Assurance of cohabitation - appendices to online ... - Migrationsverket

243011BReceived by the Swedish Mission AbroadReceived by the Swedish Migration BoardAssurance of cohabitationAppendix to application for extendedresidence permitNotes from the Migration BoardDossier numberSignatureIf you apply for an extended residence permit you must fill in this assurance together with your husband, wife,common law spouse or registered partner. This is to prove that you are still living together.Fill in the form, print it and sign it. Please note that both of you have to sign it.. You should then send the form withyour application.1. Personal detailsThe person applying for an extended residence permit (the applicant)SurnameGiven namesPrevious surname, if any Personal identity number (YYMMDD-XXXX) Telephone numberHusband/wife, common law spouse or registered partner to the applicantSurnameGiven namesPrevious surname, if any Personal identity number Telephone number2. Your relationshipAre you still married, cohabitating or registered as partners?YesNoWhen did the applicant move to Sweden? State year and month.Do you live in Sweden together?Yes, we have been living togethersince....................................... (year/month)No, we do not live together because……Have you been living together for the whole time since she/he arrived?Yes No, because .............................Will you (continue to) live together in the future?Yes No, because .............................3. Living outside of SwedenHas the applicant lived outside of Sweden since he/she received a resident permit in Sweden?243011B 130625YesNoIf you answer yes, state the time period Why did he/she live outside of Sweden? Did you live outside of Sweden together?Yes No

4. Other information you want to submit to the Migration Board5. SignatureI solemnly declare that the information that I have provided is true and that I have not knowingly omittedanything that could be of significance in the examination of this application.Place and dateName (the applicant)Place and dateName (husband/wife, common law spouse or registered partner)If you provide incorrect information in the application, or knowingly omit information that is of importance, theapplicant’s permit can be revoked. You could also be fined or imprisoned. See Chapter 20, section 6, paragraph 2 ofthe Aliens Act (2005:716).