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Antrag auf Erteilung eines Aufenthaltstitels
Application for a Visa or Residence Permit – Demande d’attribution d’un titre de séjour Domanda per il conferimento di un titolo di soggiorno
Familienname
Family name / Nom de famille / Cognome

Geburtsname
Name at birth / Nom de naissance / Cognome di nascita

Vornamen
First names / Prénoms / Nomi

Geburtstag
Date of birth / Date de naissance / Data di nascita

Geburtsort
Place of birth / Lieu de naissance / Luogo di nascita

Geburtsland
Country of birth / Pays de naissance / Paese di nascita

Geschlecht
Sex / Genre / Sesso

männlich
Male / Homme / Maschio

weiblich
Female / Femme / Femmina

unbekannt
Unknown / Inconnu / Sconosciuto

Staatsangehörigkeit(en)
Nationality / Nationalité(s) / Cittadinanza(e) bei mehreren Staatsangehörigkeiten sind alle anzugeben.

(If more than one, each should be stated) / (indiquer toutes les nationalités s'il y en a plusieurs) / (in caso di più cittadinanze indicarle tutte)

LICHTBILD des Antragstellers
Photograph of applicant Photographie du requérant Fotografia del richiedente

a) jetzige current / actuelle / attuale

b) frühere former / précédente / precedente

LABO AGen 1 (09-2012)

Pass oder sonstiges Personaldokument
– Genaue Bezeichnung –

Passport or other identification papers / Passeport ou autre pièce d´identité / Passaporto o altro documento d´identità

Nr.
No. / N° / N°

ausgestellt am issued on / établi le / rilasciato il

ausgestellt von issued by / délivré par / emesso da

gültig bis valid until / valable jusqu’au / valido fino al

Rückkehrberechtigung (falls im Pass vermerkt) nach
Authorization to return to (if entered in passport) / Autorisation de retour en (s'il en est fait mention dans le passeport) / Autorizzazione di ritorno a (se registrato sul passaporto)

bis zum valid until / valable jusqu’au / fino al

Wird ständiger Wohnort außerhalb der

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