Declaration For Study Residence Permit - REGULAR 2021-2022-2

Declaration for a Residence Permit for Study
Dear Student,
TU Delft will apply or has applied on your behalf for your Residence Permit for Study. Dutch Immigration Law requires
proof that you have sufficient financial means to study and live in the Netherlands. The right of residence may lapse in
the event of any claims being made on public funds, or if you leave The Netherlands for a period longer than 12
months. We therefore ask you to fill in the statement below and return it to us as soon as possible.
Please fill out the form digitally and place your signature.
 You need to be able to demonstrate your financial solvability on a yearly basis.
 Your residential status will be checked regularly via the Municipal Personal Records Database (BRP).
Personal details of student

Full name: Anukarsh Singh
Male Female
Birth date: 29/05/1999 Nationality: Indian Sex:
Address: 202A, Pashupati Apartments, Raja Ram Mohan Rai Marg, Lucknow, India - 226001
Phone: +91-9119904181 Email: [email protected]
V-number: Student number: 5824958
Conditions for the duration that I have a study residence permit

1) I hereby declare that I have sufficient financial means to cover the yearly tuition fee.
2) I hereby declare that I have sufficient financial means to be able to support myself (€ 980,-- per month).
3) I hereby declare that I have taken/will take out a sufficient health- and liability insurance.
4) I hereby declare that I will register via Studielink every year before the 1st of September.
5) I hereby agree that Delft University of Technology can send my personal details to IND (Immigration Office)
and other organizations that might need my details for study and/or residence purposes.*
Disclaimer and signature
I certify that I have completed this statement truthfully. I understand that false or misleading information provided
through this statement might affect my residence rights and status.
As such, I will inform the TU Delft Team Residence Permit ([email protected]) immediately in case of:
- Changes in my financial support / income position
- Me leaving the Netherlands for an exchange, internship or graduation project abroad for
maximum 12 (twelve) months
- Me leaving the Netherlands earlier than planned for another reason than mentioned above
or for a period no longer than 6 (six months)
- Changes in my personal life such as marriage / divorce / getting children
Signature: Date: 30/05/2022
*TU Delft hereby declares that your details will not be shared with third parties that do not need your details for study or residence purposes.
1
FAQ
How do you calculate the amount mentioned as ‘sufficient means to be able to support myself’?
The minimum standard amount is redefined per 1 January and 1 July of each year by the Ministry of Education, Culture
and Science). This amount does NOT include the tuition fee (if applicable).
I am filling out this form as part of my residence permit application and have not yet travelled to the Netherlands. Do I fill
in my home address or an address in the Netherlands?
As you are still applying for your residence permit, we do not expect you to have an address in the Netherlands yet. It is
therefore sufficient to provide us with your home address.
I am filling out this form as part of my yearly check for proof of income. Do I need to send proof of this along with this
form?
You do not need to send further supporting documents as proof along with this form. However, we reserve the right to
ask for these supporting documents separately when required by the IND at any time.
What is a V-number?
The V-number is a unique number that is short for ‘vreemdelingennummer’ or immigration number. You will receive this
when your application procedure with the IND has been started. If you are a first time applicant, you do not have this
number yet and can leave this field blank.
What number do I fill out at student number?

The student number is the number that you receive after you have registered via Studielink.

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Declaration for a Residence Permit for Study

Personal details of student

Phone: +91-9119904181 Email: [email protected]

V-number: Student number: 5824958

Conditions for the duration that I have a study residence permit

Signature: Date: 30/05/2022

What number do I fill out at student number?

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