Application for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay

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1 Application for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Nederlandse versie Dit aanvraagformulier is ook verkrijgbaar in het Nederlands. Bel met ( 0.10 p.m. plus de kosten voor het bellen met uw mobiele telefoon). Vanuit het buitenland belt u Of kijk op: om dit formulier aan te vragen of te downloaden. Please read the explanation on this page and the next carefully before you fill in the form. Why this form? You can use this form to submit an application for a Dutch Regular Residence Permit (VVR). You can only use this form if one of the following situations applies to you: You do not have or do not need a Regular Provisional Residence Permit (MVV); or You have an MVV for a specific purpose of stay, but you want to apply for a residence permit for a another purpose of stay; or You want to change your residence permit for a specific purpose of stay into a residence permit for a another purpose of stay; or Your personal situation has changed and you must submit a new application; or The situation of your sponsor has changed and you must submit a new application. In all other cases, it is not possible to use this form to submit an application. On page 3 of this form you can read which form you must use to submit your application. NB. If you want to stay in the Netherlands as a scientific research worker within the meaning of Directive 2005/71/EC, then contact the research institute. The institute must submit the application on your behalf. How to fill in this form Fill in one form for each person for whom an application is being submitted. The form consists of 19 pages and 21 appendices. Tick under 6 (page 7) the box stating the purpose of stay for which you are submitting an application for a residence permit. Which appendices you have to fill in depends on your situation. This has been indicated in the questions and on the appendices. Do not submit this form until you have filled in this form completely and collected all the required evidence and documents, so do not submit it in parts. If your application is not complete it cannot be assessed properly. Non-payment or overdue payment and the submission of an incomplete application may slow down the handling of the application. You can only tick one purpose of stay on each application form. Minor children If you are the parent or legal representative of a minor child, you can also fill in this form on behalf of him/her. Where the form refers to you or the applicant, the child is meant. Fill in one form for each child. Please answer all questions on behalf of the child. If the child is 12 years of age or older, then he or she must sign the form himself/herself. If the child is younger than 12 years of age, you do not have to fill in point 3, the Antecedents Declaration. NB. It is possible that the minor child has Dutch nationality by operation of law, and does not need a residence permit at all. This may be the case in the following situations: At the time the child was born, the child s father was living in the Netherlands and his father s father or mother was living in the Netherlands when he was born himself; or At the time the child was born, the child s mother was living in the Netherlands and her mother s father or mother was living in the Netherlands when she was born herself. For more information you can contact the migration/immigration desk or the Population Affairs Department in the municipality of your place of residence. Have you been staying with your spouse or partner or registered partner for a period of three years or longer? Have you had, for a period of three years or longer, a residence permit to stay with a person who is permitted to stay in the Netherlands permanently or with a Dutch national? In that case, you may qualify for a residence permit for the purpose of continued residence. The advantage of a residence permit for continued residence is that the extension of the period of validity of this residence permit Signature of the foreign national (the applicant) I have filled in this form truthfully. I know that, for the purpose of implementing the Aliens Act 2000, the personal data filled in will be processed and passed on to the institutions that require these details for this purpose. I will immediately inform the IND of any changes in the situation that relates to the residence permit. Name City/Town and date Signature City/Town I submit this form and of appendices/documents in evidence IND5007_M35A/11B

2 2 of 19 does not depend on your family situation. The residence permit for continued residence is therefore also called an independent residence permit. How to submit this application Before you submit the application, call ( 0.10 per minute plus any additional costs charged by your operator if you are calling from a mobile phone) to make an appointment with the IND desk in your region. The IND employee will tell you which information you must bring with you to the appointment. Each person submitting an application must be present when the application is being submitted. You must bring the originals of all the required evidence and documents with you. The IND verifies these documents and makes copies of them, after which the IND will return all original documents to you. The copies will be added to your application. IND desks The IND has desks in Zwolle, Utrecht, Rijswijk, Den Haag, Rotterdam, Eindhoven, Den Bosch, Amsterdam, and Hoofddorp. These are the cities/ towns where you must submit your application. Please visit for the nearest IND desk. What will happen with your application? Once you have submitted your application at one of the IND desks and you have paid the application costs (fees), your application will be assessed by the IND. If your application is not complete it cannot be assessed properly. Non-payment or overdue payment and the submission of an incomplete application may slow down the handling of the application. According to the law, the IND must make a decision on your application within 6 months. You will receive a written notice when the handling of your application has been completed. When your application is granted, you will receive a letter with information about where you can pick up your residence document. Period of validity of the residence permit You can use this form to submit an application for a Temporary VVR. The Temporary VVR is valid for one year, unless it becomes evident within that year that you no longer meet the conditions that apply to the purpose of stay you have stated in this application. You must also use this form if you currently have a VVR for study purposes and you want to make use of the so-called orientation year for highly skilled migrants. You can only apply for a VVR for one purpose of stay. Application costs (charges) Applying for a residence permit costs money. These costs must be paid the moment you submit the application. The costs depend on the purpose of stay for which you submit an application. This form does not include any information about the costs or a possible exemption from paying charges. If you want to be informed of the costs in advance, please visit or call ( 0.10 per minute plus any additional costs charged by your operator if you are calling from a mobile phone) or from outside the Netherlands. If the assessment of your application establishes that you do not qualify for the requested residence permit the money will not be refunded. Other forms Do you already have a valid MVV and do you want to apply for a residence permit for the same purpose? In that case use the form Application for a Residence Permit with an MVV. Do you have Bulgarian or Romanian nationality? Or are you a family member of a person with a nationality from an EU/EEA Member State or Switzerland? In those cases, you may, if you wish to do so, apply for a certificate of lawful residence on the basis of EU Law instead of applying for a VVR. In that case, do not use this form, but use the form Application for Verification against EU Law (certificate of lawful residence). Are you a national of the Union or a family member of a national of the Union and have you stayed in the Netherlands for a continuous period of 5 years or more? In that case, use the form Application for a Permanent Residence Permit for nationals of the Union and their Family Members. You can also use this form if you are a national of the Union who, after having worked as an employee or on a self-employed basis, has retired or has taken early retirement, who has become permanently unfit for work, or who has worked as a frontier worker. Do you want to extend your current residence permit? In that case, use the form Application for an Extension of the Residence Permit. Under specific conditions it is possible for formerly privileged foreign nationals, foreign nationals who remigrated with application of Article 8 of the Dutch Remigration Act, and adult individuals who qualify for re-entry, as referred to in Article 3.92 of the Dutch Aliens Decree, to apply for a Permanent VVR. In that case, use the form Aanvraag of wijziging verblijfsvergunning regulier voor onbepaalde tijd. If you want to be considered for a residence permit for reasons that are based on asylum-related grounds, you cannot use this form. You must apply for asylum at the Application Centre in Ter Apel. For more information about this, call ( 0.10 per minute plus any additional costs charged by your operator if you are calling from a mobile phone) or from outside the Netherlands. NB. If you want to stay in the Netherlands for study purposes, the following applies: If you want to attend a higher education course and you do not have a provisional residence permit, then do not use this form, but contact the educational institution. The educational institution must submit the application on your behalf. New passport photo, signature, and Appendix Photo Card This form must be accompanied by a Photo Card, which is necessary for making your residence permit. Please place your colour passport photo and your signature on this Photo Card. The passport photo will be placed on a chip on the residence permit. Your signature will also be included on the residence permit. Requirements of the colour passport photo Your colour passport photo, which you must place on the enclosed Photo Card, must meet the following requirements: Your passport photo may not have been used for a residence permit before and it must bear a clear resemblance. In addition, your passport photo must meet the Dutch passport requirements. You can find these requirements at If your passport photo does not meet these requirements, it will not be possible to make a residence permit and issue it to you. So it is important that you send along a proper passport photo. Always have a new passport photo made by a professional photographer who is familiar with the applicable requirements for passport photos in the Netherlands. Signature requirement Each person from 12 years or older must place his/her signature on the Photo Card himself/herself. Bring the Photo Card along when you are submitting your application. Border-crossing document When you are going to submit your application, you must also bring along your border-crossing document (e.g. your passport). A sticker will be affixed to this document and a copy will be made of it. This copy will be added to your application. Foreign documents Any official foreign documents about persons that are required for the application must have been legalised or provided with an Apostille stamp by the competent authorities of the issuing country. This may relate to documents such as birth certificates, certificates of unmarried status (not older than 6 months), marriage certificates, and court decisions regarding adoption and guardianship. This may take a great deal of time. We therefore advice you to have the relevant documents legalised or provided with an Apostille stamp in the country of origin several months before submitting the application. For more information about legalisation or Apostille requirements for documents for each country and any exceptions to this, please call the Ministry of Foreign Affairs at (+31) (0) or visit IND5007_M35A/11B

3 Application Language of the documents to be enclosed All documents must have been drawn up in Dutch, English, French, or German. Is this not the case? If this is not the case, you must have your documents translated by a translator who has been sworn in as a translator by the Dutch court. Submit the translation(s) and the document(s) together with the application to the IND. If you do not have the document(s) translated in the Netherlands by a translator who has been sworn in as a translator by the Dutch court, but abroad, not only the document, but also the translation must have been legalised or provided with an Apostille stamp by the competent authorities of the issuing country. Work permit If you want to work as an employee, you will often need a work permit. For further information about the work permit, please contact UWV WERKbedrijf (which is the work placement division of the Netherlands Employees Insurance Agency) ( Tuberculosis If you want to be considered for a residence permit, you must first take a tuberculosis test and, if necessary, undergo treatment. You must prove this with an original recent Tuberculosis Test Reference Form filled in and signed by the Dutch Municipal Health Service (GGD) if you are applying for a residence permit for the first time. This obligation does not apply to foreign nationals who have the nationality of an EU/EEA country, Australia, Canada, Israel, Japan, Monaco, New Zealand, Surinam, United States of America, and Switzerland. You are also not obliged to undergo a TB test if you have one of the following documents: An EC 3 of 19 for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Immigration and Naturalisation Service Ministry of the Interior and Kingdom Relations residence permit for long-term residents issued by another EU Member State or if you are a family member of the long-term resident and you have already been admitted to another EU Member State as a family member of the long-term resident. Dutch Personal Data Protection Act Under the Dutch Personal Data Protection Act, the IND is obliged to inform you that the IND is the organisation that processes the data included in your application. The IND does this to establish whether you qualify for an asylum residence permit. The Minister for Immigration and Asylum is responsible for this. If you have any questions about this data processing, you can ask these questions in a letter to the IND, Postbus 1200, 2280 GE Rijswijk, the Netherlands. You can also send a request to the same address asking the IND for an overview of the data processed about you. With reference to this overview, you may ask the IND to correct, supplement, delete, or block your personal data. More information Please call the IND for more information about this application form or about your situation. The IND can be reached at on working days from 9 a.m. to 5 p.m. ( 0.10 p/m plus the costs of your mobile telephone), or from outside the Netherlands, or visit You can also go to one of the IND desks. If you want to know where the nearest IND desk is, please visit or call ( 0.10 per minute plus any additional costs charged by your operator if you are calling from a mobile phone) or from outside the Netherlands. 1 Details of the foreign national (the applicant) I am submitting this application (for the maximum period of validity) for myself / my child / the child that I legally represent: > Tick the situation that applies to you. a. n An initial residence permit b. n Change of the purpose of stay of the residence permit (together with the extension of the validity of the residence permit) 1.1 V-number n Yes n No (The V-number can be found in previous correspondence from the IND or on your previous residence permit ) 1.2 Citizen Service (BSN) (if known) 1.3 Name Surname as it appears in your passport or on your identity papers First names 1.4 Gender n Male n Female 1.5 Home address Street Postal code City/Town 1.6 Date of birth 1.7 Place of birth 1.8 Country of birth 1.9 Nationality 1.10 Civil status 1.11 Contact Telephone number Do you have an EC residence permit for long-term residents in another Member State? n Yes n No IND5007_M35A/11B

4 4 of 19 2 Details of the sponsor Fill in the required data concerning the sponsor. The sponsor is the person with whom you want to stay or the organisation that will pay for your stay in the Netherlands. If you want to stay in the Netherlands, for example to work, or in preparation of a study, or to attend a course, please fill in the data of the organisation by whom you will be employed or where you will attend a course, and its contact person. 2.1 Citizen Service (BSN) (if known) 2.2 Name Surname as it appears in your passport or on your identity papers First names 2.3 Gender n Male n Female 2.4 Home address Street Postal code City/Town 2.5 Date of birth 2.6 Place of birth 2.7 Country of birth 2.8 Nationality 2.9 Civil status 2.10 Contact 2.11 Residence status Telephone number n Dutch nationality n Awaiting the outcome of an application for a residence permit n None n Privileged n Residence permit > Fill in only in cases of work/study 2.12 Name of the organisation 2.13 Contact person 3 Antecedents Declaration 3.1 Tick the situation that applies to you. You only have to fill in this declaration if you (the applicant) are 12 years of age or older. NB. If you do not fill in this Antecedents Declaration truthfully, this may have consequences for your residence status. a. n I declare the following: I have never been sentenced to a term of imprisonment - nor have I received a custodial order - for committing a crime; I have never been sentenced to perform unpaid work for the benefit of the general public or to perform community service for committing a crime; I have never received an unconditional fine for committing a crime; I have never accepted an out-of-court settlement for committing a crime; I have never received a punishment order for committing a crime; I am currently not involved in criminal proceedings for committing a crime; I have never been responsible for one of the following categories of acts as referred to in Article 1F of the Convention on Refugees of 1951: a crime against peace, a war crime, or a crime against humanity, a serious non-political crime (e.g. murder or an act of terrorism), or acts contrary to the purposes and principles of the United Nations (e.g. acts of terrorism); and I am familiar with the fact that a sentence for committing a crime may result in a refusal of a residence application or a termination of residence. b. n I cannot declare the above for the following reasons: IND5007_M35A/11B

5 Application 5 of 19 for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Immigration and Naturalisation Service Ministry of the Interior and Kingdom Relations The countries that are members of the European Union (EU) are the following: Austria, Belgium, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Greece, Germany, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Poland, Portugal, Romania, Slovenia, Slovakia, Spain, Sweden, and the United Kingdom. The countries that are members of the European Economic Area (EEA) are the following: Liechtenstein, Norway, and Iceland. 4 Tuberculosis If you want to be considered for a residence permit, you must first take a tuberculosis test and, if necessary, undergo treatment. If you are applying for a residence permit for the first time, you must prove that you have taken this test by means of the Tuberculosis Test Reference Form. Several nationalities are exempt from this obligation (see the explanation on the back/page 2 of this form). Tick the situation below that applies to you. If you as a foster child or as an adopted child have passed a TB examination in the country of origin and this is evidenced by a recent medical declaration to be submitted along with the application, you do not have to undergo a TB test. a. n I do not have to undergo a TB test, because I have the nationality of one of the following countries: Australia, Canada, Israel, Japan, Monaco, New Zealand, Surinam, Switzerland, United States of America, the EU/EEA countries. b. n I do not have to undergo a TB test, because I have a valid EC residence permit for long-term residents issued by another EU Member State, or I am a family member of a long-term resident and I have already been admitted to another EU Member State as a family member of the long-term resident. c. n I do not have to undergo a TB test, for I was born in the Netherlands and I have not moved my main residence outside the Netherlands since my birth. d. n I have already undergone a TB test in connection with my first application for a residence permit, and my new application concerns a continuation of that residence. e. n I have another nationality and n I have already undergone a TB test in the Netherlands: You must accompany your application by an original recent TB Test Reference Form. This form proves that you have undergone a TB test, but the form may not be older than 6 months; n I have not yet undergone a TB test in the Netherlands: Your application must be accompanied by a signed Declaration of Intent to Undergo a TB Test showing that you are prepared to undergo a TB test. Use the Appendix Declaration of Intent to Undergo a TB test for this purpose. You must then make an appointment for this test. You can make an appointment with the Municipal Health Service (GGD) in the region where you are staying (visit for more information). Use the Appendix TB Test Reference Form for this purpose. 5 Exemption from the Obligation to Have an MVV, and Special Situations You will usually be required to have a Provisional Residence Permit (MVV) to be able to apply for a Dutch residence permit. You must apply for an MVV in the country of permanent residence. This is your country of origin, or the country where you have been permitted to stay for a period longer than 3 months on the basis of a residence permit. You may enter the Netherlands with a valid MVV. Once in the Netherlands you can use this MVV to apply for a residence permit for the same purpose of stay. In some cases, you do not require a Provisional Residence Permit. The relevant situations are listed and explained below: Please read all the situations before ticking the situation that applies best to you. If your situation is not listed below, you will probably require an MVV. n I have a valid residence permit The period of validity is stated on your residence permit. Your application must be accompanied by copies of the front and back of your residence permit. n I have a nationality that is exempt from the MVV requirement Persons having the nationality of one of the following countries do not require an MVV to apply for a residence permit: Australia, Austria, Belgium, Bulgaria, Canada, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Greece, Germany, Hungary, Iceland, Ireland, Italy, Japan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Monaco, New Zealand, Norway, Poland, Portugal, Romania, Slovenia, Slovakia, Spain, South Korea, Sweden, United Kingdom, United States of America, and Vatican City. n The period of validity of my residence permit has expired The period of validity is stated on your residence permit. If you have not been able to extend or change your residence permit within 2 years from expiry of the document, you must state the reason for this in a separate letter. Only in cases where this was caused by circumstances beyond your control will it not be necessary for you to have an MVV. You must accompany you application by this letter together with as many pieces of evidence and documents as possible to substantiate your story. n I cannot apply for an MVV in my country of origin for health reasons If, for medical reasons, it is not safe for you to travel to your country of origin, you do not have to apply for an MVV. You must prove this with the following evidence The Appendix Declaration on Your Medical Situation filled in completely and signed by your doctor. This declaration may not be older than 1 month. Any changes in your medical situation that may be relevant to taking a decision must be declared in a new medical declaration. The Appendix Medical Information Disclosure Consent Form filled in completely and signed by you. If several doctors are in charge of your treatment, the consent to contact these doctors must be given separately for each doctor. Your consent must be given with respect to the contact with the doctor(s) in charge of your treatment in the Netherlands as well as the doctor(s) in charge of your treatment in the country of origin; n I am submitting an application for a residence permit for re-entry A residence permit for re-entry is for former Dutch nationals and foreign nationals who had a residence permit in the Netherlands in the past for many years. If you want to qualify for a residence permit for the purpose of re-entry, you are usually exempt from the MVV requirement. The situations in which you may submit an application for a residence permit for the purpose of re-entry are stated below. For each situation, an indication is given as to whether or not you are exempt from the MVV requirement. You are a former Dutch national and you were born and raised in the Netherlands. There is no general exemption form the MVV requirement in this case. It is, however, very probable that you will be exempt from the MVV requirement after all, because you were a lawful resident of the Netherlands as a Dutch national before you were 19 years of age for a period of 5 consecutive years, and you did not change your main residence to a country outside the Netherlands. For more information about this, call ( 0.10 per minute plus any additional costs charged by your operator if you are calling from a mobile phone) or from outside the Netherlands). IND5007_M35A/11B

6 6 of 19 You are a former Dutch national and you were born outside the Netherlands. There is no general exemption form the MVV requirement in this case. It is, however, possible that you will be exempted from the MVV requirement for another reason, for example, because you have the nationality of one of the countries to which the MVV requirement does not apply. For more information about this, call ( 0.10 per minute plus any additional costs charged by your operator if you are calling from a mobile phone) or from outside the Netherlands). You do not require an MVV in the following situations: You are of age and you were a lawful resident of the Netherlands for at least 10 years when you were between 4 and 19 years of age and you are submitting the application for the purpose of re-entry before you have reached the age of 23 years; You are of age or you were a lawful resident of the Netherlands for a period of at least 5 consecutive years before you turned 19 years of age and the Netherlands is the most appropriate country of residence for you; You are a minor, your accommodation and representation in the Netherlands have been arranged, and you were a lawful resident of the Netherlands (or as a Dutch national) from the age of 4 years for a period of 10 years; You are a minor, your accommodation and representation in the Netherlands has been arranged, and you were a lawful resident of the Netherlands (or as a Dutch national) for a period of 5 years before submitting the application and the Netherlands is the most appropriate country of residence for you; You are a former Dutch national and you renounced your Dutch nationality to be able to rely on the provisions of the Dutch Remigration Act; You qualify for re-entry on the basis of Article 8 of the Dutch Remigration Act; You are a former Dutch national and you lost your Dutch nationality because it was withdrawn because you did not renounce your original nationality; You are a former Dutch national because you renounced your Dutch nationality yourself because it would otherwise have been withdrawn because of the failure to renounce your original nationality; You have submitted an application to the District Court in The Hague to establish your Dutch nationality and the Minister of Security and Justice does not consider this application utterly unfounded. You lived outside the Netherlands due to imprisonment or military service. n I am staying as a family member with someone who has a privileged status. My family member himself/herself qualifies for a permanent residence permit. If you are staying - as a family member - with someone with a privileged status and you currently also have a privileged status, you do not require an MVV. This only applies if the family member with whom you are staying submitted an application for a permanent residence permit at the same time as you did. Employees of a foreign diplomatic or consular post or an international treaty organisation, for example, have a privileged status. n I have worked on a Dutch sea-going vessel or in a mining installation on the continental shelf for 7 years or more. If you can prove that you have worked on a Dutch sea-going vessel or in a mining installation on the continental shelf for 7 years or more, you do not require an MVV. You must accompany this application by the relevant evidence. n I have Turkish nationality and I have worked legally in the Netherlands during the past year If you have Turkish nationality and you have worked legally in the Netherlands during the past year, you do not require an MVV, on the basis of an international treaty. This treaty only applies if you want to continue to work as an employee in the Netherlands and you want to apply for a residence permit for this purpose. n I am a family member or a former family member of a Turkish employee and I lived with this Turkish employee. If you have lived legally in the Netherlands as a family member of a Turkish employee for three years, you do not require an MVV, on the basis of an international treaty. n I have Turkish nationality and I want to work in the Netherlands on a self-employed basis If you have Turkish nationality and you want to work in the Netherlands on a self-employed basis, the MVV requirement will not be enforced against you in advance if you immediately submit a business plan along with your application to work on a self-employed basis, and it is evident that you have sufficient personal experience and that your profession or business has added value to the Dutch economy. If during the handling of your application it becomes evident that you meet all conditions of admission concerning work on a self-employed basis, you do not require an MVV on the basis of an international treaty. n I am a victim or witness reporting human trafficking If you are a victim or witness reporting human trafficking, you must report to the police. On the basis of this report, you can obtain a residence permit. You are not obliged to submit a separate application for this purpose. You do not require an MVV in this case. n I have an EC residence permit for long-term residents that was issued by another Member State or I am the principal person s spouse or partner or registered partner or minor child, and I was admitted to the other Member State as a family member of the long-term resident If you have an EC residence permit for a long-term resident in another Member State of the EU or if you are the spouse or partner or registered partner or minor child of a person who has an EC residence permit for long-term residents and you formed a family with that person in the other Member State, you do not require an MVV. n I am the child of someone with an EC residence permit for long-term residents in another Member State. I am unmarried, and of age. I was also admitted to the other Member State as a family member of the long-term resident because I am not capable of supporting myself for health reasons. If you are the unmarried adult child of someone who has the EC residence permit for long-term residents and you were admitted to the other Member State as a family member of the long-term resident and you are not capable of supporting yourself, in that case your application must be accompanied by evidence of this. n I cannot leave the Netherlands If you cannot leave the Netherlands through no fault of your own, because you do not have a valid border-crossing document and it is not possible for you to obtain replacement documents for valid reasons, you do not require an MVV. Under 20, Residence permit due to absence of all guilt on page 16, you will find a list of documents and supplementary evidence by which you must prove this. n I am a minor child and I have been a lawful resident of the Netherlands for a period of at least 3 years. You do not require an MVV in the following cases: you are a minor; and you have been a lawful resident of the Netherlands for a period of at least 3 years; and you go to school; and you intend to stay with a parent who is a lawful resident of the Netherlands. n I want to stay with a family member with an asylum residence permit, but my nationality is different from that of this family member You do not require an MVV in the following cases: You are submitting the request for family reunification within three months after your family member who is staying in the Netherlands has been granted an asylum residence permit; You cannot stay in a country with which you have special ties (e.g. your country of origin). n I cannot leave the Netherlands because this is contrary to Article 8 of the European Convention on Human Rights If you are of the opinion that you cannot leave the Netherlands because the family life that you have in the Netherlands must be protected by Article 8 of the ECHR, you must accompany this application by evidence showing the ties with the family member who is staying in the Netherlands / the family members who are staying in the Netherlands. You must also set out clearly in which way you give content to this family life. You must also submit evidence showing that you and your family members are capable of supporting yourselves (e.g. by means of an employment agreement, salary slips, etc.). If either you or your family members do not have any means of existence, you must submit evidence showing what you and your family members have undertaken to earn an income or evidence showing that you are unfit for work or that you are exempt from the obligation to seek work. n Other You want to apply for a Dutch residence permit and you do not have a valid or correct MVV. Only if there are special and individual circumstances will you possibly be able to obtain a residence permit without an MVV. This only applies if you cannot be expected to apply for an MVV in your country of origin or a country of permanent residence outside the Netherlands. Explain in a separate letter why this is not possible for you. You must accompany your application by this letter together with as many pieces of evidence and documents as possible to substantiate your reasons. n I was born in the Netherlands, I am 12 years of age or younger and I did not change my main residence to a country outside the Netherlands A child of 12 years of age or younger that was born in the Netherlands and is part of the family of the sponsor (who also did not change the main residence to a country outside the Netherlands) does not require an MVV. The parent(s) must have been (a) lawful resident(s) in the Netherlands. IND5007_M35A/11B

7 Application 7 of 19 for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Immigration and Naturalisation Service Ministry of the Interior and Kingdom Relations 6 Purpose of Stay in the Netherlands Please state the main purpose of your stay in respect of which you are applying for a residence permit. Tick the most important purpose of stay and follow the instruction stated there. n To stay with a spouse or partner or registered partner or family member or relative If you want to stay with a spouse or partner or registered partner or family member or relative who lives in the Netherlands > Go to 7 on page 8 and follow the instruction written below this purpose of stay. n To work as an employee or as a trainee or for the purpose of work experience If you want to work as an employee or as a trainee or for the purpose of work experience for a Netherlands-based company > Go to 8 on page 12 and follow the instruction written below this purpose of stay. n To work on a self-employed basis If you want to practise a profession or operate a business in the Netherlands on a self-employed basis > Go to 9 on page 13 and follow the instruction written below this purpose of stay. n To search for a job as a highly skilled migrant or to start an innovative business after having finished your study, and to make use of the orientation year > Go to 10 on page 14 and follow the instruction written below this purpose of stay. n To work on the basis of an international treaty > Go to 11 on page 14 and follow the instruction written below this purpose of stay. n If you have an EC residence permit for long-term residents issued by another EU Member State If you have an EC residence permit for long-term residents issued by another EU Member State, you can stay in the Netherlands for the following purposes of stay: To work as an employee > Go to 8 on page 12 and follow the instruction written below this purpose of stay. To work on a self-employed basis > Go to 9 on page 13 and follow the instruction written below this purpose of stay. For study purposes > Go to 13 on page 15 and follow the instruction written below this purpose of stay. For other reasons (other than employment, study or vocational training course) > Go to 12 on page 15 for purpose of stay economically non-active, and follow the instruction written below this purpose of stay If none of the above-mentioned purposes of stay apply, but another purpose mentioned in this form applies, follow the instruction written below this purpose of stay. n For study purposes > Go to 13 on page 15 and follow the instruction written below this purpose of stay. n For Exchange Purposes If you want to become acquainted with the Dutch society and culture through the Working Holiday Scheme, the Working Holiday Program, or through a private organisation > Go to 14 on page 15 and follow the instruction written below this purpose of stay. n As an au pair If you want to stay in a host family as an au pair to become acquainted with the Dutch society and culture > Go to 15 on page 15 and follow the instruction written below this purpose of stay. n On religious or ideological grounds If you want to stay in the Netherlands with a religious or ideological organisation > Go to 16 on page 16 and follow the instruction written below this purpose of stay. n For Medical Reasons If you want to stay in the Netherlands because you must undergo medical treatment here > Go to 18 on page 17 and follow the instruction written below this purpose of stay. n As a victim or witness reporting human trafficking > Go to 19 on page 17 and follow the instruction written below this purpose of stay. n Through no fault or action of your own > Go to 20 on page 18 and follow the instruction written below this purpose of stay. n Continued residence You may qualify for continued residence in the following cases: You have Turkish nationality and - before submitting the application for continued residence - you had a residence permit for seeking and performing work whether as an employee or on a self-employed basis after the termination of the marriage; You are a minor and you have had a residence permit for at least 1 year to stay with parents or adoption or foster parents; Before submitting your application for continued residence you had a residence permit for a period of at least 3 years for the purpose of family reunification or family formation, medical treatment, as an unaccompanied minor foreign national, or because you cannot leave the Netherlands through no fault of your own; Before submitting your application for continued residence you had a residence permit to stay with your spouse or partner or registered partner, and your spouse or partner or registered partner has died; Before submitting your application for continued residence you had a residence permit to stay with your spouse or partner or registered partner, and you can prove that you are a victim of domestic violence; You had a residence permit because you are a victim or witness reporting human trafficking; You had a residence permit, but you cannot leave the Netherlands for special circumstances. > Go to 21 on page 18 and follow the instructions written below this purpose of stay. n You are a victim of domestic violence, or honour-related violence, or you are a victim of human trafficking, and you cannot or you do not want to report this to the police or render your cooperation in the criminal investigation and prosecution of the human trafficker due to serious threats and/or a medical or psychological impairment. > Go to 22 on page 19 and follow the instruction written below this purpose of stay. n You cannot leave the Netherlands because your are stateless or for other reasons If you do not have a valid travel document and you have not obtained a replacement travel document through no fault of your own. In other cases you do not have to submit supplementary evidence. If the IND has any further questions, you will receive a separate letter after having submitted this form. For more information about this, call ( 0.10 per minute plus any additional costs charged by your operator if you are calling from a mobile phone) or from outside the Netherlands.. Otherwise, due to special and individual circumstances Explain in a separate letter for which purpose you are submitting an application for a residence permit. You must accompany your application by this letter together with as many pieces of evidence and documents of the special circumstances to substantiate your reasons. If the IND has any further questions, you will receive a separate letter after having submitted this form.. n Re-entry If you have lived in the Netherlands earlier, as a Dutch national or with a residence permit > Go to 17 on page 16 and follow the instruction written below this purpose of stay. IND5007_M35A/11B

8 8 of 19 7 Residence Permit to Stay with a Spouse or Partner, Registered Partner, Family Member or Relative Please state below the specific purpose for applying for a residence permit and follow the instruction written there. Tick the most important purpose. You may not tick more than one purpose of stay. If you tick more than one purpose of stay, your application will only be assessed on the purpose ticked first. n You are married to someone or you have a registered partnership with someone (the sponsor) who lives in the Netherlands (320, 324, 340, 344) Proof of your sponsor s income, see Appendix Proof of Income ; An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identification details of your sponsor s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If your sponsor does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. If it concerns a marriage, you must also submit the following: A copy of the marriage certificate (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form). If it concerns a registered partnership, you must also enclose the following: A copy of the certificate of registered partnership. If the sponsor has a temporary asylum residence permit and if you have a different nationality from the sponsor, and the application has been submitted three months after the asylum residence permit has been granted to the sponsor, please also submit the following: Evidence showing that the family life cannot be led in a third country with which you or the sponsor have special ties. For example proof that you or the sponsor will not be admitted to that country. In that case, you do not have to send along any proof of the income of the sponsor. n You are the unmarried partner of someone (the sponsor) who lives in the Netherlands (322, 342) Proof of your sponsor s income, see Appendix Proof of Income ; An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identification details of your sponsor s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If your sponsor does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. The Appendix Sponsor Declaration filled in completely and signed by your sponsor; Your declaration of unmarried status, originating from your country of origin, or from the country where you are permitted to stay for a period of more than 3 months on the basis of a residence permit (see the explanation Foreign Documents on page 2 and Language on page 3 of this form); Your sponsor s declaration of unmarried status. The declaration of unmarried status must originate from your sponsor s country of origin, unless your sponsor has Dutch nationality or a permanent residence permit (see the explanation Foreign Documents on page 2 and Language on page 3 of this form); The Appendix Declaration of Relationship filled in completely and signed by you and your sponsor; The Appendix Questionnaire for a Stay with a Partner filled in and signed by you; If the sponsor has a temporary asylum residence permit and if you have a different nationality from the sponsor, and the application has been submitted three months after the asylum residence permit has been granted to the sponsor, please also submit the following: Evidence showing that the family life cannot be led in a third country with which you or the sponsor have special ties. For example proof that you or the sponsor will not be admitted to that country. In that case, you do not have to send along any proof of the income of the sponsor. n You are a minor child (not born in the Netherlands) and you live at the same address as your parent or your legal representative (the sponsor) (326) Proof of your sponsor s income, see Appendix Proof of Income ; An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identification details of your sponsor s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If your sponsor does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. Your birth certificate or - if the family relationship between you and your sponsor is not evident from your birth certificate - other documents showing that family relationship (see the explanation Foreign Documents on page 2 and Language on page 3 of this form); Documents relating to the parental authority the sponsor has over you (if you were born during the marriage of your parents, a birth certificate will suffice); If you are 15 years of age or older, also submit the following: An original Appendix Declaration of Non-Impediment filled in completely and signed by you and showing that you are unmarried and that you do not provide for children of your own or for children that depend on you. If you are a child by a previous relationship of the sponsor, also submit the following The declaration of consent signed by the parent staying behind in respect of your departure from abroad (if the parents have joint parental authority); Copies of the identification document of the parent staying behind; If the sponsor has a temporary asylum residence permit and if you have a different nationality from the sponsor, and the application has been submitted three months after the asylum residence permit has been granted to the sponsor, please also submit the following: Evidence showing that the family life cannot be led in a third country with which you or the sponsor have special ties. For example proof that you or the sponsor will not be admitted to that country. In that case, you do not have to send along any proof of the income of the sponsor. n You are a minor child and born in the Netherlands and since then you have lived at the same address as your parent or your legal representative (the sponsor) (764) An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identification details of your sponsor s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If your sponsor does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. Your birth certificate (NB. The document referred to here is copy of the birth certificate from the register of births, deaths, marriages, and registered partnerships. This is different from an extract from the Municipal Administration (GBA)). If your birth certificate does not show the family relationship between you and the sponsor, you must submit other documents showing that family relationship (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form). IND5007_M35A/11B

9 Application 9 of 19 for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Immigration and Naturalisation Service Ministry of the Interior and Kingdom Relations n You are married to someone or you have a registered partnership with someone (the sponsor) who has an EC residence permit for long-term residents This EC residence permit was issued by another Member State. The sponsor is a lawful resident of the Netherlands (that is, with a Dutch residence permit) (320, 324); or n You are the minor child of someone (the sponsor) who has an EC permit for long-term residents issued by another Member State and who is a lawful resident of the Netherlands (that is with a Dutch residence) (326) A copy of your residence permit showing that you were admitted to the other Member State as a family member of the long-term resident (the sponsor); Evidence showing that you permanently and independently have sufficient means of existence, whether or not together with the long-term resident, see Appendix Proof of Income ; n You are the adult child of someone (the sponsor) who has an EC permit for long-term residents issued by another Member State and who is a lawful resident of the Netherlands (that is with a Dutch residence permit) (328) A copy of your residence permit showing that you were admitted to the other Member State as a family member of the long-term resident (the sponsor); Evidence showing that you permanently and independently have sufficient means of existence, whether or not together with the long-term resident, see Appendix Proof of Income ; Evidence showing that leaving you behind in the first Member State would be disproportionally harsh (evidence showing that you are apparently not capable of supporting yourself for health reasons). n You are a family member of someone in the Netherlands (the sponsor), but your are not the minor child or spouse or partner or registered partner and you live at the same address as your sponsor (330) Proof of your sponsor s income, see Appendix Proof of Income ; An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identification details of your sponsor s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If your sponsor does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. The Appendix Sponsor Declaration filled in completely and signed by the sponsor (and, if applicable, his/her spouse or partner or registered partner); An original Appendix Declaration of Non-Impediment filled in completely and signed by you and showing that you are unmarried and that you do not provide for children of your own or for children that depend on you; Your declaration of unmarried status (this declaration of unmarried status must originate from your country of origin) (see the explanation Foreign Documents on page 2 and Language on page 3 of this form); Documents showing your family life with the your sponsor before your sponsor took up residence in the Netherlands (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); Documents showing your family life with your sponsor after your sponsor took up residence in the Netherlands (see the explanation on Foreign Documents and Language on page 3 of this form); Documents relating to family members with whom you stayed or can stay in the country of origin (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); Evidence showing that leaving you behind in the country of origin would be disproportionately harsh (e.g. documents showing that there are no family members left in the country of origin, that you depend on the family members with whom you want to stay in the Netherlands and/or that you are not capable of coping independently in the country of origin (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); Evidence relating to the contributions towards the costs of your upbringing, education and living expenses paid by your sponsor from the date your sponsor took up residence in the Netherlands (e.g. deposit receipts or bank statements). If you are an adult child, also submit the following: Documents showing the actual parental authority over you (e.g. evidence showing that the sponsor is or was involved in important decisions concerning your upbringing, education and/or care, including decisions regarding choice of school, housing, and social development); If the sponsor has a temporary asylum residence permit and if you have a different nationality from the sponsor, and the application has been submitted three months after the asylum residence permit has been granted to the sponsor, please also submit the following: Evidence showing that the family life cannot be led in a third country with which you or the sponsor have special ties. For example proof that you or the sponsor will not be admitted to that country. In that case, you do not have to send along any proof of the income of the sponsor. n You are a family member of a minor foreign national who has a temporary asylum residence permit (the sponsor) (347) Copies of the front and back of the sponsor s residence permit; Evidence showing that you are the sponsor s blood relative in the ascending line (father, mother, grandfather, grandmother) (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); If you have a different nationality from your sponsor, also submit the following Evidence showing that the family life cannot be led in a third country with which you or the sponsor have special ties. For example proof that you or the sponsor will not be admitted to that country. If you submit this application more than 3 months after your sponsor was granted a temporary asylum residence permit, also submit the following: Proof of your sponsor s income, see Appendix Proof of Income. If your sponsor has meanwhile reached the age of 18 years, also submit the following: Evidence that the Dutch Court has appointed a guardian or mentor because of your sponsor s mental faculties n You are the father or mother of a child (the sponsor) that lives in the Netherlands and you are 65 years of age or older and you are single. Your sponsor has Dutch nationality, a Dutch permanent residence permit (regular or asylum), or a temporary asylum residence permit (332) Proof of your sponsor s income and, if applicable, his/her spouse or partner or registered partner, see Appendix Proof of Income ; An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identification details of your sponsor s Dutch passport or identity card (and, if applicable, of the Dutch passport or identity card of your sponsor s spouse or partner or registered partner). Also make copies of the pages containing travel stamps. If your sponsor (and, if applicable, your sponsor s spouse or partner or registered partner) does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit(s) or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. The Appendix Sponsor Declaration filled in completely and signed by the sponsor (and, if applicable, his/her spouse or partner or registered partner); Documents showing the family relationship with your sponsor (e.g. a copy of a marriage booklet, a birth certificate, or a family extract from the register of births, deaths, marriages and registered partnerships) (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); The divorce certificate or the death certificate of your spouse or partner or registered partner or the extract from the register of births, deaths, marriages and registered partnerships from the country of origin showing that you are single (this extract may not be older than 6 months); Documents showing the original composition of your family (number of children); Documents showing the residence data of all your children (where they live). IND5007_M35A/11B

10 10 of 19 If you have other children living in the Netherlands who are sponsoring you, also submit the following: Proof of income, see Appendix Proof of Income ; The Appendix Sponsor Declaration filled in completely and signed by the children that are sponsoring you; Copies of all the pages containing the identification details of their Dutch passports or identity cards. Also make copies of the pages containing travel stamps. If they do not have Dutch nationality, please make copies of the front and back of the Dutch residence permits or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. n You are the father or mother of a minor child that lives in the Netherlands and you want to have a family life with this child on the basis of Article 8 of the ECHR (334) NB. You cannot submit this application if you are cohabiting with a spouse or partner or registered partner, or if you intend to cohabit with this spouse or partner or registered partner with whom you could reside. If you do not comply with this condition and you are submitting this application nevertheless, your application will be tested against the condition for residence with a spouse or partner or registered partner. Copies of all the pages containing the identification details of your minor child s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If your minor child does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. Evidence showing the family relationship between you and your minor child, e.g. a copy of a birth certificate (see the explanation Foreign documents on page 2 and Language on page 3 of this form); Evidence showing the manner in which you give content to the family life with your minor child. n You are a foster child of someone (the sponsor) The sponsor lives in the Netherlands (352) NB. You must be a foster child from a family member. The sponsor may only be the foster child s grandparent, brother, sister, uncle, or aunt. Proof of your sponsor s income, see Appendix Proof of Income ; An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identity details of the Dutch passport(s) and identity card(s) of your sponsor and, if applicable, your sponsor s spouse or partner or registered partner. Also make copies of the pages containing travel stamps. If your sponsor and, if applicable, your sponsor s spouse or partner or registered partner, do not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages; A copy of a medical declaration relating to you issued in the country of origin (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); Evidence showing that your parent(s) or legal representative(s) consent to your going to live in the Netherlands with the sponsor. Insofar as required by the country of origin, you must also submit evidence showing that the authorities in the country of origin consent to your taking up residence with the sponsor s family (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); Documents showing the family relationship with your sponsor (e.g. a copy of a marriage booklet, a birth certificate, or a family extract from the register of births, deaths, marriages and registered partnerships) (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); A written statement of reasons of the special circumstances of you or your family members in the country of origin showing that you cannot be taken care of, at least not properly, by the family members who live in the country of origin (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); The Appendix Sponsor Declaration filled in completely and signed by your sponsor; A certificate (e.g. a guardianship certificate) issued by the competent authorities certifying that the authority over the foster child rests with the foster parents. n You have not yet been adopted, but will be adopted into your sponsor s family (350) An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identity details of the Dutch passport(s) and identity card(s) of your sponsor and, if applicable, your sponsor s spouse or partner or registered partner. Also make copies of the pages containing travel stamps. If your sponsor and, if applicable, your sponsor s spouse or partner or registered partner, do not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages; A copy of the Approval in Principle of the Ministry of Security and Justice, Directorate-General for Prevention, Youth and Sanctions; A copy of the declaration showing that a licensed adoption placement agency was used. If no use has been made of such licensed adoption placement agency: a Declaration of Approval of the Ministry of Security and Justice, Directorate-General for Prevention, Youth and Sanctions; A copy of the official decision of the authority competent in the matter, in the country of origin (e.g. the official judgment of the court in the country of origin) as well as a translation of this decision. This must show that you are permitted to be adopted into the family and that the authorities of the country of origin assent to your adoption by the sponsor (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); Documents showing that your parent(s) has/have relinquished you (this approval may be evident from the above-mentioned judgment or from a separate official waiver) (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); A copy of the medical certificate about your state of health, as referred to in the Dutch Placement of Foreign Foster Children Act, recently issued in the country of origin. This certificate may not be older than 6 months (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form). n You have been adopted immediately into your sponsor s family following an adoption judgment The sponsor lives in the Netherlands (350) An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identity details of the Dutch passport(s) and identity card(s) of your sponsor and, if applicable, your sponsor s spouse or partner or registered partner. Also make copies of the pages containing travel stamps. If your sponsor and, if applicable, your sponsor s spouse or partner or registered partner, do not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. A copy of the Approval in Principle of the Ministry of Security and Justice, Directorate-General for Prevention, Youth and Sanctions; A copy of the declaration showing that a licensed adoption placement agency was used. If no use has been made of such licensed adoption placement agency, a Declaration of Approval of the Ministry of Security and Justice, Directorate-General for Prevention, Youth and Sanctions. A copy of the official decision of the authority competent in the matter, in the country of origin (e.g. the official judgment of the court in the country of origin) and a translation of this decision (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); Documents showing that your parent(s) has/have relinquished you (this approval may be evident from the above-mentioned judgment) (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); A copy of the medical certificate of the foreign national s state of health, as referred to in the Dutch Placement of Foreign Foster Children Act, issued in the country of origin. This certificate may not be older than 6 months (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form); If it concerns an adoption judgment rendered by a foreign authority applying the Hague Adoption Convention, also submit the following; A conformity statement IND5007_M35A/11B

11 Application 11 of 19 for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Immigration and Naturalisation Service Ministry of the Interior and Kingdom Relations n You are a family member of a former privileged person (the sponsor) and you depend on him/her (464, 465, 466, 467) Proof of your sponsor s income, see Appendix Proof of Income. An official certificate of the Ministry of Foreign Affairs showing that immediately prior to submitting the application you had a residence permit on the basis of a privileged status as a dependent family member staying with the sponsor; Document showing that you cohabit with the sponsor; Evidence showing that you are running a joint household with the sponsor; If applicable, the certificate of registration at the Municipal Administration (GBA) of your marriage or registered partnership; Copies of all the pages containing the identification details of your sponsor s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If your sponsor does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. Documents showing the family relationship: - In the case of a spouse: a copy of the marriage certificate; - In the case of a partner or registered partner: documents showing the joint partnership and the cohabitation in the country of origin; - In the case of a child: a copy of the birth certificate. NB. Under specific conditions, you may qualify for a permanent residence permit. In that case, you must have resided with the sponsor on the basis of a privileged status as a dependent family member for a period of 10 consecutive years immediately before submitting the application. In that case, use the form Application for or Change of a Temporary Regular Residence Permit n You are a family member of non-privileged NATO personnel (the sponsor) (461, 462, 463) The Appendix Employer s Declaration filled in completely and signed by your sponsor s employer (not older than 3 months); An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months. If your sponsor is not registered at the Municipal Administration (GBA), you must accompany your application by evidence showing that your sponsor s main residence is in the Netherlands Copies of all the pages containing the identification details of your sponsor s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If your sponsor does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. Evidence showing your family relationship with the sponsor: - In the case of a spouse: the marriage certificate; - In the case of a child younger than 21 years of age: the birth certificate; - In the case of relations by blood or affinity (also children of 21 years of age or older): the document showing the family relationship and evidence showing that you depend financially on the sponsor or the sponsor s spouse or partner or registered partner; Evidence showing that the main residence of the sponsor is in the Netherlands. n You are a family member of someone (the sponsor) with a residence permit to undergo medical treatment (415, 416, 417, 418) Your application must be accompanied by the following supplementary piece of evidence: An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; n You want to visit a family member (the sponsor) in the Netherlands (for a period of longer than 3 months and not more than 6 months) (470) Proof of your income, see Appendix Proof of Income. If you do not have sufficient means of existence yourself, the Appendix Sponsor Declaration must be filled in completely and signed by your sponsor or another relative of you in the Netherlands Proof of your sponsor s income and, if applicable, his/her spouse or partner or registered partner, see Appendix Proof of Income ; An original extract (not a copy) from the Municipal Administration (GBA) showing your sponsor s home address and the composition of your sponsor s family. This extract may not be older than 6 months; Copies of all the pages containing the identification details of your sponsor s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If your sponsor does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages; Documents showing the family relationship with your sponsor (e.g. a copy of a marriage booklet, a birth certificate, or a family extract from the register of births, deaths, marriages and registered partnerships) (see the explanation on Foreign Documents on page 2 and Language on page 3 of this form). IND5007_M35A/11B

12 12 of 19 8 Residence Permit to work Please state below the specific purpose for applying for a residence permit and follow the instruction written there. Tick the most important purpose. You may not tick more than one purpose of stay. If you tick more than one purpose of stay, your application will only be assessed on the purpose ticked first. n As an employee (370) Proof of your income, see Appendix Proof of Income ; If required: A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form). n For seeking and performing work whether as an employee or on a self-employed basis after the termination of the marriage and you have Turkish nationality (336) Evidence showing that you were married for at least 3 years and that your marriage has been dissolved Evidence showing that you have had lawful residence on the basis of the marriage for at least 1 year (a copy of your residence permit) n If you have an EC residence permit for long-term residents issued by another EU Member State (370) A copy of the EC residence permit for long-term residents issued by the other Member State; Evidence showing that a health insurance policy has been taken out in your name; A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form); The Appendix Employer s Declaration filled in completely and signed by your employer (not older than 3 months); or A copy of the employment agreement, or a draft employment agreement, which includes information about your income. n As a trainee (374) Proof of your income during your stay as a trainee, see Appendix Proof of Income ; If required: A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form); A copy of the trainee agreement. If you are going to do a traineeship in the context of the Young Workers Exchange Program (YWEP), please also submit the following: Evidence showing that you have Canadian nationality and that you live in Canada; Evidence showing that you are still studying at the moment of submitting the request or evidence showing that you finished your studies not more than 12 months ago. n For the purpose of work experience (375) Proof of your income during your stay for the purpose of work experience, see Appendix Proof of Income ; A copy of the work experience agreement; If required: A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form). n As a guest lecturer or paid scientific research worker (394, 395) Proof of your income, see Appendix Proof of Income ; If required: A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form). n As an unpaid scientific research worker (387) Your application must be accompanied by the following supplementary piece of evidence: A document issued by the grantor or the European Union showing that a fellowship has been granted to you, or proof of your income, see Appendix Proof of Income. n As a director-major shareholder (456) Proof of your income, see Appendix Proof of Income ; If required: A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form); Evidence showing that your employer has reported your current employment agreement to the Tax and Customs Administration; Proof that your interest in the company is not more than 25% and that you receive a salary that has been determined by third parties (if your interest is more than 25%, you must apply for a residence permit to work on a self-employed basis). n As a spiritual leader or as a teacher of religious knowledge (376) Proof of your income, see Appendix Proof of Income ; If required: A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form); The Appendix Spiritual Leader/Teacher of Religious Knowledge Awareness Declaration filled in completely and signed by you; Information about the religious community for which you will perform activities. n As a border-crossing service provider (500) You (the service provider) do not have an EU/EEA nationality, but you live and work in an EU/EEA country and you will be supplying services on the instruction of your employer (the services company) on a temporary basis A copy of your residence permit and a copy of your work permit showing that you are entitled to stay in the country where the services company has its registered office and that you work there as an employee of the services company (if you have these permits); A copy of your employment agreement (with the services company). n After having worked on a Dutch sea-going vessel or in a mining installation on the continental shelf for 7 years or more (382) A letter stating the reasons why you want to come to the Netherlands (for work on Dutch territory, or if you wish to spend a leave period in the Netherlands, or due to illness, or due to unemployment); Proof of your income, see Appendix Proof of Income ; Proof of your employment history on board a Dutch sea-going vessel or in a mining installation on the continental shelf (e.g. a copy of your seaman s book or employment agreement). In the event that this employment history has been interrupted: documents relating to the duration and reason for this interruption and, if applicable, documents relating to the benefits received by you; Proof of the national insurance schemes in connection with your employment in respect of a social security treaty concluded by the Netherlands or in respect of the Dutch national insurance schemes; An overview of the periods in which you were unemployed or when you did not work on board a sea-going vessel or in a mining installation on the continental shelf. If you want to spend your leave in the Netherlands, also submit the following: - Evidence showing that you spent your leave periods nearly entirely in the Netherlands during the employment history; - Evidence showing that you will work for at least one year as an employee on board a Dutch sea-going vessel or in a mining installation on the continental shelf by which you will acquire sufficient means of existence in a sustainable manner. n If you wish you spend your leave in the Netherlands (only if you work in a mining installation on the continental shelf) (383) A letter from your employer stating the reason why you require a residence permit to spend your leave in the Netherlands; Evidence showing that you will work for at least one year as an employee in a mining installation on the continental shelf, by which you will acquire sufficient means of existence in a sustainable manner, see Appendix Proof of Income. IND5007_M35A/11B

13 Application 13 of 19 for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Immigration and Naturalisation Service Ministry of the Interior and Kingdom Relations n As non-privileged NATO personnel (460) Proof of your income, see Appendix Proof of Income ; An original extract (not a copy) from the Municipal Administration (GBA) showing your home address and composition of the family. This extract may not be older than 6 months; If you will not be registered at the Municipal Administration (GBA) as non-privileged civilian personnel: evidence showing that you live in the Netherlands. 9 Residence Permit to Work on a Self-Employed Basis Please state below the specific purpose for applying for a residence permit and follow the instruction written there. Tick the most important purpose. You may not tick more than one purpose of stay. If you tick more than one purpose of stay, your application will only be assessed on the purpose ticked first. n To work on a self-employed basis (377) and documents, in duplicate and not bound: Proof of your income, see Appendix Proof of Income ; A copy of a document issued by the Dutch authority competent in this matter showing that you are qualified to practise a profession or operate a business; A copy of your business plan, including the following information: - Information about you, the entrepreneur (personal data, family and income situation, financial obligations, education, and professional experience); - Business information (information about the line of industry in which you will work, starting date of the enterprise, and place of business); - Legal aspects (legal form of your enterprise, trade name, licences, liability, insurance, and supply conditions); - Commercial aspects (market potential): A description of the type of business and product (features, application, need, innovative character, and unique selling points); A market analysis (description and size of the market, and potential customers/market share), competitors, barriers, co-operations, and risks; The price breakdown, substantiated by agreements and references. - Organisational aspects (description of the organisational structure of your enterprise, the required competencies, and the number of staff); - Financial aspects (investment budget, financing plan, repayment schedule, opening balance sheet, balance sheet, operating budget, and liquidity forecast); NB. The business plan must be substantiated by supplementary documents such as annual accounts, tax details, references, etc. The financial documents must have been prepared or assessed by an independent expert. If any new jobs are created, this must be demonstrated by either the contents of the business plan, which must, in particular, show the feasibility of the financial aspects, or by employment agreements. A copy of the deed of incorporation showing the powers, responsibilities, and allocation of the profit among the partners (if it concerns a general partnership or a limited partnership). A certificate of registration at the Chamber of Commerce In the case of freelance activities on a self-employed basis: Agreement(s) for the provision of services showing that you will perform activities on a freelance basis. It is your responsibility to substantiate your application as much as possible by evidence showing that your enterprise can make a major contribution to the Dutch economy. For this purpose, you must also submit the following documents in duplicate and not bound: Copies of diplomas obtained (if the diploma(s) were obtained abroad; the diploma(s) must have been recognised by the Nuffic. You must arrange for this yourself); copies of certificates of education courses in the Netherlands or abroad (diploma(s) or Doctorates); evidence of any previous experience gained as an entrepreneur; if there is also an enterprise in the country of origin, you must also submit a deed of incorporation and the articles of association of this enterprise; Evidence of previous work experience, for example, by submitting reference(s) and/or testimonial(s), employment agreement(s) from/with former employer(s); Income statement over the last 12 months before the application, for example, by submitting an annual income statement, tax assessment, or employment agreement(s); Evidence of experience in the Netherlands, for example, by means of agreement(s) or reference(s) of Dutch partners and business partners, or sales figures concerning the Dutch market; NB. If you have failed to substantiate your application sufficiently by means of the above-mentioned documents, your application will not be submitted for advice to the Minister of Economic Affairs, Agriculture and Innovation. If you have an EC residence permit for long-term residents issued by another EU Member State, also submit the following: A copy of the EC residence permit for long-term residents issued by the other Member State; Evidence showing that a health insurance policy has been taken out in your name; A copy of your business plan as referred to above. In this context, however, this business plan does not have to include a description of the innovative character of the business and the product. n Work on a self-employed basis, and you have Turkish nationality (377) and documents, in duplicate and not bound: Proof of your income, see Appendix Proof of Income ; A copy of a document issued by the Dutch authority competent in this matter showing that you are qualified to practise a profession or operate a business; A copy of your business plan, including the following information: - Information about you, the entrepreneur (personal data, family and income situation, and financial obligations) - Business information (information about the line of industry in which you will work, starting date of the enterprise, and place of business); - Legal aspects (legal form of your enterprise, trade name, licences, liability, insurance, and supply conditions); - Commercial aspects (market potential): A description of the type of business and product (features, application, need, and unique selling points); A market analysis (description and size of the market, and potential customers/market share), competitors, barriers, co-operations, and risks; The price breakdown, substantiated by agreements and references. - Organisational aspects (description of the organisational structure of your enterprise, the required competencies, and the number of staff); - Financial aspects (investment budget, financing plan, repayment schedule, opening balance sheet, balance sheet, operating budget, and liquidity forecast); NB. The business plan must be substantiated by supplementary documents such as annual accounts, tax details, references, etc. The financial documents must have been prepared or assessed by an independent expert. A copy of the deed of incorporation showing the powers, responsibilities, and allocation of the profit among the partners (if it concerns a general partnership or a limited partnership). A certificate of registration at the Chamber of Commerce. It is your responsibility to substantiate your application as much as possible by evidence showing that your enterprise can make a major contribution to the Dutch economy. NB. If you have failed to substantiate your application sufficiently by means of the above-mentioned documents, your application will not be submitted for advice to the Minister of Economic Affairs, Agriculture and Innovation. If you have an EC residence permit for long-term residents issued by another EU Member State, also submit the following: A copy of the EC residence permit for long-term residents issued by the other Member State; Evidence showing that a health insurance policy has been taken out in your name; A copy of your business plan as referred to above. In this context, however, this business plan does not have to include a description of the innovative character of the business and the product. IND5007_M35A/11B

14 14 of Residence Permit for an Orientation Year for Graduates Please state below the specific purpose for applying for a residence permit and follow the instruction written there. Tick the most important purpose. You may not tick more than one purpose of stay. If you tick more than one purpose of stay, your application will only be assessed on the purpose ticked first. n Orientation year for graduates (501) If you want to search for a job as a highly skilled migrant within one year after having finished your study at a Dutch university or a college of higher professional education, and you want to make use of the orientation year Your application must be accompanied by the following supplementary piece of evidence: A legalised copy of the diploma showing the graduation date. This must be a diploma for a study programme followed at an educational institution in the Netherlands. n Orientation year for highly educated migrants (508) If you want to search for a job as a highly educated migrant or if you want to start an innovative business within three years after having finished your study, and you want to make use of the orientation year. You must have obtained a Master degree or a Doctorate at a Dutch university or a college of higher professional education or at a educational institution abroad which has been included in the Top 150 of the lists of the 'Times Higher Education Supplement' or the 'Jiao Tong Shanghai University' published in A legalised copy of the Master or Doctorate diploma of an accredited educational institution, as included in the CROHO (Central Register of Higher Education Study Programmes), showing the graduation date or the date on which you obtained your Doctorate degree. This certificate may not be older than 1 month. Or a legalised copy of the Master or Doctorate diploma at a educational institution abroad which has been included in the Top 150 of the lists of the 'Times Higher Education Supplement' or the 'Jiao Tong Shanghai University' published in 2007, together with the relevant list of marks. Together with the diploma, you must also submit the written credential evaluation of Nuffic (Credential Evaluation Information Centre). If you want to be awarded points in the system of points, please also submit the following (where possible): A copy of your employment agreement or your Employer's Declaration if you have worked in the Netherlands in the past for a period of six months or more; A copy of a certificate of participation in a course in the Netherlands, which course you attended for a period of six months or more; A copy of an NT2 diploma for 'Dutch as a Second Language' at A2 level'; If you did not graduate in an English-speaking country: a copy of a declaration or a certificate of a language institute showing that you speak the English language at level 6 of the International English Language Testing System (IELTS) A copy of a diploma showing that you have obtained a Bachelor, Master or Doctorate degree in a country that is party to the Bologna Declaration. If the diploma is not written in the Dutch, English, French or German language, you must have this diploma translated. 11 Residence Permit to Work on the Basis of an International Treaty Please state below the specific purpose for applying for a residence permit and follow the instruction written there. Tick the most important purpose. You may not tick more than one purpose of stay. If you tick more than one purpose of stay, your application will only be assessed on the purpose ticked first. n To work as an employee in the context of an EU action programme or an international agreement to which the Netherlands is a party, but not the Dutch-American Friendship Treaty, the Treaty of Amity and Commerce between the Netherlands and Japan, the Turkish Association Treaty, or the Dutch-German Convention on Establishment (370) Evidence showing that paid research or paid work is to be carried out temporarily in the context of an EU action programme or an international agreement to which the Netherlands is a party; Proof of your income, see Appendix Proof of Income ; n Work as an employee on the basis of the Dutch-German Convention on Establishment (450) : Evidence showing that you have sufficient means of existence for the duration of your stay. This may be your own declaration or a declaration from a third party. n Work as a key employee on the basis of the Dutch-American Friendship Treaty or the Treaty of Amity and Commerce between the Netherlands and Japan (454, 511) Proof of your income, see Appendix Proof of Income ; If required: A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form). Evidence showing that you are employed as a key employee. n Work on a self-employed basis on the basis of the Dutch-American Friendship Treaty or the Treaty of Amity and Commerce between the Netherlands and Japan (453, 510) A recent original extract from the registration of the enterprise/company at the Chamber of Commerce. Evidence showing the legal form of the company; Evidence showing that you have made a substantial capital contribution to your enterprise or your company. n Work as an employee on the basis of the EC-Turkish 1/80 Association Treaty (337) Proof of your income, see Appendix Proof of Income ; If required: A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form). Evidence showing that you have been employed by a Netherlands-based company for at least 1 year (may also be a transport company) and that your current employer has work for you for another year in employment. 12 As an Economically Non-Active Long-Term Third-Country National n As an economically non-active person with a residence permit as a long-term third-country national in another member state (507, 763) A copy of the EC residence permit for long-term residents issued by the other Member State Evidence showing that a health insurance policy has been taken out in your name; Evidence showing that you permanently and independently have sufficient means of existence, such as benefit payments from the Member State that issued the EC residence permit for long-term residents to you (it must concern a benefit payment that can be received in the Netherlands) or income from previous employment outside the Netherlands (such as a salary or a corporate or private pension, or on the basis of a early retirement scheme) or income from capital. IND5007_M35A/11B

15 Application 15 of 19 for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Immigration and Naturalisation Service Ministry of the Interior and Kingdom Relations 13 Residence Permit to Attend a Secondary Education Course or a Vocational Education Course If you want to attend an institution of higher education or a university, do not use this form, but contact the educational institution. n To attend a Secondary Education course or a Vocational Education course (393) Evidence showing your registration (provisional or definite) at or admission to the institution. This evidence must have been issued by the competent authority of the educational institution; The Appendix Study Awareness Declaration filled in completely and signed by you; An original extract (not a copy) from the Municipal Administration (GBA) showing your home address. This extract may not be older than 6 months; Written substantiation that the foreign national can make a positive contribution to the development of his/her country of origin with this education. In the case of an Upper Secondary Vocational Education course (MBO), a declaration from the COLO that this education course cannot be attended in the country of origin (see COLO's website for more information In the case of a Secondary Education course, a declaration of the Ministry of Education in the country of origin stating that the relevant course cannot be attended in the country of origin. If you receive a study grant, also submit the following: A copy of the document showing that the study grant has been awarded to you. If you or a third party abroad (e.g. a private person or a legal person) is wholly or partially paying for the course, also submit the following: A copy of a bank statement from a bank account jointly or exclusively made out in your name, with the balance that is available for the study year; or An original declaration from the bank (not a copy) showing which monthly amount is being transferred in favour of you to a bank account jointly or exclusively made out in your name. If a third party in the Netherlands (e.g. a private person or a legal person) is wholly or partially paying for the course, also submit the following: The Appendix Sponsor Declaration filled in completely and signed by your financial sponsor and, if applicable, his or her spouse or partner or registered partner; An original extract (not a copy) from the Municipal Administration (GBA) showing your home address and the composition of the family of your financial sponsor. This extract may not be older than 6 months; Proof of the income of the financial sponsor and, if applicable, his or her spouse or partner or registered partner, see Appendix Proof of Income ; Copies of all the pages containing the identity details of the Dutch passport(s) and identity card(s) of your financial sponsor and, if applicable, his or her spouse or partner or registered partner. Also make copies of the pages containing travel stamps. If your financial sponsor and, if applicable, his or her spouse or partner or registered partner, do not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. If you have the EC residence permit for long-term residents issued in another Member State, you are also permitted to attend the course on a part-time basis. You do not have to fill in and sign the Appendix Study Awareness Declaration. You must also submit the following: A copy of the EC residence permit for long-term residents issued by the other Member State; Evidence showing that a health insurance policy has been taken out in your name. 14 Residence Permit for Exchange Purposes Please state below the specific purpose for applying for a residence permit and follow the instruction written there. Tick the most important purpose. You may not tick more than one purpose of stay. If you tick more than one purpose of stay, your application will only be assessed on the purpose ticked first. n Exchange through a private organisation (403) An original extract (not a copy) from the Municipal Administration (GBA) showing the home address and the composition of your host family. This extract may not be older than 6 months; The Appendix Exchange Organisation Sponsor Declaration filled in completely and signed by the private organisation; The Appendix Declaration of Non-Impediment filled in completely and signed by you, showing that you are unmarried and that you do not provide for children of your own or for children that depend on you. If the exchange concerns voluntary work, also submit the following: A copy of the application for a work permit or a copy of the work permit itself (see the explanation on page 3 of this form). n Exchange on the basis of the Working Holiday Scheme or Working Holiday Program (402) Your application must be accompanied by the following supplementary piece of evidence: A copy of the return ticket or evidence showing that you have sufficient means to buy a return ticket. 15 Residence Permit as an Au Pair n as an au pair (400) NB. At the time of submitting the application for the residence permit in the Netherlands, you must at least be 18 years of age, but not yet 26 years of age. Copies of all pages of the identification documents of your host family (the sponsor) if they are Dutch nationals, or of the front and back of the residence permits or of all pages containing the identification details, stamps, travel stamps and endorsements in the border-crossing document in which the residence permits of your host family have been recorded. It is not necessary to copy empty pages. An original extract (not a copy) from the Municipal Administration (GBA) showing the home address and composition of your host family (the sponsor). This extract may not be older than 6 months; The Appendix Declaration of Non-Impediment filled in completely and signed by you and showing that you are unmarried and that you do not provide for children of your own or for children that depend on you. The Appendix Au Pair Awareness Declaration filled in completely and signed by you and your host family; The Appendix Au Pair Host Family Agreement filled in completely and signed by you and your host family; The Appendix Sponsor Declaration filled in completely and signed by your host family; A description about the manner in which you will become acquainted with the Dutch society and culture; Proof of the income of your host family, see Appendix Proof of Income. The income of the host family must at least be equal to the subsistence level applicable to the host family, supplemented by the subsistence level for a single person of 21 years of age or older. IND5007_M35A/11B

16 16 of Residence Permit to Stay in the Netherlands with a Religious or Ideological Organisation n On religious or ideological grounds (378) The monastery or convent or religious or ideological organisation must submit the following supplementary evidence and documents when the application is submitted: A written explanation about the need for the foreign national to stay with the religious or ideological organisation; Written evidence showing that the foreign national at the time of the application was already a member of the religious or ideological organisation; A detailed description of the activities the foreign national will perform at or through the intermediary of the religious or ideological organisation; A written statement of the means by which the stay of the foreign national will be paid (which facilities will the foreign national receive at the expense of the organisation); The Appendix Sponsor and Awareness Declaration Regarding a Stay with Religious or Ideological Organisations filled in completely and signed by the organisation; The Appendix Awareness Declaration Regarding the Transitional Regime on Religious or Ideological Grounds filled in completely and signed by you; Written evidence by which the organisation or the monastery or convent shows that it has sufficient financial means and that it is capable of providing for the foreign national s living expenses. If the foreign national intends to stay with another organisation than the following: The Stichting Jeugd met een Opdracht, in Heerde; or The Kerk van Jezus Christus van de Heiligen der Laatste Dagen, in Dordrecht; or Centraal Missie Commissariaat, in The Hague; or The Syrian Orthodox Church, in Losser; or Stichting Congregatie FIC, in Maastricht; or Maharishi European Research University/Maharishi Vedic University, in Vlodrop; or Stichting International Buddhist Progress Society Holland, in Amsterdam; or An individual monastery or convent, the religious or ideological organisation must then also submit the following: Evidence showing that in the five years preceding the effective date of this scheme (8 January 2004) a residence permit was granted to a foreign national on religious or ideological grounds in respect of the organisation where the foreign national intends to stay. In this context, the reason for applying for a residence permit is not for study purposes or to work as an employee. 17 Residence Permit for Re-entry Please state below the specific purpose for applying for a residence permit and follow the instruction written there. Tick the most important purpose. You may not tick more than one purpose of stay. If you tick more than one purpose of stay, your application will only be assessed on the purpose ticked first. n You are a former Dutch national and you were born and raised in the Netherlands (362) Your application must be accompanied by the following supplementary piece of evidence: Documents and information regarding the duration and nature of your previous stay in the Netherlands; n You are a minor and your accommodation and legal representation in the Netherlands have been arranged and you were a lawful resident of the Netherlands (or as a Dutch national) from the age of 4 years for a period of 10 years (360) Documents and information regarding the duration and nature of your previous stay in the Netherlands; Documents and information showing that your accommodation and representation in the Netherlands have been arranged. n You are a minor and your accommodation and legal representation in the Netherlands have been arranged and you were a lawful resident of the Netherlands (or as a Dutch national) for a period of 5 years before submitting the application and the Netherlands is the most appropriate country for you (360) Documents and information regarding the duration and nature of your previous stay in the Netherlands; Documents and information showing that your accommodation and representation in the Netherlands have been arranged. NB. For the purpose of assessing whether the Netherlands is the most appropriate country of residence for you, it is important that your ties with the Netherlands are stronger than your ties with your country of origin. In this assessment, the following factors may be included: The reason for remigration; The duration of your stay in the Netherlands and in the country of origin; The education/schooling received in the Netherlands and abroad; The work experience gained in the Netherlands and abroad; Knowledge of the Dutch language. You must accompany your application with as much information as possible. n You are a former Dutch national and you renounced your Dutch nationality to be able to rely on the provisions of the Dutch Remigration Act (your situation before remigration) (364) A certificate from the Social Insurance Bank (SVB) stating that the decision on your application for remigration provisions will, in principle, be positive, provided that you renounce Dutch nationality; A copy of your 'Declaration of Renunciation of Dutch Nationality'; A certificate from the Population Affairs official that your 'Declaration of Renunciation of Dutch Nationality' has been received. n You qualify for re-entry on the basis of Article 8 of the Dutch Remigration Act (your situation after remigration) (315) If one of following situations applied to you immediately prior to your remigration from the Netherlands: You were a lawful resident in the Netherlands for a continuous period of at least 3 years and you had a Regular Residence Permit; You stayed in the Netherlands with a valid residence permit as a minor child of a person who himself or herself qualifies for re-entry on the basis of the Dutch Remigration Act, insofar as you both remigrated from the Netherlands at the same time and you are submitting an application for re-entry at the same time; or You stayed in the Netherlands with a valid residence permit as a minor child of a person who himself or herself had lawful residence, you remigrated together with this person from the Netherlands on the basis of Article 8 of the Dutch Remigration Act and you came of age within one year after remigration and you are submitting an application for re-entry within that year.) A copy of the decision of the SVB awarding the right to the basic provisions or the remigration provisions and stating the departure date; A copy of the Appendix to the decision of the SVB showing the entrance date of the residence permit granted previously for a non-temporary purpose and the continuous duration of your previous stay in the Netherlands. NB. Under specific conditions, you may qualify for a permanent residence permit (if immediately prior to your remigration you stayed in the Netherlands as a Dutch national, as a holder of a permanent residence permit, or as a holder of a Regular Temporary Residence Permit for a continuous period of at least five years). In that case, use the form 'Application for or Change of a Temporary Regular Residence Permit' IND5007_M35A/11B

17 Application 17 of 19 for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Immigration and Naturalisation Service Ministry of the Interior and Kingdom Relations n You lived outside the Netherlands due to imprisonment or military service (360) Copies of the front and back of your last residence permit; Documents and information on your imprisonment abroad and the termination of this, or on doing military service and the termination of this. n You have submitted an application to the District Court in The Hague to establish your Dutch nationality (361) Your application must be accompanied by the following supplementary piece of evidence: A complete copy of your application to the District Court concerning the establishment of you Dutch nationality (pursuant to Article 17 of the Netherlands Nationality Act). n You are a former Dutch national, you have lost your Dutch nationality because it was withdrawn because you did not renounce your original nationality (if you had had lawful residence in the Netherlands for a continuous period of at least 3 years before the date of becoming a Dutch national) (314) Documents regarding the duration and nature of your previous stay in the Netherlands; A copy of the notice of naturalisation; Letters from the Minister of the Interior and Kingdom Relations in which your attention is drawn to the obligation to renounce your original nationality; A copy of the decision by which the Dutch nationality has been withdrawn. NB. Under specific conditions, you may qualify for a permanent residence permit (if you had had lawful residence in the Netherlands for a continuous period of at least 5 years before the date of becoming a Dutch national). In that case, use the form 'Application for or Change of a Temporary Regular Residence Permit' n You are a former Dutch national because you renounced your Dutch nationality yourself because it would otherwise have been withdrawn because of the failure to renounce your original nationality (313) Documents and information regarding the duration and nature of your previous stay in the Netherlands; A copy of the notice of naturalisation; Letters from the Minister of the Interior and Kingdom Relations in which your attention is drawn to the obligation to renounce your original nationality; An original extract (not a copy) from the Municipal Administration (GBA) showing the date on which you renounced Dutch nationality. NB. Under specific conditions, you may qualify for a permanent residence permit (if you had had lawful residence in the Netherlands for a continuous period of at least 5 years before the date of becoming a Dutch national). In that case, use the form 'Application for or Change of a Temporary Regular Residence Permit' n You are a former Dutch national, you are 18 years of age or older, and you do not live in the country of which you are a national, and you have special ties with the Netherlands (360) Documents and information regarding the duration and nature of your previous stay in the Netherlands; Documents and information showing that you do not live in the country of which you have the nationality; Documents and information showing that you received at least half of your primary school education in the Netherlands, the Netherlands Antilles, or Aruba, or that when you were a minor you attended an education course that was focused on the Netherlands in a manner that was more than usual at the time, or that you have established close ties with the Netherlands due to other circumstances, such as upbringing, social position and/or employment. 18 Residence Permit for Medical Reasons n To undergo medical treatment (410) The Appendix Declaration on Your Medical Situation filled in completely and signed by your doctor. This declaration may not be older than 1 month. Any changes in your medical situation that may be relevant to the decision to be made must be declared in a new Declaration on Your Medical Situation. The Appendix Medical Information Disclosure Consent Form filled in completely and signed by you. If several doctors are in charge of your treatment, the consent to contact these doctors must be given separately for each doctor. This consent must be given with respect to the doctor(s) in charge of your treatment in the Netherlands as well as the doctor(s) in charge of your treatment in the country of origin; Proof of insurance for medical expenses incurred in the Netherlands or any other evidence showing that financing the costs of the medical treatment has been arranged adequately; A written explanation of why the Netherlands is the most appropriate country to undergo the relevant medical treatment(s). Accompany your application with as many pieces of evidence as possible. Evidence showing that you have sufficient means of existence for the duration of your stay in the Netherlands. If you yourself do not have sufficient means of existence, also submit the following: The Appendix Sponsor Declaration filled in completely and signed by a family member, relative or other relation of yours; Proof of the guarantor s income and, if applicable, his/her spouse or partner or registered partner, see Appendix Proof of Income ; Copies of all the pages containing the identification details of the guarantor s Dutch passport or identity card. Also make copies of the pages containing travel stamps. If the guarantor does not have Dutch nationality, please make copies of the front and back of the Dutch residence permit or of the pages containing the identification details of the valid border-crossing document (e.g. a passport) in which the residence permit has been recorded. Also make copies of the pages containing travel stamps and the residence permit. It is not necessary to copy empty pages. If you are a national of Surinam, also submit the following: A copy of a visa issued on medical grounds. 19 Residence Permit for a Victim of Human Trafficking or for a Witness Reporting Human Trafficking n As a victim of human trafficking or as a witness reporting human trafficking (420) Go to the police with this application form, and report human trafficking to the police or render your cooperation in the criminal investigation and prosecution investigation of human trafficking. The police will help you with your application for a residence permit. If you submit this application without having been to the police and you did not report the human trafficking or you did not cooperate, your application will not be handled. IND5007_M35A/11B

18 18 of Residence Permit through no Fault or Action of Your Own n Residence Permit through no Fault or Action of Your Own (491) Documents showing that you have tried to realise your departure from the Netherlands independently and that you did not succeed in this. You must prove that you have applied to the diplomatic representation of your country, or other countries where you had a residence permit and/or countries which may be expected to give you permission to enter, and that the request to issue travel documents has not been granted. You can prove this, for example, by declarations of the relevant authorities showing that you have demonstrably applied to those diplomatic representations and stating that a request to issue travel documents has not been granted. Documents showing that you have applied to the International Organisation for Migration to facilitate your departure, and that this organisation informed you that it is not capable of realising your departure due to the fact that you claim that you cannot obtain any travel documents, or that this organisation has declared to be able to facilitate your departure as soon as you have obtained the travel documents. Documents showing that you have applied to the Repatriation and Departure Service with the request to assist you in submitting an application for a replacement travel document, a so-called laissez passer. The Repatriation & Departure Service will also be willing to provide assistance at one or more diplomatic representations to obtain the required travel documents. 21 Residence Permit for Continued Residence Please state below the specific purpose for applying for a residence permit and follow the instruction written there. Tick the most important purpose. You may not tick more than one purpose of stay. If you tick more than one purpose of stay, your application will only be assessed on the purpose ticked first. n You have Turkish nationality and you have a residence permit for seeking and performing work, whether as an employee or on a self-employed basis, after the termination of the marriage (304) Evidence showing that - no later than the date that the period of validity of your residence permit will expire - you have employment for at least 1 year, n Pursuant to Article 7 of the EEC-Turkey Association Agreement - Association Council Decision No 1/80 (301) Evidence showing that the principal person was a Turkish employee when you cohabited with him or her for a period of three years; Evidence showing that a health insurance policy has been taken out in your name An original historical extract (not a copy) from the Municipal Administration (GBA) showing your home address and composition of the family. This extract may not be older than 6 months. n After a residence period of 3 years or more with your spouse or partner or registered partner (301); or n After a residence period of 3 years as an adult child with a parent (301); or n After a residence period of 3 years as a parent with a child (301) Appendix Declaration of Circumstances filled in completely and signed by you Evidence showing that a health insurance policy has been taken out in your name An original extract (not a copy) from the Municipal Administration (GBA) showing your home address and composition of the family. This extract may not be older than 6 months; Appendix 'Civic Integration Requirement (continued residence after three years of family reunification or family formation) filled in completely and signed by you. n After a residence period of 1 year as a minor child with a parent or adoption parent or foster parent (301); or n After a residence period of 3 years as an unaccompanied minor foreign national (301); or n After a residence period of 3 years, if you were unable to leave the Netherlands through no fault or action of your own (301) Appendix Declaration of Circumstances filled in completely and signed by you Evidence showing that a health insurance policy has been taken out in your name An original extract (not a copy) from the Municipal Administration (GBA) showing your home address and composition of the family. This extract may not be older than 6 months. n Marriage, partnership, or registered partnership: compelling humanitarian grounds (301); or n Residence with a partner: compelling humanitarian grounds (301) Appendix Declaration of Circumstances filled in completely and signed by you Evidence showing that a health insurance policy has been taken out in your name An original extract (not a copy) from the Municipal Administration (GBA) showing your home address and composition of the family. This extract may not be older than 6 months; Evidence showing that compelling humanitarian grounds are involved. n Marriage, partnership, or registered partnership: after the death of your spouse or partner or registered partner (302); or n Minor child after the death of a parent or adoption parent or foster parent (302); or n Adult child after the death of a parent (302) Appendix Declaration of Circumstances filled in completely and signed by you Evidence showing that a health insurance policy has been taken out in your name An original extract (not a copy) from the Municipal Administration (GBA) showing your home address and composition of the family. This extract may not be older than 6 months; The death certificate of your marriage partner, registered partner, or partner, or of your parent or adoption parent or foster parent. n To undergo medical treatment (301) Evidence showing that a health insurance policy has been taken out in your name Appendix Declaration of Circumstances filled in completely and signed by you Appendix Declaration of Your Medical Situation filled in completely and signed by your doctor. This declaration may not be older than 1 month. Any changes in your medical situation that may be relevant to the decision to be made must be declared in a new 'Declaration on Your Medical Situation'. If several doctors are in charge of your treatment, each doctor must fill in and sign a separate Appendix; Appendix Medical Information Disclosure Consent Form filled in completely and signed by you. If several doctors are in charge of your treatment, the consent to contact these doctors must be given separately for each doctor. This consent must be given in respect of the doctor(s) in charge of your treatment in the Netherlands as well as the doctor(s) in charge of your treatment in the country of origin; Evidence showing that the financing of the medical expenses to be incurred in the Netherlands has been arranged adequately; A written explanation of why the Netherlands is the most appropriate country to undergo the relevant medical treatment(s). n As a victim of domestic violence (303) Evidence showing that a health insurance policy has been taken out in your name Evidence showing that you have demonstrably experienced domestic violence: - a copy of the official record of the report to the police, and a declaration of a doctor, confidential doctor or other professional; or - a declaration of the Public Prosecution Service or the Commissioner of Police showing that ex officio prosecution investigation has been instituted against the offender, and a declaration of a doctor, confidential doctor or other professional. n As a victim of human trafficking or as a witness reporting human trafficking (301) If you are a victim of human trafficking, your application must be accompanied by the following supplementary evidence: A copy of the Court judgment following your report of human trafficking or following your cooperation in the criminal investigation and prosecution IND5007_M35A/11B

19 Application 19 of 19 for a Regular Residence Permit without a Regular Provisional Residence Permit, or for a Change of Purpose of Stay Immigration and Naturalisation Service Ministry of the Interior and Kingdom Relations investigation of human trafficking and by which judgment the accused has been convicted (a conviction for one of the other charges made against the accused in the criminal proceedings is also relevant, provided that human trafficking was one of the charges made); or A copy of the Court judgment following your report of human trafficking or following your cooperation in the criminal investigation and prosecution investigation of human trafficking and by which judgment the accused has not been convicted (a conviction for one of the other charges made against the accused in the criminal proceedings is also relevant, provided that human trafficking was one of the charges made), but the judgment is otherwise; and if you have been in possession of a residence permit for a period of less than 3 years on the basis of the B9 scheme, you must also submit evidence showing that you cannot return to the country of origin (e.g. because you may become the victim of revenge) or evidence showing that there are compelling humanitarian grounds that, in your opinion, should justify continued residence (e.g. because you have psychological problems for which you are being treated in the Netherlands, or because you must provide for children who were born in the Netherlands or who attend an education course here); If you have been in possession of a residence permit for a period of more than 3 years on the basis of the B9 scheme and the criminal investigation is still before the court, a copy of the declaration of the police or the Public Prosecution Service that the criminal investigation is still before the court. If your report to the police or your cooperation in the criminal investigation or criminal prosecution of human trafficking resulted in a decision not to prosecute, also submit the following: Evidence showing that you cannot return to the country of origin (e.g. because you may become the victim of revenge) or evidence showing that there are compelling humanitarian grounds that in your opinion should justify continued residence (e.g. because you have psychological problems for which you are being treated in the Netherlands or because you must provide for children who were born in the Netherlands or who are attending an education course here). If you are a witness of human trafficking, your application must be accompanied by the following supplementary evidence: A copy of the conviction following your report of human trafficking; Evidence showing that you cannot return to your country of origin because of the risk of reprisals. n After 1 year of residence, on the basis of honour-related violence or the threat thereof (303); or n After 1 year of residence, on the basis of domestic violence or a real threat thereof (303) Evidence showing that the threat, on the basis of which the permit had been granted, is continuing. Accompany your application by a separate letter in which you provide a description of the situation you are in and the reason why you cannot return to the country of origin. Enclose as many pieces of evidence with your letter to substantiate this. n After 1 year of residence, as a victim of human trafficking who cannot or does not want to report this to the police or who cannot or does not want to render his/her cooperation in the criminal investigation and prosecution of the human trafficker (301) Evidence showing that the threat, on the basis of which the permit had been granted to you, is continuing or evidence showing that you, given your medical or psychological condition, are still not capable of rendering your cooperation in the criminal proceedings. Accompany your application by a separate letter in which you provide a description of the situation you are in and the reason why you cannot return to the country of origin. Enclose as many pieces of evidence with your letter to substantiate this. 22 Victims of violence Please state below the specific purpose for applying for a residence permit and follow the instruction written there. Tick the most important purpose. You may not tick more than one purpose of stay. If you tick more than one purpose of stay, your application will only be assessed on the purpose ticked first. n You are a victim of domestic violence (300) Recent information from the police, for example, the recent report of an incident, or a recent official record of the report; and Recent information from a doctor, confidential doctor or other professional; it is not necessary for the confidential doctor to be your own general practitioner; or Recent information about your stay in a women s refuge; or Other recent information, insofar as it concerns objective information from a reliable source. Evidence showing that you cannot withdraw from the violence by taking up residence in the country of origin. n You are a victim of honour-related violence (300) Explain in a separate letter for which purpose you are submitting an application for a residence permit. You must accompany your application by this letter together with as many pieces of evidence and documents of the special circumstances. If the IND has any further questions, you will receive a separate letter after having submitted this form. n You are a victim of human trafficking and you cannot or you do not want to report this to the police or render your cooperation in the criminal investigation and prosecution of the human trafficker due to serious threats and/or a medical or psychological impairment (420) A declaration from the police showing that you are a victim of human trafficking; and If applicable, a declaration from the police showing that you cannot be expected to render your cooperation in the criminal proceedings in connection with serious threats issued by the human trafficker in the Netherlands; or If applicable, medical information showing that a physical or psychological condition prevents you from rendering your cooperation in the criminal proceedings. The medical information must be provided by a professional who is listed either in the BIG register or in the NIP register. 23 Submitting your application > Place your colour passport photo and your signature on the Appendix Photo Card you will find enclosed with this form. Your passport photo may not have been used for a residence permit before, it must bear a clear resemblance, and it must meet the Dutch passport requirements (see > Check whether you have filled in the form completely. > Please accompany your application by all enclosures, evidence and documents that have been requested. Do not use any staples or paperclips. > Now place your signature on the front page of this form. > First call ( 0.10 per minute plus any additional costs charged by your operator if you are calling from a mobile phone) or from outside the Netherlands to make an appointment to visit the IND desk in your region. You must also make an appointment if you downloaded this form from Once you have made an appointment, you can hand in the application at the IND desk. IND5007_M35A/11B

20 Appendix Proof of income M35A / M35A-1 This list states which items of evidence that demonstrate proof of income are required by the IND for the assessment of the application. The application form states in which cases and from which person(s) you must enclose these items of evidence to prove the income. In most cases, this proof of income must be provided by you (the person providing residence) and your sponsor. The pieces of evidence you are submitting as a proof of your income may be copies, unless stated otherwise. NB. The IND may verify the correctness of the enclosed wage, employment and benefit details at another government agency (e.g. the Netherlands Employees Insurance Agency (UWV) or the Tax and Customs Administration). If you or your sponsor has an employment agreement which is valid for a period of at least 1 year at the time of submitting your application; or If you (the foreign national) will perform activities as an employee (in the context of an EU action programme or an international agreement to which the Netherlands is a party) Your current employment agreement(s); The Appendix Employer s Declaration filled in completely and signed (not older than 3 months); Pay slips over the past 3 months. Only if you earn structurally more than is apparent from your employment agreement (e.g. because of overtime) Pay slips over the past 12 months. If you or your sponsor has an employment agreement which is valid for a period for less than 1 year at the time of submitting your application Your current employment agreement(s) showing that you will have work; The Appendix Employer s Declaration filled in completely and signed (not older than 3 months); Over the past 3 years: - All salary statements; and - All annual income statements; and - All employment agreement(s) and temporary employment agreement(s) (through an employment agency); and - grant decision(s) and benefit slip(s). If you or your sponsor works as an agency employee or on the basis of an on-call contract, a seasonal work contract, a zero-hours contract, or any other employment agreement with a deferred duty of performance Your current employment agreement(s) or temporary employment agreement(s) (through an employment agency) showing that you will have work; The Appendix Employer s Declaration filled in completely and signed (not older than 3 months); Over the past 3 years: - All salary statements; and - All annual income statements; and - All employment agreement(s) and temporary employment agreement(s) (through an employment agency); and - grant decision(s) and benefit slip(s). If you or your sponsor receives supplementary or full benefits If you or your sponsor receives a supplementary or full benefit payment (e.g. an unemployment benefits (WW), sickness benefits (ZW), old age benefits (AOW), dependant's benefits (ANW), or a reintegration benefit payment (REA)) The letter of your benefits agency granting your benefit; The most recent benefits statement; If you or your sponsor receives occupational disability benefits (WAO benefits), benefits under the Invalidity Insurance (Self-Employed Persons) Act (WAZ benefit), or benefits under the Invalidity Insurance (Young Disabled Persons) Act (Wajong benefit) The grant decision showing that you are unfit for work (and which percentage); The most recent benefits statement (over a period of at least 1 year following the grant decision); If you or your sponsor has received invalidity benefits under the Work and Income (Capacity for Work) Act (WIA benefit) since 1 January 2006 The confirmation of benefits awarded that shows on the basis of which regulations you are receiving the relevant benefits (Full Invalidity Benefit Regulations (IVA) or Return to Work (Partially Disabled) Regulations (WGA)); (If available) the most recent reassessment; If you or your sponsor is permanently unfit for work and you or your sponsor does not receive occupational disability benefits (WAO benefits), invalidity benefits under the Work and Income (Capacity for Work) Act (WIA benefits), benefits under the Invalidity Insurance (Self-Employed Persons) Act (WAZ benefits), or benefits under the Invalidity Insurance (Young Disabled Persons) Act (Wajong benefit) A declaration from the Municipal Health Service, or the company doctor, or the medical examiner showing that you are wholly unfit for work, the date on which you became wholly unfit for work, and what the expected duration of the incapacity for work is; If you or your sponsor receive(s) social assistance benefits and it is permanently impossible for you or your sponsor/partner to work again All grant decisions of the past 5 years and any correspondence with the Municipal Executive about the exemption of the obligation to seek work, and evidence showing that integration into the workforce is not to be expected within a reasonable period of time. If you or your sponsor is a self-employed person The Appendix Declaration of Income as a Self-Employed Person filled in completely and signed by you and a registered accountant, an auditor, an accounting consultant, a tax adviser of the Dutch Federation of Tax Advisers (NFB), or an accountant with a BECON number issued by the Tax and Customs Administration, together with the required appendices. A recent original extract from the registration of the enterprise/company at the Chamber of Commerce (unless registration is not possible). If you or your sponsor is a director-major shareholder The official documents showing the percentage of your interest in the company (percentage of ownership); A copy of your employment agreement (or agreements, if you have several jobs); An original Appendix Employer s Declaration filled in completely, stating the date and provided with a signature of the employer and a company stamp (not older than 3 months); Information about the 3 months prior to the date of your application showing that you received a monthly salary (salary slips, bank statements); Proof that the wage tax that was withheld by the company was paid to the Tax and Customs Administration (bank statement). As an unpaid research worker If you receive sponsor money: evidence showing the amount of money you receive and the duration of the sponsor agreement; or If you receive periodic payments to pay for your stay in the Netherlands: proof of these payments; or If you have paid work abroad: a copy of an employment agreement with the current employer abroad. BE01/11B