Application For Residence Permit For Persons Who ... - Migrationsverket

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136011_en

Inkom utlandsmyndighet Inkom Migrationsverket

Application for residence permit for


persons who are long-term residents
in another Member State and their
family members
Dossiernummer Signatur

You should use this form if you are a long-term resident of another EU country (according to the Council Directive
2003/109/EC) or family member of a long-term resident of another EU country. You must pay an application fee.

I am applying for a residence permit as:


Employee (H1) Husband/wife/cohabit/child of person with long-
Self-employed (H2) term residence status (H6)
Recipient/supplier of service (H3) Parent of person with long-term residence status
Student (H4) (H7)
Pensioner or other person of adequate
means (H5)

Period of stay in Norway


Permanent settlement Temporary stay from ......................... to .......................

Personal particulars
Surname

Given names (in full)

Birth date (year, month, day, ID digits if any) Sex Citizenship


Male Female

Identification document and entry in Norway


Passport number
Passport
Issued by Date Expiry date

If you are in Norway please note which date you Which Member State has granted your long-term Date when you received your long-term residents
entered the country resident status? status

Address in Norway
c/o Street & no.

Postcode & district e-mail

Tel. (private) Tel. (daytime) Tel. (mobile)

Husband/wife/partner – personal particulars (accompanying husband/wife/partner must apply separately)


MIGR137011 rev. 110520

Surname, given names (in full) Birth date (year, month, day)

Citizenship Marital status Sex


Male Female

UT
Accompanying children under 21 years (accompanying children must apply separately)
Surname, given name (in full) Birth date (year, month, day)

Citizenship Sex
Male Female
Surname, given name (in full) Birth date (year, month, day)

Citizenship Sex
Male Female
Surname, given name (in full) Birth date (year, month, day)

Citizenship Sex
Male Female

Parents– personal particulars (only to be filled out if you are under 21 years)
Your father’s surname Given names (in full)

Birth date (year, month, day) Citizenship

Your mother’s surname Given names (in full)

Birth date (year, month, day) Citizenship

Further particulars

Attachments
If you are registering your right of residence please enclose:
copy of passport or national ID showing your citizenship and following documents according to your category
copy of a EC residence permit which proves that you are a long-term resident of another EU country (does not apply
to citizens of Switzerland)
As employee As pensioner or other person of adequate means
Hiring certificate Certificate or similar document confirming that you have a
pension or independent means
As self-employed Health insurance coverage certificate
Swedish corporate registration certificate As husband/wife/child of person with long term residence
status in EC
As recipient/supplier of service Certificate of kinship
Certificate clearly showing the nature and duration of the
service, e.g. agreement, contract
As parent of person with long term residence status in EC
As student Certificate of kinship
Certificate of acceptance for and duration of studies at Certificate showing that you are financially dependent on the
“gymnasium” or higher education person living in Norway
Statement of means of support
Health insurance coverage certificate

Signature
I am applying for a Swedish residence permit. I solemnly declare that the information I have supplied is
correct.

Place and date Signature (for minors etc., signature of custodian(guardian)

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