NATO UNCLASSIFIED/ RELEASABLE TO INTERNET - PERSONAL IN CONFIDENCE (WHEN COMPLETED) TO BE COMPLETED ELECTRONICALLY
In-processing form (SF94 - 03 SEP 2018) is also available for download, at: https://www.shape2day.com/arrivingleaving/inprocessing SF 94 - AUG 18 ANNEX D SD 040-009
SHAPE ID CARD APPLICATION All personnel must be in possession a valid National Passport/Military ID Card when applying for a SHAPE ID Card
Part 1 Personal Details (applicable to all)
Name (Surname first) Marital Status (2)
Maiden Name Date of Marriage
Rank/Title Place of Marriage
Gender Service (3)
Country of Birth & Town Type of Member (4)
Nationality (1) Date of arrival in Belgium
Date of Birth Date of departure:
State of Birth (US and Canada only) NATO Rank
Part 2 Employment Details (not applicable for dependents)
Authorized post number (PE) Branch
Posting Start Date Bldg.
Posting End Date Rm.
Division Tel. Ext
Part 3 For dependents only (tick as appropriate) - please attach supporting notes/official documentation*
Name of the holder (titulaire) SHAPE ID CARD Nr./Post Number
Relationship with the holder (titulaire) Spouse Son Daughter *Civil Partnership *Cohabitation *Other
Part 4 Other details: complete where applicable
Have you been registered in Belgium Yes No From: To:
Do you hold any valid Belgium Id Yes No From: To:
Do you intend to reside in Belgium? If “yes” please indicate your current or future address. If “no”, leave the box blank.
Yes City/post code/name street Nr.
No
Last address abroad City/post code/name street Nr.
Tel. number/and GSM
Email address (official/personal)
Part 5 Situation related to vehicles imported in Belgium where applicable.
How many vehicles will you bring into Belgium and plate number Nr. Plate Nr: Plate Nr:
Part 6 SHAPE Language Testing Centre, Linguistic Services (Bldg 101, Room M104/105) For Military Personnel Assigned to an ACO PE Post
Language test
Yes - No
Presented him/herself with a valid English language proficiency certificate OR signed up for an English language proficiency test
Date: Stamp & Signature, SLTC
Applicant’s declaration ANY FALSE DECLARATION MAY RESULT IN THE LOSS OF SHAPE PRIVILEGES AND/OR IMMUNITIES. I UNDERSTAND THAT SHOULD ANY SUBSEQUENT INFORMATION ASCERTAINED BY SHAPE OR HOST NATION OFFICIALS REVEAL THAT I AM NOT ENTITLED TO RECEIVE SHAPE PRIVILEGES AND/OR ENTITLEMENTS, SUCH PRIVILEGES AND/OR ENTITLEMENTS CAN BE WITHDRAWN AND BELGIAN AUTHORITIES ARE EMPOWERED TO DEMAND REIMBURSEMENT OF APPLICABLE TAXES.
Applicant’s signature
Certified by Stamp/Date/Signature (NMRs/SU/J1 CHRM/SHAPE NCIA/ACTSEE)
(stamp of entitled authority) See SD 040-009
Determination Individual’s Legal Status and Classification
SHAPE BSG - FSCEP - REGISTRATION
SECTION (BLDG 210 - RM.110) TO BE COMPLETED BY BSG/FSCEP/RGN Personnel ONLY
Type of Member
Type of Card Stamp/Date/Signature
Matrix Status & Entitlements. APMS - Nr.
Remarks:
Nr. (to be numbered in order to permit a MIN FIN verification). BEL SID - Mod P or S. Request Nr. (if applicable):
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NATO UNCLASSIFIED/RELEASABLE TO INTERNET - PERSONAL IN CONFIDENCE (WHEN COMPLETED)
TO BE COMPLETED ELECTRONICALLY
SF94 – AUG 18
ANNEX D of SD 040-009
1. NATIONALITY
NATO
MEMBERS ALB ALBANIA BEL BELGIUM BGR BULGARIA CAN CANADA
HRV CROATIA CZE CZECH REPUBLIC DNK DENMARK EST ESTONIA
FRA FRANCE DEU GERMANY GRC GREECE HUN HUNGARY
ISL ICELAND ITA ITALY LVA LATVIA LTU LITHUANIA
LUX LUXEMBOURG MNE MONTENEGRO NLD NETHERLANDS NOR NORWAY
POL POLAND PRT PORTUGAL ROU ROMANIA SVK SLOVAKIA
SVN SLOVENIA ESP SPAIN TUR TURKEY GBR UNITED KINGDOM
USA UNITED STATES
PFP
MEMBERS* ARM ARMENIA AUT AUSTRIA AZE AZERBAIJAN BLR BELARUS
BIH BOSNIA AND HERZEGOVINA FIN FINLAND FYR FYROM GEO GEORGIA
IRE IRELAND KAZ KAZAKHSTAN KGZ KYRGYSTAN MLT MALTA
MDA MOLDOVA RUS RUSSIA SRB SERBIA SWE SWEDEN
CHE SWITZERLAND TJK TAJIKISTAN TKM TURKMENISTAN UKR UKRAINE
UZB UZBEKISTAN
MEDITERRANEAN
DIALOGUE
DZA ALGERIA EGY EGYPT ISR ISRAEL JOR JORDAN
MRT MAURITANIA MAR MOROCCO TUN TUNISIA
ICI* BHR BAHRAIN KWT KUWAIT QAT QATAR ARE UNITED ARAB EMIRATES
PATG* AFG AFGHANISTAN AUS AUSTRALIA COL COLOMBIA IRQ IRAQ
MNG MONGOLIA NZL NEW ZEALAND JPN JAPAN PAK PAKISTAN
PRK REPUBLIC OF KOREA
2. MARITAL STATUS
A MARRIED B CIVIL PARTNERSHIP C SINGLE D DIVORCED
E WIDOW(ER)
3. SERVICE
A ARMY AF AIR FORCE C CIVILIAN N NAVY
M MARINES
4. TYPE OF MEMBER
MIL MILITARY NIC NATO CIVILIAN CIV COMP NATIONAL CIVILIAN COMPONENT DEP DEPENDENT
CON CONSULTANT INT INTERNSHIP CCS CONCESSIONAIRES SAT SATELLITE
SFP FEDERAL POLICE LWF LOCAL WORK FORCE LWR LOCAL WAGE RATE LWS LOCAL WAGE SCALE
DIP DIPLOMAT PFP PARTNERSHIP FOR
PEACE
SIS SHAPE INTERNATIONAL SCHOOL CTR IHP US CONTRACTOR INDIRECT HIRE
TDY TEMP NATO DUTY (TRAVEL
ORDER IS REQUIRED)
OTH OTHERS CIV VOL CIVILIAN VOLUNTEER
PfP: Partnership for Peace
ICI: Istanbul Cooperation Initiative
PatG: Partners across the Globe
The SHAPE Visitors’ Office is located in Bldg 108 [Berlin Gate] and there a clerk will issue a one day access pass / vehicle pass (for the in-processing).
FSCEP - Registration Section (RGN), is located in Bldg 210 - Room 110. Opening hours: Monday to Thursday: 08.45 hrs to 13.00 hrs / 14.00 hrs to 17.00 hrs, Friday: 08.45 hrs to 13.00 hrs.
This request does not give access to Class II areas. Therefore, a validated SF 1, AF 107 and a Security Clearance are mandatory.
AMENDMENTS/COMMENTS
Users of this form are invited to send amendments/comments and suggested improvements to SHAPE J1-MOR - SHAPE Bldg.101
In-processing form (SF94 – 03 SEP 2018) is also available for download, at: http://www.shape2day.com/arriving--leaving-shape/inprocessing.aspx
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CTR CONTRACTOR
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