Please see Declaration of Proof Form and if applicable host is required to fill in details and subsequently you are required to submit together with this form.
3 of 6 04 PARENTAL AUTHORITY (IN CASE OF MINORS UNDER 18 YEARS OF AGE) / LEGAL GUARDIAN
Parent 1 / Legal Guardian 1
Surname
Name
Nationality
Mobile Number
Email
Address (if different from applicant’s contact)
Postcode
Country
Parent 2 / Legal Guardian 2
Surname
Name
Nationality
Mobile Number
Email
Address (if different from applicant’s contact)
Postcode
Country
4 of 6 In the case that the family member is an EU, EEA, Swiss citizen or a person who has been granted beneficiary status in Malta under the EU/UK withdraw agreement provide the following details in respect of the said family member:
Surname
Name
Travel Doc. or ID Card No.
Date of birth
Nationality
Family Relationship Spouse Child Grandchild
Dependent Ascendant Registered Partnership Other
Applicant’s Signature Date of Signature
05 DECLARATION
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:
I am aware of and consent to the following: the collection of the data required by this application form and the taking of my photograph and, if applicable, the taking of fingerprints, are mandatory for the examination of the application; and any personal data concerning me which appear on the application form, as well as my fingerprints and my photograph will be supplied to the relevant authorities in Malta and processed for the purposes of a decision on my application. I hereby grant my explicit consent to Identità to complete the necessary background checks and relative verification performed in the course of the visa application process. I acknowledge that Identità engages an external service provider to perform administrative and non-judgmental tasks related to the entire lifecycle of the visa application process. I further acknowledge that, as part of its duties, the external service provider shall perform the dynamic background checks on Identità’s behalf, wherein it may consult authorized third parties, databases and other sources, including but not limited to, public sources, such as the internet, and returning relevant information to Identità by reference to the information I have provided in my D-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 Management System known as (VMS) or National Visa Management System (NVMS) 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 Malta’s external borders within Malta, immigration and asylum authorities in Malta for the purposes of verifying whether the conditions for the legal entry into, stay and residence on the territory of Malta are fulfilled, of identifying persons who do not or who no longer fulfil these conditions, of examining an asylum application and of determining responsibility for such examination. The authority of Malta responsible for processing the data is vested jointly in the Ministry of Foreign and European Affairs and Identità (Ministry for Home Affairs and National Security). Personal data will be processed in accordance with the General Data Protection Regulation EU 2016/679. I am aware that I have the right to obtain a notification of the data relating to me recorded in the VMS, to which authorities within Malta it has been transmitted, and to request that data relating to me which is 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 the laws of Malta. The Office of the Information and Data Protection Commissioner ([email protected]) 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 applicable laws of Malta. 23/07/2024 Applicant’s Signature Date of Signature
5 of 6 06 SUPPORTING DOCUMENTS
X Valid Passport
X Invitation
X Means of Transport
X Health Insurance (Including repatriation if need be)
