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Annex 1B — Implementing protocol to the Agreement between The Kingdom of Belgium, The Grand Duchy of Luxembourg and The Kingdom of The Netherlands (the States of the Benelux) and The Republic of Kosovo concerning the readmission of persons who have entered and/or are residing without authorisation (readmission agreement) Overeenkomst tussen het Koninkrijk België, het Groothertogdom Luxemburg en het Koninkrijk der Nederlanden (de Benelux-staten) en de Republiek Kosovo betreffende de terug- en overname van onregelmatig binnengekomen en/of verblijvende personen en haar Uitvoeringsprotocol

Implementing protocol to the Agreement between The Kingdom of Belgium, The Grand Duchy of Luxembourg and The Kingdom of The Netherlands (the States of the Benelux) and The Republic of Kosovo concerning the readmission of persons who have entered and/or are residing without authorisation (readmission agreement)

REQUEST FOR THE READMISSION OF A THIRD STATE NATIONAL (art. 4 of the Agreement and art. 2 of the Implementing Protocol)

DATE OF REQUEST: ..... | CASE NO.: .....

FROM: COMPETENT AUTHORITY (requesting Party)

.....

Tel: | Fax: | Email:

TO: COMPETENT AUTHORITY (requested Party)

.....

Tel: | Fax: | Email:

1 - PERSONAL DETAILS OF THE PERSON WHOSE READMISSION IS REQUESTED

SURNAME | ..... | GIVEN NAMES

MAIDEN NAME | .....

OTHER NAMES | .....

(alias, etc.) | .....

.....

.....

SEX | .....

DATE OF BIRTH | ..... | PLACE OF BIRTH | .....

NATIONALITY | ..... | LAST PLACE OF RESIDENCE IN THE TERRITORY OF THE REQUESTED PARTY | .....

CIVIL STATUS: | □ Married | SPOUSE OF | .....

□ Divorced

□ Widow/widower

MINOR

CHILDREN | ..... | (number)

name(s) | .....

.....

.....

date of birth | .....

.....

2 - PROOF WITH REGARD TO THIRD STATE NATIONALS (art. 6 of the Agreement) (NB – here one should include the date of issue, period of validity of documents, etc.)

1. .....

2. .....

3. .....

4. .....

5. .....

(copies attached)

3 - INFORMATION ON THE UNAUTHORISED RESIDENCE IN THE TERRITORY OF THE REQUESTING PARTY

DATE OF DETERMINATION OF UNAUTHORISED RESIDENCE

4 - ANNEXES

NUMBER OF DOCUMENTS (incl. brief descriptions) | 1. .....

2. .....

3. .....

4. .....

5. .....

6. .....

NAME OF OFFICIAL | STAMP AND SIGNATURE

RESPONSE TO THE REQUEST FOR READMISSION (art. 7, paragraph (3) of the Agreement and art. 2, paragraph 5 of the Implementing Protocol)

DATE OF RESPONSE: .....

1 - DECISION TAKEN

□ APPROVED | □ REFUSED

GROUNDS FOR REFUSAL IN THE EVENT OF A NEGATIVE RESPONSE

2 - SPECIAL OBSERVATIONS

NAME OF OFFICIAL | STAMP AND SIGNATURE

Regeling
Overeenkomst tussen het Koninkrijk België, het Groothertogdom Luxemburg en het Koninkrijk der Nederlanden (de Benelux-staten) en de Republiek Kosovo betreffende de terug- en overname van onregelmatig binnengekomen en/of verblijvende personen en haar Uitvoeringsprotocol
Soort
Verdrag
Geldend vanaf
01-04-2014
BWB-id
BWBV0005360
Versie
2014-04-01_0

In de hele regeling · Officiële tekst op wetten.overheid.nl