Notification of accommodation
For completion by the authority!
Authority receiving the notification (code and name):
Time of receiving the notification:
_____ year ___ month _____day
PLEASE COMPLETE THE FORM LEGIBLY, IN BLOCK LETTERS, USING LATIN CHARACTERS
Telephone number:
E-mail address:
I. Personal data of the applicant:
1. Surname:
Sex:
Forename(s): Citizenship:
2. Mother’s surname and forename at birth:
3. Date of birth: year month day Place of birth:
4. Marital status:
□ single □ married
□ divorced □ widow(er)
5. Passport number and validity: year month day
Number of residence permit:
6. Address of accommodation (precise):
:
Postal code: Land register ref. number
Locality: District:
Name of public place:
Type of public place (road, street, square, etc):
Building number:
Building: Block: Floor: Door:
7. Legal title of residence at the accommodation:
o owner
o tenant
o other: .......................
Date:..................................................
……………………….. …………………………..
Signature of landlord Signature of applicant
INFROMATION
Mandatory enclosures:
proof of the use of accommodation (e.g. residential lease contract, document on accommodation by courtesy, etc.)
copy of valid passport
Information for applicants: When relocating, third-country nationals shall - within three days - notify the regional directorate of jurisdiction
by reference to the place where the new place of abode is located, according to the (1) subparagraph of Section 156 of Government
Decree 114/2007. (V.24.) on the Implementation of Act II of 2007 on the Admission and Right of Residence of Third-Country Nationals.
The competent regional directorate shall be entitled to consult the register of personal data and address records to verify the address
registered.