need to have an adequate travel medical insurance for my first stay and any subsequent visits to the territory of Member
I am aware of and consent to the following: the collection of the data required by the 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 my 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 of the Member
States 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)
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 State 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 fulfill 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 prevention, detection and investigation of terrorist offence
of other serious criminal offences. The authority of the Member State responsible for processing the data is the Directorate General for the
Consular Affairs and the Portuguese Communities (DGACCP).
I am aware that I have the right to obtain in any of the Member States notification of the data relating to me recorded in the VIS and of the
Member State Which transmitted the data, 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
national law of the State concerned. The national supervisory authority [Portuguese Data Protection Commission (CNPD) – Rua de São Bento
nº. 148 – 3º, 1200-821 Lisboa – www.cnpd.pt ] 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 under the law of the
Member State which deals with the application.
I undertake to leave the territory of the Member States before the expiry of the visa, if granted. 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.
(for minors, signature of parental authority/legal guardian):
In so far as the VIS is operational.