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at my abovementioned address at the following secondary address:

Address

declare being able to bear living costs and repatriation *

  • -

    for the person(s) mentioned under

1

2

  • -

    during the period of stay indicated under

3

ADDITIONAL INFORMATION the person(s) mentioned under 1

under 2

subscribe(s) to their own travel medical insurance for the

duration of stay, as required by Article 12(1)(b) of the Visa Code.

I subscribe to health insurance on their behalf during the period of stay.

I am aware that the personal data contained in this form is stored and handled by the services receiving the form, that it is stored in the Visa Information System (VIS) and made accessible to the authorities of the other Member States and I have the right to have them altered or deleted, in particular, should they be inaccurate.

I am aware that

  • -

    if any information provided is false or incorrect, I will be liable to criminal responsibility in accordance with Articles 188 and 189 of the Criminal Code (Chapter 9 of the Laws of Malta); and Article 32 of the Immigration Act (Chapter 217 of the Laws of Malta) as well as any other law or regulation which may be in force at the time of the unlawful declaration.

  • -

    the original the present Declaration, duly stamped by the competent authority, must be presented in original within six (6) months to the consular authorities competent for examining the visa application of the person(s) invited

I solemnly declare that the information provided in this Declaration of Proof is true.

Read and approved

Witnessed for certification of the signature of

Date & Signature of the Invitee

Date

Documents to be attached:

  • -

    copy of the Invitee's ID Card or of the bio-data page of his/her Passport;

  • -

    proof of residence (ie property title deeds, rental agreement, energy bills);

  • -

    proof of income (salary slip, receipt of pension, official document stating the amount of income);

  • -

    if applicable, health insurance policy for the invited person(s)

FOR USE BY THE AUTHORITY

Proof of accomodation The accomodation conditions have not been verified

Proof of bearing of costs The level of financial means of the Invitee has not been verified

have been judged compatible with the intended invitation

has been judged sufficient in relation to the applicable reference amounts and the duration of stay of the invited persons(s)

Date & Place

Stamp

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