Department of Justi

OFce, EqualitAND
y and Law Reform
FORM EU1
DEPARTMENT JUSTICE EQUALITY
Irish
IRISH Naturalisation &Immi
NATURALISATION grationService
& IMMIGRATION SERVICE

Application for a Residence Card 2018-05

For non-EEA national family member

This form is to be completed by each non-EEA national applying for a residence card as the family member of a European Union,
EEA or Swiss citizen under the European Communities (Free Movement of Persons) Regulations 2006 and 2008.

 This form must be completed in BLOCK CAPITALS. Where indicated, please place a tick (  ) in the appropriate box.

 You must fill out a separate application form for each non-EEA national seeking a residence card, including each minor child.

 All sections must be completed as required. Both declarations in Section 5 must be signed. Incomplete applications cannot be processed
and will be returned.

 Please note that certain documents are required to be submitted with this form and some of those documents must be original. The
Department will return original documents to you by Registered Post. Please refer to the checklist in Section 4 of this form.

 If you are presently unable to provide any of the information or details requested in any of the relevant sections, please explain the
reasons in a letter and enclose it with this application form.

 You and the EU citizen of whom you are a family member may be required to attend for an interview in connection with this application.

 A decision will be taken on the application no later than six months from the date of receipt of a fully completed application form with the
relevant supporting documentation.

 While your application is being processed at this office, the onus is on you, the applicant, to advise this office of any change in your
circumstances (including change of residence or change in activities of the EU citizen). You must submit new supporting documentation
as appropriate.

Section 1 Applicant Details

1.1 Surname / Family name (as in passport)

1.2 Forename(s) (as in passport)

1.3 Other name(s) (maiden name, name at birth, any other names by which you are or have been known)

1.4 Date of Birth 1.5 Gender (please tick) 1.6 PPS Number

Day Month Year Male Female

1.7 INIS Person ID Number (if applicable) 1.8 Old Department Reference Number (if applicable)

– 6 9
1.9 Nationality

1.10 Relationship to EU citizen (please tick)

Spouse Child Dependent Parent

Civil Partner Grandchild Dependant Grandparent

Form EU1 (2018-05) - Page 1 of 8

1.11 Contact Telephone Number

1.12 Email Address

1.13 Current Residential Address in Ireland

1.14 Passport Number

1.15 GNIB Registration Number (if applicable) 1.16 Date of arrival in the State

Day Month Year

1.17 Place of arrival in the State

1.18 Status on arrival in the state (please tick)

Asylum-seeker Visitor

Student Employment Permit or Green Card Permit

Family member of EU citizen Other

If "Other", please give details:

1.19 Have you previously resided in the State? Yes No

(If "yes", please give details)

1.20 Have you been convicted of any criminal offence in the State or abroad? Yes No
(If "yes", please give details)

1.21 Are there any charges pending against you in the State or abroad? Yes No
(If "yes", please give details)

1.22 Have you ever been deported from the State? Yes No

1.23 Are you currently subject to a Deportation or Transfer Order made in Ireland? Yes No

Deportation Transfer
(If "Yes", please specify)
Order Order

Form EU1 (2018-05) - Page 2 of 8

 Section 2 Details of EU citizen of whom the applicant is a family member

2.1 Surname / Family name (as in passport)

2.2 Forename(s) (as in passport)

2.3 Other name(s) (maiden name, name at birth, any other names by which you are or have been known)

2.4 Current Residential Address in Ireland

2.5 Date of Birth 2.6 Gender (please tick) 2.7 PPS Number

Day Month Year Male Female

2.8 Nationality 2.9 Date of arrival in the State

Day Month Year

2.10 Passport or National Identity Card Number 2.11 Identification type (please tick)

Passport National ID Card

2.12 Department Reference Number (if applicable) 2.13 Contact Telephone Number

6 9
2.14 Email Address

Section 3 Current activity of the EU citizen in the State

3.1 Type of activity (please tick)

(A) Employment (B) Self-employment (C) Study

(D) Involuntary unemployment (E) Residing with sufficient resources

Please fill out Parts (A - E) below as applicable to the current activity of the EU citizen in the State.
NOTE: it is important to provide accurate contact details for employer/college as they may be contacted to verify the information provided.

(A) Employment (or vocational training)

3.2 Name of employer

3.3 Employer's contact telephone number 3.4 Number of hours worked each week

3.5 Employer’s email address

3.6 Address of workplace

Form EU1 (2018-05) - Page 3 of 8

(B) Self-employment
3.7 Name of business

3.8 Nature of business

3.9 Address of business

3.10 Business telephone number

(C) Study
3.11 Name of college

3.12 Address of college

3.13 College telephone number 3.14 Comprehensive sickness insurance (please tick)
Yes No

(D) Involuntary unemployment

3.15 Name of last previous employer

3.16 Address of last previous employer

3.17 Last previous employer's contact telephone number 3.18 Date of redundancy

Day Month Year

3.19 Total duration of all previous employment in the State 3.20 Registered as job-seeker (please tick as applicable)

Years Months Employment Services Department of Social Protection

(E) Residing with sufficient resources

3.21 Details of financial resources

3.22 Comprehensive sickness insurance (please tick)

Yes No

Form EU1 (2018-05) - Page 4 of 8

 Section 4 Document Checklist
Please provide copies of the documents requested below, except where originals are specified. Original documents submitted will be returned to
you by Registered Post. Please do not send original documents except where specified. For further information on the documents which must
accompany this application form please refer to the Irish Naturalisation & Immigration Service website at http://www.inis.gov.ie.

Evidence of identity
Passport or National Two passport-size photos of
Passport of applicant
Identity Card of EU citizen applicant and EU citizen

Evidence of relationship of applicant to EU citizen

Please provide supporting evidence of your family relationship as selected on Section 1.10 of this form.
Civil Marriage Certificate Partnership Certificate Birth Certificate(s)
(For Spouse) (For Civil Partner) (For Child, Parent or Sibling)

Evidence of residence in the State

If Renting
Letter from landlord/agency, rental contract or tenancy agreement

Letters of Registration of Tenancy from the Private Residential Tenancies Board

Utility bills in the names of both the applicant and the EU citizen

If Home-owning
Letter from mortgage provider, local authority or County Council

Title or deeds (as applicable)

Utility bills in the names of both the applicant and the EU citizen

Evidence of current activity of EU citizen in the State

Please provide supporting documents for the current activity as per Section 3, Parts (A - E).
(A) Employment
Current letter from employer setting out terms, conditions and hours of employment
AND/OR Signed contract of employment
Two recent payslips

Most recent P60 or Tax Credit Certificate

(B) Self-employment
Agreed Tax Assessment from the Revenue Commissioner for the last financial year (if applicable)
OR Letter of Registration for Self-Assessment (Income Tax) from the Revenue Commissioner
Receipts issued for sales or services in the last six months

Bank statements of the business for the last six months

(C) Study
Letter from college/course provider including course description, start date and completion date

Letter from private medical insurance provider (for EU citizen and any dependents)

Bank statements AND/OR other evidence of financial resources

(D) Involuntary Unemployment

Letter from Department of Social Protection with details of benefit claims

Letter from Employment Services Office acknowledging registration as a jobseeker

Letter from previous employer outlining circumstances of redundancy

P60s for prior two years of employment

P45 from last employment

(E) Residing with sufficient resources

Evidence of financial resources and corresponding bank statements

Letter from Department of Social Protection with details of any benefit claims (or stating that there are no claims)

Letter from private medical insurance provider (for EU citizen and any dependents)

Form EU1 (2018-05) - Page 5 of 8

 Section 5 Declarations

Applicant
This declaration should be signed and dated by the applicant or by the parent or guardian of an applicant under
the age of 18.

I hereby apply for a residence card for myself. The information I have given is complete and is true to the best of my
knowledge. I also declare that the photographs submitted with this form are a true likeness of me. I confirm that if, before
my application is decided, there is a material change in my circumstances or new information relevant to this application
becomes available, I will inform the EU Treaty Rights Section of the Department of Justice and Equality in writing
immediately. I understand that any false or misleading information or fraudulent supporting documentation submitted will
result in the refusal of this application.

I understand that, under Section 8 of the Immigration Act 2003 and Regulation 26 of the European Communities (Free
Movement of Persons) Regulations 2015, the data in this application may be disclosed to other Irish Government
Departments as well as to public authorities of the Member States of the European Union and European Economic Area
(EEA) for purposes connected to this application. I acknowledge that the EU Treaty Rights Section may make enquiries to
confirm any of the details or documents provided by me in this application, including my participation in an interview
process.

I am aware that a person who asserts an entitlement to any rights on the basis of information which he or she knows to be
false or misleading in a material particular shall be guilty of an offence and shall be liable on summary conviction to a fine
not exceeding €5,000 or to a term of imprisonment not exceeding 12 months, or both.

Signed by applicant Date

Day Month Year

EU Citizen
This declaration should be signed and dated by the European Union, EEA or Swiss citizen.

The information given in this form is complete and is true to the best of my knowledge. I also declare that the photographs
submitted with this form are of a true likeness of me. I confirm that if, before the application is decided, there is a material
change in my circumstances or new information relevant to this application becomes available, I will inform the EU Treaty
Rights Section of the Department of Justice and Equality in writing immediately. I understand that any false or misleading
information or fraudulent supporting documentation submitted will result in the refusal of this application.

I understand that, under Section 8 of the Immigration Act 2003 and Regulation 26 of the European Communities (Free
Movement of Persons) Regulations 2015, the data in this application may be disclosed to other Irish Government
Departments as well as to public authorities of the Member States of the European Union and European Economic Area
(EEA) for purposes connected to this application. I acknowledge that the EU Treaty Rights Section may make enquiries to
confirm any of the details or documents provided by me in this application, including my participation in an interview
process.

I am aware that a person who asserts an entitlement to any rights on the basis of information which he or she knows to be
false or misleading in a material particular shall be guilty of an offence and shall be liable on summary conviction to a fine
not exceeding €5,000 or to a term of imprisonment not exceeding 12 months, or both.

Signed by European Union, EEA or Swiss Citizen Date

Day Month Year

Submission of incomplete forms or failure to submit all requested documentation will result
in the automatic return of your application.

Please return completed forms and documents by registered post to:

EU Treaty Rights Unit

Residence Division
Irish Naturalisation and Immigration Service
13/14 Burgh Quay
Dublin 2

Form EU1 (2018-05) - Page 6 of 8

 Privacy Notice

1. The data you provide in this form is collected by the Irish Naturalisation and Immigration Service (INIS), a
part of the Department of Justice and Equality. The data controller for the information you provide is the
Department of Justice and Equality. The data controller’s contact details are: EU Treaty Rights, Residence
Division, Irish Naturalisation and Immigration Service, the Department of Justice and Equality, 13 – 14
Burgh Quay, Dublin 2, D02 XK70.

2. You can contact the Data Protection Officer for the Department of Justice by writing to: The Data Protection
Officer, the Department of Justice and Equality, 51 St. Stephen’s Green, Dublin 2, D02 HK52. Or by email
– [email protected]

3. We will use the personal data you provide in this form for the following purposes

 Assessing your entitlement to reside in the State as the family member of the EEA National named in
your application.
 We may also use the personal data you provide in this form and in associated correspondence as part
of any future considerations regarding your immigration or citizenship status.

4. We collect and process this data in order to comply with our legal obligations or to perform tasks in the
public interest. The specific basis for collecting and processing this data is as follows:

 Directive 2004/38/EC
 Regulation 26 of the EC (Free Movement of Persons) Regulations 2015, and
 Section 8 of the Immigration Act, 2003

5. The personal data provided here will be stored securely in INIS’s databases and the Garda National
Immigration Bureau’s databases. It may be shared, if necessary, with the following third parties:

 Government departments and agencies,

 An Garda Siochána,
 EEA Competent authorities,
 EEA police forces.
 Individuals with your consent, for example, employer, landlord.

 Service providers of the Department of Justice and Equality, for example data handling and storage
providers, producer of Residence Card/Irish Residence Permit

6. The personal data you provide in this form is necessary for us to determine if you meet the criteria for a
residence card as the family member of the EEA National named by you. If this data is not provided, your
application cannot be processed.
Form EU1 (2018-05) - Page 7 of 8
 7. This data may be retained until INIS can be sure that neither party will have no further contact with the
immigration services. This may be an indeterminate period as your immigration history in the State may
span a full lifetime. It will be referred thereafter to the Director of National Archives for appraisal under the
National Archives Act 1986

8. Both you and the EEA National have the right to request access to, and a copy of any personal data
pertaining to you or them that we process. You can do this by filling in a Subject Access Request form,
available at www.justice.ie, and sending it to [email protected]. You may be required to
verify your identity before we send the information to you.

9. You or the EEA National have the right to request us to rectify any errors in your data or to erase your data,
as well as to seek a restriction of the processing of your data or to object to the processing of your data in
certain circumstances. To do this you or the EEA National should write to EU Treaty Rights, Residence
Division, Irish Naturalisation and Immigration Service, the Department of Justice and Equality, 13 – 14
Burgh Quay, Dublin 2, D02 XK70 explaining what errors need to be rectified or erased or your reasons for
seeking the restriction of, or objecting to, the processing.

10. You or the EEA National have a right to lodge a complaint with the Data Protection Commission if you
believe your personal data is being processed by us unlawfully. Information about how to make a
complaint can be found on www.dataprotection.ie.

I acknowledge that I have read and understood the information outlined above, which relates to my data
protection rights.

Name _____________________________

Signature (Applicant) __________________________ Date ____________________

Name of Parent/Guardian of applicant aged under 18 years ________________________

Signature of Parent/Guardian _________________________ Date ______________

Signature (EEA Citizen)________________________ Date ____________________

Form EU1 (2018-05) - Page 8 of 8