SHARFIC VISA APPLICATION FORM .pdf

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MINISTRY OF INTERNAL AFFAIRS OF THE SHARFIC REPUBLIC
VISA APPLICATION FORM

Fill out the application form with capital letters – BLACK INK ONLY
Passport number

Country of issue

Citizenship/nationality

City of issue

District of issue

Date of issue

Date of expiry

Surname (family name/last name)

Colour photo
3x4cm

First name (given name)
Middle (other) names
Date of birth

District of birth

Nationality

City of birth

Sex:

Country of birth

Marital status:

Male
Married
Female
Single
Permanent address (country, city/town, district, road, number, postal zip code)
Telephone number: office

Fax

Mobile

Name and address of your employing institution

Date/ port of arrival to the Republic

Divorced

E-mail address

Position and description of role and duties

Date/ port of departure from the
Republic

Number of entries

PURPOSE OF VISIT TO THE SHARFIC REPUBLIC (VISA issued according to purpose of visit)

Place of stay in the Sharfic Republic (name and full address of hotel, guesthouse, diplomatic mission, state
agency or private dwelling)

Telephone number of place of
stay: office

Fax

Name of person financially responsible for trip (in case
of incarceration, medical evacuation or etcetera)

Mobile

E-mail address:

Please detail any dates and locations of previous
stays in the Sharfic Republic

MINISTRY OF INTERNAL AFFAIRS OF THE SHARFIC REPUBLIC
VISA APPLICATION FORM

When?

Have you ever been issued a Sharfic Visa? if YES:
Where?
Type of visa?
Requested length
of stay?

Given length of
stay?

When?

Have you ever been refused a Sharfic Visa? if YES:
Where?
Type of visa?
Requested length
of stay?

Reasons provided
for refusal?

Do you intend to work in the Sharfic Republic? (if YES
please indicate name and address of employer)

Do you intend to study in the Sharfic Republic? (if
YES please indicate name and address of institution
or university

IMPORTANT: PLEASE READ AND COMPLETE THE FOLLOWING QUESTIONS CAREFULLY AND
ATTENTIVELY
1.
2.

3.

Have you ever been arrested or convicted of any crime within the territory of
the Sharfic Republic? If YES please describe on separate page
Have you ever been a member of a terrorist or extremist group or organisation
(as designated by the Ghzelka Pact Convention on Non-State Actors) or been
involved in the trafficking and smuggling of narcotics, weapons and
ammunition, state secrets, or human beings?
Do you have a criminal record in the Sharfic Republic or any other state?

YES

NO

YES

NO

YES

NO

4.
5.

Have you ever been granted a pardon or amnesty?
YES
NO
Have you ever received military training or been a part of a state, regional or
YES
NO
local military, paramilitary or self-defence organisation?
6. Have you visited the occupied Sharfic territories of Qeiam or Mai Dolumgar
YES
NO
between the years of 1997 and 2010? If YES please describe on separate page
7. Did you enter the territory of the Sharfic Republic and take part in intra-state
YES
NO
violence between the years of 1997 and 2010? If YES please describe on
separate page
8. Have you ever been accused or convicted of the crimes of heresy, adultery,
YES
NO
immorality or apostasy? If YES please describe on separate page
9. Have you ever fallen ill with an infectious disease considered harmful to society
YES
NO
by the Southern Crataea Convention on Infectious Disease (SCCID)? If YES
please describe on separate page
10. Do you pledge to uphold the moral and social norms of the Sharfic Catholic
YES
NO
Church for the duration of your trip to the Sharfic Republic?
11. Was this visa application prepared by another person (organisation)? If YES
YES
NO
then:
The invitee is formally informed that according to the legislature of the Government of the Sharfic Republic,
The inviter assumes all responsibility for entry, movement in and exit of the territory of the Sharfic Republic
by the invitee.
Name of invitee
Relation with applicant
Full address and
Date and signature
telephone number
(organisation stamp)

I hereby declare that the information entered on this form is true to the best of my knowledge. I am aware the
false or omitted information can result in the permanent denial of visa or possible incarceration inside the
Sharfic Republic. I understand that a visa does not automatically entitle the bearer to enter the Sharfic
Republic.

Applicant’s
signature:_____________________________

Date:_______________________________________________

MINISTRY OF INTERNAL AFFAIRS OF THE SHARFIC REPUBLIC
VISA APPLICATION FORM
CONSULAR SECTION – DO NOT WRITE ON THIS PAGE

JAPO KONSOLARU ________________________________________
KATEGORIJA VISA _______________________________________
KOMENT
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
LJUQIPA:


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