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Stamp embassy Or consulate Application for Schengen Visa Photo This application form is free N 12225×01 1. Surname(s) family name(s)) FOR EMBASSY / CONSULATE USE ONLY 2. Surname(s) at birth (earlier
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. Citizenship (name of foreign state) 13. Issuer State of issue, issue date 14. Issuer/Name of issuing country(IES) 15. Issuer (incl. country of issue) : 16. Language of issue : 17. Date issue of visa issued to applicant (year/month/day) 18. Issuing country of issuance 19. Signature of issuing authority 10. Application date of stamp : 1. Application number 2.