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Registration for temporary stay in Limburg-Noord

Dear Sir / Madam,
 
Please find below the registration form in connection with your compulsory registration in the Netherlands. The maximum period of your stay will therefore be 90 days. If you intend to stay in the Netherlands for more than 90 days, you will need to apply for either a residence permit, or – in special cases – an extension of your visa, in both cases to be issued by the IND. You can make an appointment by telephone: 0900-1234 561 (€ 0,10 p/m).

Please note: you will require an authorization for temporary stay (MVV) for this (unless you are exempt), which you can only apply for in your own country. For further information, please go to www.ind.nl.
N.B. If you are staying at an official campsite or in a hotel, you do not have to register with the Aliens Police, unless your visa explicitly states that you have to register with the chief constable (Aliens Police).

You can only use the form if you are staying in the Utrecht police region. This region consists of the following 15 municipalities: Beesel, Gennep, Bergen(L), Echt - Susteren, Peel en Maas, Horst aan de Maas, Leudal, Maasgouw, Mook en Middelaar, Nederweert, Roerdalen, Roermond, Venlo, Venray, Weert

You are kindly requested to fill in the form completely and clearly. Any comments you may have can be made at the bottom of the form. When completing the form, you must use the data from your passport and (possibly) your visa sticker – otherwise you will not be able to register!

According to the law, you must register with the Aliens Police within 3 days; the date the form is sent is the date of registration.
Please note: Failure to register within 3 days is an offence punishable under article 4.48 of the Aliens Decree (Vb). It is also a punishable offence 'not to register if you are an alien with no legal residence'. Penalties in these matters range from 60 to 800 Euros. The following is also subject to punishment: 'any person providing accommodation to an alien with no legal residence in the Netherlands and failing to notify the relevant chief constable without delay'.

Upon receipt, all your details will be processed directly in the PSHV aliens records. Your personal data will be processed in an agenda. Within 2 working days you will be notified by email on the date and time you are expected to come to the aliens police department to have your visa sticker placed in your passport.

Please give us your e-mail address, so we can send you the letter of confirmation digitally.

If you have any questions, please call the general telephone number 0900-8844 (ask for the Utrecht Aliens Police).
I trust you have all the information you require and I look forward to your cooperation in this matter.

Yours faithfully,
Chief Constable of the Limburg-Noord police region

	Registration for temporary stay in Limburg-Noord
	One person per form. Children should register separately.
*	E-mailaddress:
	A. short stay
	What is your V-number? (See registration sticker in your passport):
	B. Personal details (use details in passport)
*	Surname (as shown in passport):
*	Sex:	M    F
*	First name(s):
*	Date of birth (dd-mm-yyyy):
*	Place of birth:
*	Country of birth:
*	Nationality:
	C. Residential address (within the Limburg-Noord police region)
*	Street:
*	Number:
*	Postcode:
*	Town / city:
*	Municipality:	Beesel Gennep Bergen(L) Echt - Susteren Peel en Maas Horst aan de Maas Leudal Maasgouw Mook en Middelaar Nederweert Roerdalen Roermond Venlo Venray Weert
*	Telephone number:
	D. Passport details
*	Number:
	Valid from (dd-mm-yyyy):
*	Valid until (dd-mm-yyyy):
*	Country of issue:
	E. Information concerning (green) visa sticker (if visa requirement)
	No sticker than "xxxx" form
*	Number of visa sticker: BNL:
*	Valid for:	Schengen states    Benelux Other (please specify below)
	Other:
*	Valid from date (dd-mm-yyyy):
*	Valid until date (dd-mm-yyyy):
*	Number of entries:	1    2 Mult
*	Length of stay:	90 days    60 days 30 days    Other (please specify below)
	Other:
*	Issued at (place):
*	Issued on (dd-mm-yyyy):
	F. Information concerning arrival, purpose, sponsor and departure
*	Arrival date in the Netherlands, or in Schengen area (see entry stamp) (dd-mm-yyyy):
*	Checkpoint (see entry stamp):	Schiphol    East border of Slovenia Düsseldorf Airport    Southern border of Spain Brussels Airport    Other (please specify below)
	Other:
*	Purpose of stay:	Family visit    Visiting friends Short study programme    Other (please specify below)
	Other:
	The referent is present in person during the Obligation to register
*	Name of sponsor:
*	date of Birth:
*	street:
*	Postal code:
*	place:
*	Phone:
*	Date of departure (dd-mm-yyyy):
	G. Comments
*	Comments concerning temporary stay:
	H. Signature
	I hereby declare that I have provided a true record of my personal details. I know that the personal details supplied will be processed for the purpose of the implementation of the Aliens Act 2000 and will be passed on to the agencies that require it for this purpose. It is a punishable offence to misuse this form.
*	Name:
*	Date (dd-mm-yyyy):
*	Place:

 

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