"Caribbean Netherlands Visa Application Form" - Netherlands

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Visa application form
RECENT COLOUR
PHOTO
Kingdom of the Netherlands
3 x 4 cm
in the Caribbean
NB: Read the explanatory note and guidelines through before filling in the form.
APPLICANT’S DETAILS
1.
Surname(s) (as stated in travel document)
FOR OFFICIAL USE ONLY
Visa application number:
2.
Given names (as stated in travel document)
Submitted on:
Processed by:
3.
Other surnames(s) (e.g. maiden name etc.)
Supporting documents
4.
Date of birth
5.
Place of birth
7. ID number
Standard:
(Year-month-day)
 Valid travel document
 Financial means
6.
Country of birth
 Means of transport
 Health insurance/(medical) travel
insurance
8.
Current nationality
9.
Other nationality/nationalities
Optional (depending on purpose of
travel):
 Invitation
10. Sex
11. Marital status
 Guarantee/guarantor’s declaration
 male
 Single
 Married
 Divorced
 VTA / landing permit /
 Cohabiting
 Widowed/widower
 female
letter of notification / MVV-BES
 Other:
 Other:
12.
Father’s name (in case of minor)
13. Mother’s name (in case of minor)
Referral (yes/no):
 no, independent decision
14.
Type of travel document
 Travel document (1951 Convention
 yes, referred to:
travel document)
(fill in: country and authority)
 National passport
 Alien’s passport
 Diplomatic passport
 Maritime passport/seaman’s book
Visa:
 Official passport
 Other travel document (please describe):
 Granted
 Territorially Limited Visa due to:
15.
Travel document number
16. Issued by
 entry for specific purpose of travel
 public order
17.
Issued on
18. Valid to
 national security
 public health
19.
If you currently live in a country other than your country of origin, has
 Refused
this country issued you with a re-entry permit?
Code for ground of refusal:
 Not applicable
 No
Code for explanation:
 Yes (provide copy of document)
Number of document:
Number of entries:
Issued on (date):
Valid to:
 Multiple
19a. What is your current permanent address?
 Single (for specific purpose of travel)
Street and number:
Place and postal code:
Country:
Period of stay for each visit:
Telephone number:
Email:
.……..days
20.
What is your current profession?
(maximum of 90 days)
Valid from ………………………….…………
To ………….……………….……………………
21.
Please supply your employer’s contact details (name, address and
telephone number)
For students: please supply the name, address and telephone number of your
educational institution.
This form is provided free of charge.
AVT15/BZ114167B
1
Visa application form
RECENT COLOUR
PHOTO
Kingdom of the Netherlands
3 x 4 cm
in the Caribbean
NB: Read the explanatory note and guidelines through before filling in the form.
APPLICANT’S DETAILS
1.
Surname(s) (as stated in travel document)
FOR OFFICIAL USE ONLY
Visa application number:
2.
Given names (as stated in travel document)
Submitted on:
Processed by:
3.
Other surnames(s) (e.g. maiden name etc.)
Supporting documents
4.
Date of birth
5.
Place of birth
7. ID number
Standard:
(Year-month-day)
 Valid travel document
 Financial means
6.
Country of birth
 Means of transport
 Health insurance/(medical) travel
insurance
8.
Current nationality
9.
Other nationality/nationalities
Optional (depending on purpose of
travel):
 Invitation
10. Sex
11. Marital status
 Guarantee/guarantor’s declaration
 male
 Single
 Married
 Divorced
 VTA / landing permit /
 Cohabiting
 Widowed/widower
 female
letter of notification / MVV-BES
 Other:
 Other:
12.
Father’s name (in case of minor)
13. Mother’s name (in case of minor)
Referral (yes/no):
 no, independent decision
14.
Type of travel document
 Travel document (1951 Convention
 yes, referred to:
travel document)
(fill in: country and authority)
 National passport
 Alien’s passport
 Diplomatic passport
 Maritime passport/seaman’s book
Visa:
 Official passport
 Other travel document (please describe):
 Granted
 Territorially Limited Visa due to:
15.
Travel document number
16. Issued by
 entry for specific purpose of travel
 public order
17.
Issued on
18. Valid to
 national security
 public health
19.
If you currently live in a country other than your country of origin, has
 Refused
this country issued you with a re-entry permit?
Code for ground of refusal:
 Not applicable
 No
Code for explanation:
 Yes (provide copy of document)
Number of document:
Number of entries:
Issued on (date):
Valid to:
 Multiple
19a. What is your current permanent address?
 Single (for specific purpose of travel)
Street and number:
Place and postal code:
Country:
Period of stay for each visit:
Telephone number:
Email:
.……..days
20.
What is your current profession?
(maximum of 90 days)
Valid from ………………………….…………
To ………….……………….……………………
21.
Please supply your employer’s contact details (name, address and
telephone number)
For students: please supply the name, address and telephone number of your
educational institution.
This form is provided free of charge.
AVT15/BZ114167B
1
QUESTIONS ABOUT YOUR INTENDED JOURNEY AND
PURPOSE(S) OF TRAVEL
22.
What is your main destination ?
NB: for the purposes of questions 22, 24 and 30 Bonaire,
St Eustatius and Saba are seen as 1 country (the
 Aruba
 Bonaire
Netherlands in the Caribbean) when calculating the
 Curaçao
 St Eustatius
period of uninterrupted stay in 1 country.
 St Maarten
 Saba
23.
Number of entries and period of validity of the visa
24. Period of stay (per visit per country)
(maximum uninterrupted stay in the Kingdom of the
STANDARD
Netherlands in the Caribbean country is 90 days)
 Multiple-entry, valid for 6 months
Visa required for: …….… days each stay
OTHER
 Single-entry (for a specific purpose of travel), valid for 90 days
 Multiple-entry, valid for:
NB: You will need to be able to show you have sufficient means
1 year / 1 to 2 years / 2 to 3 years / longer than 3 years
for the period of your stay in a country/countries of the
(cross out the categories that do not apply )
Kingdom of the Netherlands in the Caribbean
25.
Date of arrival in the Caribbean parts of Kingdom
26. Date of departure from Caribbean parts of Kingdom
27.
Country or island of first entry or transit
28.
Mean(s) of transport
 Aeroplane
 Ship
29.
Purpose of travel
 Culture/Music
 Sport
 Tourism
 Official
 Religious
 Business
 Medical reason
 Timeshare/own property
 Family visit
 Work
 Study/education/work placement
 Relocation
 Humanitarian
30.
Are you planning to visit other parts of the Caribbean in addition to your main destination? If so, indicate below.
Period (fill in: from/to and length of the stay) Purpose of travel (choose one of the categories from question 29)
 Aruba
from:………………to:……………………days:..……….
………………………………………………………………………………………
 Curaçao
from:………………to:……………………days:..……….
………………………………………………………………………………………
 St Maarten
from:………………to:……………………days:..……….
………………………………………………………………………………………
 Bonaire
from:………………to:……………………days:..……….
………………………………………………………………………………………
 St Eustatius
from:………………to:……………………days:..……….
………………………………………………………………………………………
 Saba
from:………………to:……………………days:..……….
………………………………………………………………………………………
Total period of stay in the Caribbean (including period of stay under question 24) in days:………… (each calendar year)
NB: The maximum total period may not exceed 90 days in any 180-day period.
31.
Have you previously visited one or more of the parts of the Kingdom of the Netherlands in the Caribbean ? If so,
please specify below.
Period:
Purpose of travel (choose one of the categories from question 29)
 Aruba
…………………………………………………………………….
………………………………………………………………………………………
 Curaçao
…………………………………………………………………….
………………………………………………………………………………………
 St Maarten
…………………………………………………………………….
………………………………………………………………………………………
 Bonaire
…………………………………………………………………….
………………………………………………………………………………………
 St Eustatius
…………………………………………………………………….
………………………………………………………………………………………
 Saba
…………………………………………………………………….
………………………………………………………………………………………
32.
Have you been issued with visas by other countries in the last 3 years? If so, for which period are/were they valid?
(State the country, the date of issue and the date until which the visa is/was valid. Provide this information on a
separate sheet if necessary.)
33. Have you previously worked in one or more parts of the Kingdom of the Netherlands in the Caribbean?
 No
 Yes, in paid employment (give details of most recent position)
 Yes, other (please describe)
Employer:
Employed from :
Employed from :
To
:
To
:
34. Who is paying your travel costs and living costs during your stay?
 I am
 The people I am staying with/hosts (state who and how)
 Host company or organisation (state who and how and provide documentation to back this up)
 Other:
35. What are your means of support during your stay?
 Cash
 Accommodation:
 Travellers’ cheques
 Other:
 Credit card(s)
 (Medical) travel insurance and/or health insurance. Valid to………………………………………………………
This form is provided free of charge.
AVT15/BZ114167B
2
36. Spouse’s / registered partner’s surname(s)
37. Spouse’s surname at birth
38. Given name(s) of spouse
39. Date of birth of spouse
40. Place of birth of spouse
41.
Children (a separate application must be submitted for each passport holder)
Surname
Given name(s)
Date of birth
1)
……………………………………………………………………………….
…………………………………………………………………………
……………………………
2)
……………………………………………………………………………….
…………………………………………………………………………
……………………………
3)
……………………………………………………………………………….
…………………………………………………………………………
……………………………
Please add a separate sheet if more than 3 children are travelling with you.
42.
Name of host / host business in main destination
If not applicable, please provide the name of your hotel or temporary address at your destination.
Name:
Telephone and fax:
Full address:
Email:
43.
If applicable, personal details of the Caribbean resident acting as guarantor
Surname(s)
Given name(s)
Address
Telephone number
Email
Date of birth
Nationality
Passport number
Family connection (or other connection, please explain):
Declaration:
-
I have read and understood the information in the explanatory note and the guidelines for completing the form and on the
basis of the information have completed the form fully, correctly and truthfully;
I understand that the visa is a condition for entry to the Caribbean countries but does not give absolute right to entry. At
-
each border control I will need to be able to show that I satisfy all the requirements for the intended purpose of travel in the
country in question. If at the border control I do not satisfy all the conditions I will be refused entry;
I will only use the visa granted on the basis of this application correctly and lawfully. I will therefore not overstay i.e. exceed
-
the permitted period of stay (for each visit). Misuse of the visa may mean my removal from the country and that I will not be
admitted to the Kingdom of the Netherlands in the Caribbean in the future.
I am aware of and consent to the following:
The collection of the data required by this application form, including my photograph, are mandatory for the examination of the visa
application. Any personal data concerning me which appear on the visa application form, as well as my photograph can be supplied to
the relevant authorities of the Caribbean parts of the Kingdom of the Netherlands and processed by those authorities, for the purposes
of a decision on my 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 stored and will be accessible to the visa authorities and the authorities competent for carrying out checks on visas at
external borders and to immigration and asylum authorities in the (Caribbean parts) of the Kingdom of the Netherlands. This data will
enable these authorities to verify whether the conditions for the legal entry, stay and residence on the territory are fulfilled, of
identifying persons who do not or who no longer fulfil these conditionsThe authority responsible for processing the data is: Ministry of
Foreign Affairs, Consular Affairs and Visa Policy Department (DCV), Postal code 20061, 2500 EB DEN HAAG.
I am aware that I have the right to obtain the data relating to me and to request that data relating to me which are 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 national law. The national supervisory authority will hear claims concerning the
protection of personal data. For the Netherlands this is: Data Protection Authority (Autoriteit Persoonsgegevens) Postal code 93374,
2509 AJ DEN HAAG.
Place and date
Signature (for minors: the signature of the person(s) with parental
responsibility/guardian)
This form is provided free of charge.
AVT15/BZ114167B
3
EXPLANATORY NOTE
NB: Read the explanatory note and the guidelines through carefully before completing the application
form.
Kingdom of the Netherlands
The Kingdom of the Netherlands comprises four countries: the Netherlands, Aruba, Curaçao and
St Maarten. In terms of geography, the Netherlands as a country is split into two: the Netherlands in
Europe, and the Netherlands in the Caribbean. Schengen visa regulations only apply to the Netherlands in
Europe.
The Kingdom of the Netherlands in the Caribbean consists of the countries Aruba, Curaçao and St
Maarten and the three Dutch public bodies Bonaire, St Eustatius and Saba (‘the Netherlands in the
Caribbean’).
The terms ‘countries’, ‘Caribbean parts ’ and ‘Caribbean’ used in the application form and in this
explanatory note refer to Aruba, Curaçao, St Maarten and the Netherlands in the Caribbean. ‘Embassy’,
‘consulate’ and ‘mission’ all refer to the missions of the Kingdom of the Netherlands in third countries.
Contact details are available at
www.government.nl/issues/embassies-consulates-and-other-
representations.
This application form can be used to apply for a short stay visa (up to 90 days) for the Kingdom of the
Netherlands in the Caribbean only. The Caribbean visa is valid for the Caribbean only, i.e. it is not valid
for the Netherlands in Europe.
For a stay exceeding 90 days in Aruba, Curaçao and St Maarten (e.g. in the case of relocation or work) a
host in the Caribbean country in question will need to submit the application for you. If you wish to stay
for more than 90 days in the Netherlands in the Caribbean you will need to apply for an authorisation for
temporary stay for the Netherlands in the Carribean (‘MVV-Netherlands in the Caribbean’), using a form
available from the embassy. You can, if you wish, submit this application to the embassy yourself.
Objective of granting a visa
In accordance with prevailing international practice, the purpose of visa policy and of granting visas for
the Caribbean is, on the one hand, to ensure that undesirable aliens whose admission to the countries
would have unfavourable effects are turned away in advance. This may be linked to illegal immigration,
threats to public health, national security or public order, or human trafficking/people smuggling. On the
other hand, visa policy and granting visas are an effective and efficient way of facilitating the admission
of bona fide travellers who, in a broad sense, can make a positive economic and social contribution to the
Caribbean countries.
Caribbean visa
In principle, all aliens require a visa for the Caribbean, in accordance with prevailing international
practice. Exceptions may be made for specific target groups on the basis of nationality, international
agreements or exemptions. If you are unsure whether you fall into one of these categories the embassy
or consulate of the Kingdom (hereafter: ‘the mission’) in your region will be able to tell you.
Period of stay The Caribbean visa is intended for short stays, i.e. a maximum period of 90 days in any
180-day period, in total, for all countries in the Caribbean.
In which countries is the visa valid? The Caribbean visa is issued on behalf of the authorities of the
country of your main destination and/or where the purpose of your intended journey lies, and is also
valid for all the other Caribbean countries. Exceptions may be made (in the form of a territorial limitation,
i.e. the visa will not be valid in all countries) if you are considered to be a threat, or possible threat, to
national security, public order or public health in one or more parts of the Kingdom of the Netherlands in
the Caribbean, or in the case of certain specific purposes of travel (for example, entry for the purpose of
long-term stay).
Main destination / purpose of travel In the application form you are asked to state your main
destination (country) and main purpose of travel. You are also asked to state any other destinations
and/or purposes of travel. In principle, your application will be assessed according to the destination and
purpose you fill in on the form. It is, however, up to the mission to determine which purpose of travel is
the most important element of your intended journey/journeys. This is done in your own interest.
This form is provided free of charge.
AVT15/BZ114167B
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For example: you are planning to go to Aruba on holiday and continue on to Curaçao for a family visit.
Both visits will last 14 days. You want to start your journey in Aruba, so fill in ‘Aruba’ as main destination,
with ‘Tourism’ as the purpose of travel. Under other destinations, you fill in ‘Curaçao’, giving ‘Family visit’
as purpose of travel. For the purpose ‘Family visit’ you will need to submit extra documents and/or will
be subject to extra requirements, for example a guarantee or guarantor’s declaration, as part of your
application.
If the mission did not check this, you could find yourself at the border control in Curaçao without the
required documents. As it would be impossible for you to produce a guarantee or guarantor’s declaration
there and then, you would be refused entry on the grounds that you failed to satisfy the requirements for
your purpose of travel. If your travel plans are assessed by the mission, this problem can be avoided.
NB: At all times you remain fully responsible and liable for the correct use of your visa and for satisfying
the specific admission requirements for your purpose/purposes of travel.
Period of validity of visas
Standard visa
As a rule multiple-entry visas are valid for six months. This means that you can enter the Caribbean
country/countries in question several times within the six-month period for which the visa is valid (see
‘valid from…to…’ on the visa sticker in your travel document).
NB: This does NOT mean that you can stay in any one or all of the countries for six consecutive months.
Non-standard visa
For long-term stay, e.g. for temporary or permanent relocation or performance of work, submit your
application to the competent authority of the country in question. Assuming permission is granted, in
the form of a temporary admission document (VTA) (for Aruba), a letter of notification
(oproepingsbrief) (for Curaçao), a landing permit (for St Maarten) or an authorisation for temporary
stay (MVV) (for the Netherlands in the Caribbean) a single-entry visa valid for 90 days will be issued
in response to your application for entry to the country. This means that you can use the visa once
within the 90-day period of validity. Once you have entered the country of destination you must
apply to the competent authority, specified in the conditions of the temporary admission document,
letter of notification, landing permit or authorisation for temporary stay, for a residence permit.
Multiple-entry visas valid for one year, one to two years, or longer (to a maximum of four years) may
be issued to travellers who have previously been issued with a visa for the Caribbean countries and
who can show that they have used their visa correctly. Examples of people in this category are
frequent travellers, e.g. tourists who own property in the Caribbean or business travellers who need
to visit the Caribbean frequently. In principle you cannot be granted a visa valid for more than one
year (‘multi-year visa’) the first time you submit a visa application. The mission may refer a multi-
year visa application to more than one country for advice/approval, given how such a visa may be
used. This may mean that you will have to wait longer for a decision.
Extending or changing a visa / extending your stay
Extending or changing a visa. Once you have used the visa to enter one of the countries covered
by the visa you can no longer extend or change the visa. After all, the visa represents an assessment
conducted before you enter the country or countries in question of whether you satisfy the admission
requirements at the moment you make the application. The competent authority in the country
where you are staying is, however, authorised to cancel a visa, declare it invalid or to curtail it, for
example in the case of misuse.
Extending your stay In principle, you cannot apply to extend your stay once you have entered the
country of your destination. Exceptions can be made but are subject to very strict conditions. You
should apply directly to the competent authority in the country in question, usually the aliens
department or the local police. Permission to extend a stay only applies to the country in question.
The next time you make a visa application you will need to provide proof of the extension (e.g. a
document issued by local authorities or a stamp in your travel document). In Aruba specific
categories of alien (for example those who own a timeshare or other property in the country) can
apply after entry to extend their stay to a maximum of 180 days per calendar year.
This form is provided free of charge.
AVT15/BZ114167B
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