Place and date Your signature
9 Signature
8 Power of attorney
Have you been charged with a criminal offence? If yes, in which police district/country?
Have you ever been convicted of a criminal offence in
Norway or abroad?
If yes, when and where were you convicted?
7 Criminal offences
The Immigration Act requires that there are no circumstances that give grounds to deny you access to
Norway, or a permit to live or work here. Such grounds may include convictions for criminal offences.
If you have been charged, the Directorate of Immigration can wait until the matter has been claried to
process your application.
Sentence Type of offence
Have you served the sentence/paid the ne (or is the probation period over)?
The information will be registered in the computer system for immigrant and refugee cases (DUF).This
information may also be used in relation to later applications and applications from family members.
Your information may be passed on to other relevant authorities in order to check and obtain more
details of the information you have given. Where necessary, information about you will also be collected
from other Norwegian and foreign authorities, including the police. This will not be carried out where
consideration for your safety so determines. If you are granted a permit, information on this will be
entered in the National Population Register.
It is a punishable offence to give materially incorrect or clearly misleading information, including omis-
sion of information of material signicance. In addition to criminal charges, breach of the Immigration
Act or the Norwegian Penal Code may lead to rejection or expulsion and registrationin the Schengen
Information System (SIS). Any permit granted based on incorrect or incomplete information may be
withdrawn.
UDI will use your phone number and e-mail address to contact you in the further application process in
this and future applications. It is therefore important that you check that you agree to receive information
about your case on sms / e-mail.
I hereby conrm that the information given in this application is correct and complete.
I accept to receive information about my case on sms / e-mail.
Yes
No
Fine (amount): Prison (days):
- not older than two
years
- Conditional prison. Not older than ve years.
- Unconditional prison. Not older than 10 years.
I am aware that correspondence from the immigration authorities will be sent to my representative,
and that my representative will have access to my case.
I am aware that my representative will be notied of the decision instead of me.
I give the following person power of attorney to act on my behalf in connection with my application.
Representative’s family name Representative’s rst name
Representative’s address Postcode Town
Country Telephone Cell phone number E-mail
Yes
No
Yes
No, explain