CEA/23

Department for Citizenship and Expatriate Affairs 3, Castille Place

VALLETTA Application for a residence permit

for Non-EU/EEA nationals (being persons who are not nationals of EU Member States, Iceland, Liechtenstein or Norway)

N. B. This form should be completed by a residence permit holder in respect of family members

1. Details of Residence Permit holder

Surname

Name

Nationality Residence permit application number Maltese ID Card number

Address in Malta

Phone Fax E-mail

2. Details of Person for whom a Residence Permit is required

Surname Former surname

Forename(s)

Present Nationality / Nationalities Former Nationality / Nationalities

Birth date Day Month Year

/ /

Gender Male Female

Maltese ID card number

Place of birth Country of birth

Foreign permanent address

Address in Malta

Relationship to residence permit holder:

For Office Use Only Application number

Passport number Country of issue Place of issue

Date of issue Day Month Year

/ /

Valid until Day Month Year

/ /

Date/s of previous/current residence in Malta (if any):

From: To: From: To:

3. Application details

Application is being made for:

First Residence Permit Transfer of current Permit to a new passport* Extension of current permit*

For the Period Day Month Year Day Month Year

/ / 2 0 To / / 2 0

4. Supporting documents

Spouse Numbers: 1, 2, 3, 4, 5, 6 Minor child Numbers: 1, 2, 3, 4, 5, 6, 7 and/or 8 (if applicable) Other family member Numbers: 1, 3, 4, 5, 6 (others as the case may be)

List of documents:

Tick documents enclosed with this application

1 2 x Photographs (two recent coloured passport size photos) 2 Marriage certificate

3 Proof of financial resources

4 Evidence of sickness insurance

5 Passport (or photocopy of passport part containing details in case of applications sent by post authenticated by a police officer)

6 Birth certificate

7 Documentation of parental authority (if parents are divorced/separated) 8 Declaration of consent of father/mother (when minors are not accompanied by both parents) 9 Present residence permit (in case of permit extension or transfer of permit to a new passport)

10

11

12

*Current Residence permit number

5. Declaration

I hereby solemnly declare that the information given in this application is true to the best of my knowledge and belief and that no details have been omitted that could be of decisive importance when the application is considered.

Signature: Date

Form completion instructions for a residence permit application for family members

-Applicant refers to a Residence Permit holder who is already residing in Malta or to a person who has submitted an application for such a permit.

- Applying for a residence permit in respect of a family member

The Applicant should complete this form: either in respect of the spouse or in respect of a child (under 18 years of age)

The fee for a residence permit (valid for 1 year or less) is Lm10, paid at the time of application. FEES ARE NOT REFUNDABLE

Any application that contains omissions or is incorrectly completed will be returned to the Applicant.

- Documentation

All required documents together with photocopies thereof ( + English translations, if applicable) should be presented with an application.

Applicant must attach two recent coloured photographs in respect of the person whose name appears on the application.

- Rules

The passport shall have a validity period at least equivalent to or longer than the validity period of the Residence Permit.

If false information has been deliberately given, or a matter has been concealed which would have led to the rejection of the application, the residence permit will be revoked.

- Data

Information furnished in this application may be forwarded to other Government Departments during the examination of the case.

The information supplied by you (the applicant) in connection with the processing of your application for a residence permit will be registered in the Residence database for which the Maltese Immigration Authorities are responsible. All the relevant information that you supply subsequently in connection with your application for a residence permit will also be registered in the Residence database.

This information will be used when considering issues regarding your residence in Malta and the Police, the Ministry for Justice and Home Affairs as well as other relevant authorities or organizations may receive information about you from the Residence database.

20/12/2006