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(x) Fields 1-3 shall be filled in accordance with the data in travel document.1. Surname (Family name) (x)For official use onlyDate of application:Visa application number:Application lodged atEmbassy/consulateCACService provider
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Date of application:
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CAC
Service provider
Commercial intermediary
Border
Name:
Other:
File handled by:
Supporting documents:
Travel document
Means of subsistence
Invitation
Means of transport
TMI
Other:
Visa decision
Refused
Issued:
A
C
LTV
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From………………………....
Until ………………………….
Number of entries
1 2 Multiple
Number of days:
3. First name(s) (Given name(s)) (x)
For official use only
Date of application:
Visa application number:
Application lodged at
Embassy/consulate
CAC
Service provider
Commercial intermediary
Border
Name:
Other:
File handled by:
Supporting documents:
Travel document
Means of subsistence
Invitation
Means of transport
TMI
Other:
Visa decision
Refused
Issued:
A
C
LTV
Valid
From………………………....
Until ………………………….
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1 2 Multiple
Number of days:
4. Date of birth (day-month
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