Application

for a Permanent Residence

Document for Nationals of the
Union and their Family Members

Nederlandse versie Minor children

Dit aanvraagformulier is ook verkrijgbaar in het Nederlands. If you are the parent or representative of a minor child, you can also fill
Kijk op www.ind.nl om dit formulier aan te vragen of te downloaden. in this form on behalf of him/her. Where the form refers to you or the
applicant, the child is meant. Please answer all questions on behalf of
Please read the explanation on this page and the next carefully before you fill in the form. the child, and accompany your application with all the documents
required. If the child is 12 years of age or older, he/she must sign the
Why this form? form himself/herself. Fill in one form for each child.
This form is intended for nationals of the Union and their family members
(irrespective of their nationality) who have had lawful residence in the How to submit this application
Netherlands for a continuous period of 5 years or longer. An exception to Please send your application to the IND. You can use the return envelope
the period of 5 years applies to those nationals of the Union who, after you have received together with this form. Do not submit the application
having worked as an employee or on a self-employed basis, have now until you have filled in this form completely; so do not submit it in parts.
retired or have taken early retirement, or who have become permanently Send all the documents required together with your application.
unfit for work, or who have started working as a cross-border worker.
If these situations apply, these nationals will qualify for the Permanent Copies
Residence document for Nationals of the Union. Please read the Provide copies of all required documents and evidence. Submit the
applicable conditions under Purpose of Stay on page 3 of this form. copies together with the form. Never send original documents by mail.
Make sure that the copies are clearly legible, and A4 size. Do not use
You are a national of the Union if you are a national of one of the other sizes of paper. Write your V-number (if known), customer number
Member States of the European Union. Nationals of the member states (if known), or your personal data on every copy. Never include objects,
of the European Economic Area (EEA) as well as nationals of Switzerland like USB-drives, DVDs or photo albums.
have the same rights as nationals of the union.
The countries that are members of the European Union (EU) are the Municipal Administration
following: Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, The IND verifies information in the Municipal Administration. Check at
Denmark, Estonia, Finland, France, Greece, Germany, Hungary, Ireland, the reason of stay whether registration is required.
Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Poland,
Portugal, Romania, Slovenia, Slovakia, Spain, Sweden, and the United Application costs (charges)
Kingdom. The countries that are members of the European Economic Applying for a residence document costs money. Do not send any
Area (EEA) are the following: Liechtenstein, Norway, and Iceland. money together with your application. Once the IND has received your
application, it will send a giro collection form. You must always pay by
With this form, you can submit your application for a Permanent using this giro collection form; if you fail to do so, your application will
Residence Document for Nationals of the Union to the IND. In all other not be handled. You cannot pay in any other way or in instalments.
cases, it is not possible to use this form. Please visit www.ind.nl for this The giro collection form is also a confirmation that the IND has received
purpose. your application. This form does not include any information about the
charges or a possible exemption from paying charges. If you want to
NB. If you already have a Permanent Residence Document for Nationals know in advance what charges you will have to pay, please visit
of the Union, but the validity of this document is going to expire, then www.ind.nl. If the assessment of your application shows that you do not
use the form Application for replacement, renewal or first application qualify for the residence document applied for, the money will not be
for a residence document. refunded.

How to fill in this form What will happen with your application?
This form consists several appendices. Whether you have to fill in an If your application is not complete, it cannot be assessed properly.
appendix depends on your situation. Do not submit this form until you Non-payment or overdue payment of the charges and the submission
have filled in this form, signed completely and collected all the required of an incomplete application may slow down the handling of the
evidence and documents, so not in parts. If your application is not application. According to the law, the IND must make a decision on your
complete it cannot be assessed properly. application within 6 months. You will receive a written notice when your
application is completed. When your application is granted, you will
receive a letter with information about how and where you can pick up
your residence document.

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Passport photo, fingerprints and signature Personal Data Protection Act

If you are a family member of a citizen of the European union and you The Personal Data Protection Act (Wbp) places an obligation on the IND
are a third country national, than the IND needs your passport photo, to inform you that the IND is the organisation which processes the data
fingerprints and signature to create a residence permit. Fingerprints are in your application. The IND does this to be able to process your request
taken from applicants 6 years and older. Every person of 12 years and or application. If you have any questions regarding the data processing
older has to put their signature at the IND pillar. procedure you can submit them in writing to the IND, Postbus 287,
7600 AG Almelo. This is the department you must contact if you would
NB. You have to pay a visit to the IND desk to have your passport photo like a summary of your personal data held on file. Following a request
and fingerprints taken and to put your signature. This has to be done for such a summary you can ask to have your personal data changed,
within three weeks after your application has been sent to the IND. removed or blocked.
There is no need to make an appointment for it. If the IND does not have
your fingerprints, passport photo and signature, your residence permit Do you need more information?
cannot be prepared and issued to you. It is important therefore that you Then visit the IND website at www.ind.nl. You can also contact the IND
visit the IND desk. There are IND desks in Amsterdam, Den Bosch, by telephone via 088 043 04 30 (local call charges plus any additional
Eindhoven, Hoofddorp, Rijswijk, Rotterdam, Utrecht and Zwolle. costs charged by your operator if you are calling from a mobile phone).
Check www.ind.nl for the addresses and opening hours. From abroad you can call +31 88 043 04 30.

EU, EER and Switzerland citizens

If you are an EU, EER or Swiss citizen no fingerprints will be put in the
residence permit. The residence permit does have to bear your passport
photo and signature. You can use the photo card. The annexed photo
card tells you what to do for that. You may also choose to go to an IND
desk to have the photo taken and to put your signature. An appointment
will not be needed. The IND Desk addresses and opening hours are
available at www.ind.nl.

1 Details of the applicant (holder of the residence document)

The V-number can be found in previous correspondence from the IND or on your previous residence permit

1.1 V-number

1.2 Citizen Service Number (if known)

Surname as stated in the passport

1.3 Name |
First names

|
> Please tick the applicable situation Day Month Year

1.4 Sex and Date of birth n Male n Female

1.5 Place of birth |

1.6 Country of birth |

1.7 Nationality |
Street Number

1.8 Home address | |

Postcode Town

|
> Please tick the applicable situation

1.9 Civil status n unmarried n married n registered partnership n divorced n widow/widower

1.10 Telephone number

1.11 E-mail |

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Application for a Permanent Residence Document for Nationals of the Union and their
Family Members
Immigration and Naturalisation Service
Ministry of Security and Justice

2 Purpose of stay in the Netherlands

Please state below the specific reason for applying for a residence document and follow the instruction written
there. Tick the most important reason. You may not tick more than one reason for your stay. If you tick more
than one reason, your application will only be assessed on the reason ticked first.

n f or permanent residence as a national of the Union or as a family member n you are permanently unfit for work (502)
of a national of the Union (502) Your application must be accompanied by the following supplementary evidence
NB. For this reason of stay registration at the Municipal Administation (BRP) is and documents:
required. Evidence showing that you had worked in the Netherlands for a period of at
In order to qualify for permanent residence as a national of the Union least 2 years immediately preceding the date on which you were declared
uninterrupted lawful residence during the previous five years is required. unfit for work, and that you stopped working due to permanent incapacity
You have had lawful residence if you have actually stayed in the Netherlands for work;
and were employed and / or had sufficient means of existence to support Evidence showing that you had lived in the Netherlands for a period of
yourself. You have to provide means of evidence and documents with your 2 years immediately preceding the date on which you were declared unfit
application showing this. For instance: Employment contracts (of you or your for work.
spouse/ (registered) partner) with an employer in the Netherlands or a copy
of a health insurance policy providing coverage during the previous 5 years or n y ou are permanently unfit for work due to an accident at work, or
evidence showing you had a bank account registered to you on an address in due to an occupational disease and you are entitled to a WAO benefit
the Netherlands during the previous 5 years. received under the Dutch Invalidity Insurance Act or, as of 1 January 2006,
If a national of the Union qualifies for permanent residence, then you as a a WIA benefit received under the Dutch Work and Income (capacity for
family member also qualify for permanent residence if you had uninterrupted Work) Act (502)
lawful residence during the previous five years with this national of the Union. In this situation, the duration of your stay in the Netherlands is not applicable.
If your relationship has ended or marriage has been dissolved you in principle Please enclose the evidence and documents relevant to this purpose of stay
do not qualify for permanent residence. Some exceptions apply to this rule. with your application.
The IND will assess if an exception applies to you.
n you are a cross-border worker (502)
n you have retired or taken early retirement (502) Your application must be accompanied by the following supplementary evidence
Your application must be accompanied by the following supplementary evidence and documents:
and documents: Evidence showing that you have continuously worked and stayed in the
Evidence showing that you had worked in the Netherlands for a period of at Netherlands for a period of at least 3 years;
least 12 months immediately preceding the date on which you reached the Evidence showing that you have subsequently worked in another EU
statutory pensionable age or on which you took early retirement; Member State, but that you have kept your dwelling in the Netherlands and
Evidence showing that you had stopped working because you had reached that you return to the Netherlands daily or at least once a week.
the pensionable age or because you had taken early retirement;
Evidence showing that you had lived in the Netherlands for a period of at
least 3 years immediately preceding the date on which you reached the
statutory pensionable age or immediately preceding the date on which you
took early retirement.
These periods do not apply if your spouse or partner or registered partner has Dutch
nationality or has lost this nationality due to the marriage.

3 Identification
Please accompany your application by copies of the pages with the identity data, stamps, travel stamps and
endorsements of the valid border-crossing document (e.g. a passport or identity card).
What to do if you do not have a valid border-crossing document? In that case, enclose a letter with your
application in which you explain why you do not have such a document.
If it concerns a minor child without its own valid border-crossing document: provide copies of the pages with
the identity data, stamps, travel stamps and endorsements of the valid border-crossing document of the
parent, in which the name of the minor child has been entered. It is not necessary to copy empty pages.

4 Signature by the applicant (holder of the residence document)

I am requesting the issue of the Permanent Residence Document for Nationals of the Union for me/my child/
the child I legally represent. 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 my situation/the situation of the
child relating to the right of residence.

I submit this form and (number) of appendices/documents in evidence.

4.1 Name |
Place Day Month Year

4.2 Place and date |

4.3 Signature |

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5 Submitting the application

> Place your colour passport photo and your signature on the Appendix > Submitting this form. Send the form to the IND. Please use the return enve-
Photo Card you will find enclosed with this form. Your passport photo lope accompanying this form. If you have downloaded this form from www.
may not have been used for a residence permit before, it must bear a clear ind.nl, please use an envelope of your own.
resemblance, and it must meet the Dutch passport requirements (see www.
paspoortinformatie.nl/nederlands/reisdocumenten/pasfoto). Please send this form to:
> Check whether you filled in the form completely.
> Check whether you placed your signature on the form. Immigratie- en Naturalisatiedienst
> Make sure that your application is accompanied by all the enclosures, evi- Postbus 245
dence and documents that have been requested. Do not use any staples or 7600 AE Almelo
paperclips.

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Do not enclose this appendix with the form! Appendix
Fingerprints, passport photo and
signature

In order to be able to make a residence document, the Immigration and When abroad, application for temporary Regular Residence Permit
Naturalisation Service (IND) need the fingerprints, passport photo and for persons who do not require a Regular Provisional Residence
signature of the foreign national. How can the foreign national submit Permit
these?
I f an application is submitted in the Netherlands by a (recognised)
This can be done while still abroad, by means of the Entry and sponsor for a foreign national who does not require a Regular
Residence procedure Provisional Residence Permit, then the foreign national must go
to an Immigration and Naturalisation Service (IND) counter
T he sponsor (in the Netherlands) will have submitted the application immediately after arrival in the Netherlands. The Immigration and
for Regular Provisional Residence Permit for the foreign national Naturalisation Service (IND) employee will make fingerprints and a
(who is still abroad) . passport photo and the foreign national will be required to sign the
- I f a positive decision is given, then the foreign national can collect document. No appointment needs to be made for this. The addresses
the Regular Provisional Residence Permit from the Dutch Embassy and opening hours of the Immigration and Naturalisation Service
or Consulate in his/her country of origin or long-term residence. (IND) counters can be found on the website www.ind.nl
When collecting the Regular Provisional Residence Permit, the
foreign national must take a new (and not previously used) passport Applying for a first residence permit in the Netherlands or changing
photo with him/her. This passport photo must comply with the the purpose of residence
requirements which also apply for Dutch passports. The Embassy
can inform the foreign national where he/she is able to have T he foreign national or sponsor submits the application in writing
passport photos made locally, which comply with the relevant (and sends the application by post to the Immigration and
requirements. A photo that does not comply with the requirements Naturalisation Service (IND)). The foreign national must then go to
will cause unnecessary delay. the Immigration and Naturalisation Service (IND) counter within
- The employee at the Dutch Embassy or the Consulate will take 2 weeks in order to have his/her fingerprints and passport photo
fingerprints and the foreign national will also be required to sign taken. No appointment is necessary for this purpose. The addresses
the document. and opening hours of the Immigration and Naturalisation Service
(IND) counters can be found on the website www.ind.nl.
T he foreign national has submitted the Regular Provisional Residence The foreign national must submit the application immediately at
Permit to the Dutch Embassy or the Consulate in the country of origin the counter. A passport photo and the fingerprints will be taken at
or long-term residence. the counter. The foreign national will also be required to sign the
- When submitting the application, the foreign national must take document. Submitting an application to an Immigration and
a new (and not previously used) passport photo with him/her. Naturalisation Service (IND) counter is by appointment only.
The employee at the Dutch Embassy or the Consulate will also take Information about making appointments can be found on the
the fingerprints and the foreign national will be required to sign the website www.ind.nl.
document.
Application for extension of a residence permit, a permanent
residence permit or an application for renewal or replacement of
a residence document

T he foreign national or sponsor submits the application in writing

(and sends the application by post to the Immigration and
Naturalisation Service (IND)). The foreign national must then go to
the Immigration and Naturalisation Service (IND) counter within
2 weeks in order to have his/her fingerprints and passport photo
taken. No appointment is necessary for this purpose. The addresses
and opening hours of the Immigration and Naturalisation Service
(IND) counters can be found on the website www.ind.nl.

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This appendix may only be used for children younger than 6 years Appendix
and Union citizens and nationals of the EEA and Switzerland.
Passport photo form

The passport photo and signature Please note! No residence document can be issued to you if your
The passport photo and signature of the foreign national is stated on the passport photo does not meet the Dutch passport requirements.
residence document (card). Each person from the age of 12 must place
his or her own signature in this passport photo form. It is important for Instruction enter personal data and signature
the signature to be clearly visible. Any unclear signatures cannot be used. 1. Complete in this passport photo form the foreign nationals personal
details (1 to 5).
The foreign nationals passport photo, which you have to place in this Please note! Complete in capital letters
passport photo form, must meet the following requirements: 2. Have the foreign national place a signature in the signature box on
The passport photo is in color. the lower left side (6). Use a pen with dark, preferably black ink.
The passport photo may not have been used for a residence Please note! If the signature is not clearly visible, a residence
document before and must bear a clear resemblance; document can not be issued.
The passport photo must meet the Dutch passport requirements. 3. Stick the passport photo with glue in the grey photo frame on the
These requirements can be found at www.rijksoverheid.nl (Welke eisen lower right side.
stelt de overheid aan mijn pasfoto voor mijn paspoort of identiteitskaart?) Please note! Never use paperclips or staples, the passport photo will
damage hereby.

1. First name(s) and surname |

Street Number

2. Home address | |
Postcode Town

| |
Day Month Year

3. Date of birth

4. Nationality |

5. V-number

6. Signature

Stick the passport

photo here

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