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Application for Danish residence permit based on previous Danish citizenship, Danish heritage or affiliation with the Danish minority in South Schleswig Uses Use this form when applying for a Danish residence permit based on previous Danish citizenship, Danish heritage, or if you belong to the Danish minority in South Schleswig. More about the rules covering residence permits granted based on the above-mentioned criteria can be found on page 2 of this form, where you will also find examples of approved documentation. Instructions To apply for a Danish residence permit: 1. Fill out and sign this form, following the instructions given. 2. Include the required documents 3. Submit the application to a Danish diplomatic mission (embassy or consulate general) in your country of residence. If you are currently in Denmark, submit the application at the local police station or the Service Centre at the Immigration Service What documents are required when submitting an application? When submitting your application, please present your passport or ID card (EU citizens only), so the authorities can verify your identity. If you send the application, please present your passport or your ID card (EU citizens only) when retrieving your residence permit.. If your spouse or minor child is also seeking a Danish residence permit In order for your spouse / registered partner / cohabiting partner or minor child to qualify for a Danish residence permit, you must meet all the normal requirements for family reunification in Denmark. Apply using the appropriate forms. For more information More information about the rules governing family reunification is available at www.newtodenmark.dk, where you can also find information about processing times, etc. If you have questions when filling out the forms, you can also contact the Immigration Service in writing, by telephone or in person. (See contact information below.) Which documents are required? Please include the following documents when submitting this form: A copy of your passport (all pages including cover) or a copy of your ID card (EU citizens only) Two passport photos Proof of previous Danish citizenship, Danish heritage or that you belong to the Danish minority in South Schleswig (see examples on page 2) Applicant Surname Former surname (if applicable) Given name(s) Nationality Date of birth (day, month, year) Former nationality (if applicable) CPR number (if applicable) Alien identification number (if applicable) Place of birth (city) Country of birth

About previous Danish citizenship, Danish heritage and affiliation with the Danish minority in South Schleswig Previous Danish citizenship Foreign nationals who have previously held Danish citizenship are eligible for a residence permit under the terms of section 9 d of the Aliens Act. However, you are not eligible if you have lost your citizenship in accordance with section 8 a or section 8 b of the Danish Citizenship Act. Documentation of previous Danish citizenship includes your own baptismal certificate or one of your parents baptismal certificates. Danish heritage Other foreign nationals of Danish heritage are normally eligible for residence and work permits under the terms of section 9 c (1) of the Aliens Act, if the applicant can prove that both parents (father and mother) or both parents parents (all four grandparents) are or were born Danish citizens. It is not required that the grandparents still retain their Danish citizenship. It is not permitted to apply for a residence permit based on Danish heritage more than once. Documentation of Danish heritage includes your parents or your grandparents baptismal certificates. Affiliation with the Danish minority in South Schleswig German citizens belonging to the Danish minority in South Schleswig are normally eligible for a Danish residence permit under the terms of section 9 c (1) of the Aliens Act. Documentation of your affiliation with the Danish minority includes a diploma from a school belonging to the Association of Danish Schools of South Schleswig (Den Danske Skoleforening for Sydslesvig), a membership card or letter from the Southslesvigian Organization Sydslesvigsk Forening or a membership card from the SSW (Sydslesvigsk Vælgerforening). 1. Grounds for your application On what grounds are you applying for a Danish residence permit? (Choose only one) Previous Danish citizenship Danish heritage Member of the Danish minority in South Schleswig 2. Information about you (the applicant) Gender Job title Male Marital status Female Cohabiting Married Widow(er) Registered partner Divorced Do you have children? Yes No Address in home country If you are currently in Denmark, please answer the following questions: Date of entry Address in Denmark (street and number) C/O (name) (if applicable) Postcode and city Telephone number Email address (if applicable) 2/7

3. Information about your passport and previous visits to Denmark and other countries National passport Other travel document. Please state which Passport number Date of expiry Date of issue In which country was your passport issued? Have you been in Denmark before? Yes No If yes, please state when Have you lived outside of your home country for more than six months at any one time? Yes No If yes, please state which country (countries) and period of residence 4. Information about your spouse / registered partner / cohabiting partner Surname Former surname (if applicable) Given name(s) Nationality Date of birth (day month year) City and country of birth Address (street and number) Country Former nationality (if applicable) If you are married or registered partners, please state where and when the marriage / registered partnership was made official Postcode and city Telephone number Email address (if applicable) Is your spouse / partner also applying for a Danish residence permit? Yes No If yes, your spouse / registered partner / cohabiting partner must submit an application for family reunification of spouses. 3/7

5. Information about your children under age 18 living in your home country Date of birth (day, month, year) Gender Is the child in Denmark? Given name(s) Nationality Male Female Is the child also applying for a residence permit? If yes, the child must submit an application for family reunification Ye s No Yes No 6. Solemn declarations A. Sworn declaration of correctness I solemnly swear that the information in this application is correct and complete. If the information is found to be false or incomplete, I am subject to the following penalties: Fine or imprisonment of up to two years I can be required by law to repay the expenses incurred by the Danish state as a consequence of the false or incomplete information My residence permit can be revoked B. Declaration of consent to allow authorities to gather necessary information I consent to letting the Danish immigration authorities obtain and pass on information about my private affairs for the purpose of enabling them to process my application. Information can be obtained from or passed on to other Danish and foreign public authorities, including the police authorities. Such information includes: Previous criminal proceedings against me My familial relations Verification that the documents submitted with my application are genuine I also consent to giving authorities contacted by the Immigration Service while processing my application permission to gather information about my private affairs for use in responding to the Immigration Service's enquiry. C. Notification that information can be passed on to Danish intelligence agencies and prosecuting authorities The information and documents that you submit with your application can be passed on to Danish intelligence agencies and the Danish public prosecuting authority. Prosecuting authorities will be able use the information to evaluate whether there are grounds for prosecuting you for crimes committed in Denmark or abroad. D. Notification that some information will be passed on to local Danish authorities Danish immigration authorities are permitted to give certain information to the municipality (kommune) in which you settle if you receive a residence permit. 4/7

Such information includes: The grounds for issuing you a residence permit Exemptions to restrictions placed on your residence permit (if any) The municipality will be informed if: Your residence permit is revoked or not extended Your residence permit is found to have expired Your residence permit is made permanent E. Notification that Danish authorities have registered information about you and your affairs The information you supply or have supplied in connection with your application for a passport will be registered in the Aliens Register. The same holds true for information you give in conjunction with an application to extend your residence. The Aliens Register is a computerised register maintained by the Immigration Service. If you receive a residence permit, it will be registered in the Central Person Register. The Central Person Register is a computerised register maintained by the Interior and Health Ministry. The information in the Aliens Register and the Central Person Register will be used to answer questions relating to your residence in Denmark. Public administration authorities (record keeping), the police (record keeping and verification) and the Ministry of Integration (reviewing complaints) will have access to the information about you contained in the Aliens Register and the Central Person Review. Other authorities or organisations will receive information about you from the Aliens Register and the Central Person Register if they require the information to answer questions about your residence in Denmark. You are obligated to provide the information necessary for deciding whether you are eligible for a Danish residence permit. Failure to provide the information can result in a fine or up to four months imprisonment, as well as placing your residence permit in jeopardy. You are entitled to right of access to the information about you in the Aliens Register and the Central Person Register. Enquiries about this can be addressed to the Danish Immigration Service, Ryesgade 53, DK-2100 Copenhagen Ø. 7. Signature I am applying for a Danish residence permit. By signing below, I confirm that I have read, understood and accepted the terms laid out in section 6. Date and place Signature 5/7

Checklist If your application for a Danish residence permit is filled out correctly and includes the necessary documents, the Immigration Service can give you an answer faster. Before submitting your application, use the checklist below to make sure you have filled out the form correctly and attached the necessary documents. Before submitting your application, it is important to make sure you have included the following: A copy of your passport (all pages including the cover) or a copy of your ID card (EU citizens only) Two passport photos Documentation that you previously held Danish citizenship, documentation of your Danish heritage or documentation of your affiliation with the Danish minority in South Schleswig It is also important to answer all questions and sign and date the application Remember to bring your passport or your ID card (EU citizens only) if submitting the application in person. If the application is sent by post, bring your passport or ID card (EU citizens only) when retrieving your residence permit. 6/7

For official use only Udl. nr. Tilmeldt CPR den Pasfoto 3,5 * 4,5 cm Modtaget dato Modtaget af Bemærkninger og fremsendelsespåtegninger Navne og pasoplysninger er i overensstemmelse med forevist legitimation Der vedlægges: Kopi af pas, id-kort (kun EU-borgere), eller anden rejselegitimation 2 stk. foto Dokumentation for tidligere dansk statsborgerskab Dokumentation for dansk afstamning Dokumentation for tilhørsforhold til det danske mindretal i Sydslesvig Andet Modtaget dato Modtaget af 7/7