Application for admission and residence to work (foreign

national)

To be filled in by the Dutch embassy or consulate

Location of the
embassy/consulate Passport photo
where the application is
size 35 x 45 mm
submitted
(width x height)
Date Day Month Year

Name and initials

embassy employee

Please note! If you have received a printed version of this information form, please check out the digital version,
including direct links, on [Link].
Please check that you have the latest version of this form on [Link]/en/forms.
Please read the explanation before you start filling in this form.

With this form, you apply for admission and residence in the Netherlands for working purposes. You can only use this
form if you are a foreign national staying outside the Netherlands. You submit the application to the Dutch embassy or
consulate in the country of origin or the country of continuous residence.* Please check the contact page of
[Link]/making-appointment to find out where and how you can make an appointment for this.

* In case there is no Dutch consulate or embassy in your country of origin or permanent residence, please turn to the
nearest Dutch representation.

You can use this form to apply for admission and residence in the Netherlands for different residence permits to work:
• Paid employment.
• Work experience within the context of a studies on mbo level.
• Work experience within the context of a studies on hbo/wo level.
• Work experience after graduation at hbo/wo level.
• Work experience for employment purposes (apprentice).
• Work experience within the framework of the Young Workers Exchange Program.
• Work experience within the framework of an EU action programme:
▪ within the context of a studies on hbo/wo level.
▪ after graduation at hbo/wo level.
▪ within the context of a studies on mbo level.
▪ work experience for employment purposes (apprentice).
• Paid employment as non-privileged soldier or as non-privileged civilian personnel.
• Paid employment on a Dutch seagoing vessel.
• Waiting for recovery from illness and resumption of paid employment on board a Dutch seagoing vessel or mining
installation on a continental shelf.
• Looking for paid employment on board a Dutch seagoing vessel or mining installation on a continental shelf.
• Paid employment in a mining installation on a continental shelf.
• Cross-border service provision.
• Labour on grounds of a Headquarters Agreement.

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• International Trade Regulation.
• Intra-company transferee other than Intra Corporate Transferee under Directive ICT 2014/66/EU)
• Carrying out work as a spiritual counsellor
• Supply of goods to a foreign company.
• Supply of goods from a foreign company.
• Seasonal labour.
• Employment as essential start-up personnel.
• Holder of a European blue card.
You can also use this form to apply for admission and residence in the Netherlands if you have the Turkish nationality
and want to work:
• as highly skilled migrant; or
• as a researcher within the meaning of Directive (EU) 2016/801.

Appointment at the Dutch embassy or consulate

Please take this application form, your passport photo and valid passport with you to the appointment at the Dutch
embassy or consulate. The embassy or consulate employee will register your application and fill out the information box
above. You will also receive a confirmation letter with your registration number (V-number). Please keep this letter:
you will need it later. After submitting the application to the embassy or consulate, you will receive this application
form back.

After the appointment

To be able to assess your application, the Immigration and Naturalisation Service (IND) in the Netherlands needs
information from you. Please complete and send this form, with all the necessary documents mentioned in section
‘5 Means of evidence’, to the IND within three weeks from the date of your application (see the date above). Please
also enclose the confirmation letter you received from the embassy or consulate. If you do not send all the necessary
documents, the assessment of your application will be delayed. If the IND does not receive the information and
documents in time, your application may be rejected.

1 Your personal details Write in block letters

1.1 V-number

Please note! It is imperative that your V-number is mentioned above.

Without this number, your application can not be processed. The
embassy or consulate will give you this number.

1.2 Dutch Citizen service number

(if applicable)
The Dutch Citizen service number (BSN) is a unique number for
everyone who has dealings with the Dutch government.

1.3 Name Surname

(as stated in the passport)

First names

1.4 Sex  Male

 Female

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1.5 Date of birth Day Month Year

1.6 Place of birth

1.7 Country of birth

(as stated in the passport)

1.8 Nationality at birth

1.9 Current nationality

1.10 Civil status  unmarried (single or living together)

 married
 registered partnership
 divorced
 widow/widower
1.11 Home address Street

Number

Postcode

Town

Country

1.12 Telephone number

1.13 E-mail

1.14 Type of travel document  National passport

 Diplomatic passport
 Service passport
 Official passport
 Special passport
 Other type of travel document, namely:

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1.15 Specifications of the travel document Travel document number

Date of issue

Day Month Year

Valid until

Day Month Year

Issued by

1.16 Education

Only if you want to apply for a residence permit for employment as essential start-up personnel:

1.17 Position of the start-up staff

member
1.18 Gross monthly salary (Excluding €
vacation pay)

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2 Details of the sponsor

Please check section ‘5 Means of evidence’ first to understand which details of the sponsor must be filled in.
The letters in the left hand column correspond to the letters in front of the various working purposes in section
5. Choose the exact purpose of residence and check which details you have to fill in.

A, F, G, H, I, J, K, M, N, U and V > please fill in 2.1 to 2.8

B, C, D, E, O, P, Q and R > please fill in 2.1 to 2.13
L > please fill in 2.1 to 2.13 and 2.16
S > please fill in 2.1 to 2.15
T > please fill in 2.1 to 2.8 and 2.17 to 2.20

2.1 Company name

2.2 IND client number (if known) 1-

2.3 Correspondence address Street

Number

Postcode

Town

2.4 Name of contact person

2.5 Telephone number

2.6 E-mail

2.7 Website

2.8 Chamber of Commerce number

2.9 Business address (only if different Street

from correspondence address)

Number

Postcode

Town

2.10 Sector in which the company

is active

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2.11 Total workforce of the company

2.12 Payroll tax number

2.13 RSIN

2.14 Has the start-up entrepreneur  Yes If so, fill in the V-number of the start-up entrepreneur
made use of the start-up regulation below:
in the past?
(This is the case if the entrepreneur
applied for and received a
residence permit for the purpose of  No
residence ‘Start-up’ working on a
self-employed basis).
2.15 Was the first residence permit for  Yes. The means of proof to demonstrate that the company is a
employment as essential start-up start-up and innovative company with scalable business activities
personnel issued for this company do not need to be provided with the application, except for
in the preceding three-year period? company documentation that shows the essential role the
prospective employee will play within the company to achieve
growth (see section 4 Means of evidence).
 No.

2.16 Registration number of the

registration at
[Link] For cross-border service provision, the employer must register work
online at [Link]. The IND checks whether the
registration has taken place.

2.17 You are going to work in the  highly skilled migrant subsequent to graduation or after orientation
Netherlands as a… year for highly educated persons (396);*
 highly skilled migrant under 30 years of age (396);*
> Please tick the applicable  highly skilled migrant 30 years of age or older (396);*
situation  scientific researcher (396);
 guest lecturer (396); or
> Please consult the website for
 trainee doctor (396).
more information on the purpose of
stay as a knowledge migrant and
the conditions for the reduced
salary criterion.

2.18 * Your position

The appointment decision or

contract contains the job
classification and job code as set
out in the University Job
Classification System (UFO).
2.19 Gross monthly salary (excluding €
vacation pay)
2.20 UFO code (if applicable)

The appointment decision or

contract contains the job
classification and job code as set
out in the University Job
Classification System (UFO).

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3 Details of the authorised representative

Please enclose an authorisation if the representative is acting on your behalf. If the authorised representative
is a lawyer, no authorisation needs to be submitted.

3.1 Company name

3.2 Name of the authorised

representative
3.3 Name of contact person

3.4 Correspondence address Street

Number

Postcode

Town

3.5 Telephone number

3.6 E-mail

4 Declaration of intent to undergo a TB test

In order to obtain a residence permit, you must be prepared to undergo a tuberculosis (TB) test in the
Netherlands and - if necessary -treatment. If you are granted a residence permit, you will actually have to
undergo a TB test within three months after having received your residence permit.

When you are in the Netherlands, you should make a TB test appointment with the Municipal Health Service
(GGD) in the area where you live or will be living (for further information visit the website [Link]).

Should it become clear after the issue of a residence permit that - despite signing the declaration of intent -
you failed to undergo a TB test within the period of three months, this may result in a cancellation of the
permit that was granted.

Please note! The obligation to undergo the test does not apply if you are a national of one of the countries
listed in the appendix ‘Exemption from the obligation to undergo a tuberculosis (TB) test’.

> Please check either one of the following two boxes

 I hereby declare that I am prepared to cooperate in a tuberculosis test and any treatment. I am aware of
the fact that I must undergo a TB test within three months after the residence permit has been received.
If I fail to do so, this might have consequences for my right of residence in the Netherlands.
 I do not need to undergo a TB test because I am a national of one of the countries listed in the appendix
‘Exemption from the obligation to undergo a tuberculosis (TB) test’.

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5 Means of evidence

Requirements of foreign means of evidence

Documents must be in Dutch, English, French or German. In case the documents are drafted in another
language, you need to have these translated by an authorised translator. Send a copy of the original
documents together with a copy of the translation.

> Please choose the purpose of residence and check either one of the following boxes

A  Paid employment (370)

Only when a Single Permit* is not required.
Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty
pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• an employer’s declaration; and
• a copy of the employment contract showing that the foreign national will be carrying out paid
employment.

* A Single Permit is a permit that entitles the foreign national to stay and work in the Netherlands. The
Single Permit combines the residence permit and the TWV. For further information visit Work |
Immigration and Naturalisation Service (IND)?

B  Paid employment (GVVA 370)

Only when a Single Permit is required. Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• an employer’s declaration;
• a copy of the employment contract showing that the foreign national will be carrying out paid employment;
• copies of diplomas and/or certificates obtained by the employee;
• a curriculum vitae (CV) signed by the employee;
• the completed and signed appendix ‘Gegevens arbeidsplaats’ (only available in Dutch);
• the completed and signed appendix ‘Gegevens toekomstig woonadres in Nederland’ (only available in
Dutch);
• the completed and signed appendix ‘Gegevens vacaturevoorziening’ (only available in Dutch).

In case of employment in art and culture:

• the completed and signed appendix ‘Gegevens musicus/artiest in topsegment’ (only available in Dutch).
Please note! In case of employment in art and culture the appendix ‘Gegevens vacaturevoorziening’ is not
required.

C  Work experience within the context of a studies on mbo level (GVVA 643)
 Work experience within the context of a studies on hbo/wo level (GVVA 523)
 Work experience after graduation at hbo/wo level (GVVA 523)
Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• the completed and signed appendix ‘Gegevens toekomstig woonadres in Nederland’ (only available in
Dutch);
• the completed and signed appendix ‘Gegevens arbeidsplaats’ (only available in Dutch);
• the completed and signed appendix ‘Gegevens (over noodzaak) van lerend werken (stagiair)’ (only available
in Dutch).

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D  Work experience for employment purposes (apprentice) (GVVA 643)
Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• the completed and signed appendix ‘Gegevens toekomstig woonadres in Nederland’ (only available in
Dutch);
• the completed and signed appendix ‘Gegevens arbeidsplaats’ (only available in Dutch);
• the completed and signed appendix ‘Gegevens (over noodzaak) van lerend werken in het kader van arbeid
(praktikant)’ (only available in Dutch).

E  Work experience within the framework of the Young Workers Exchange Program (GVVA 404)
Please note! To be eligible for this purpose of residence, you must have Canadian nationality.
Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• the completed and signed appendix ‘Gegevens toekomstig woonadres in Nederland’ (only available in
Dutch);
• the completed and signed appendix ‘Gegevens arbeidsplaats’ (only available in Dutch);
• the completed and signed appendix ‘Gegevens (over noodzaak) van lerend werken (stagiair)’ (only available
in Dutch);
• means of evidence showing you are enrolled in a regular educational programme, or graduated at hbo
(higher vocational) or university level no more than 12 months ago.

F Work experience within the framework of an EU action programme

 within the context of a studies on hbo/wo level (523)
 after graduation at hbo/wo level (523)
 within the context of a studies on mbo level (643)
Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• a statement of the educational institution that the traineeship will take place within the framework of an EU
action programme;
• a scholarship statement;
• the completed and signed appendix ‘Gegevens (over noodzaak) van lerend werken (stagiair)’ (only available
in Dutch), completed with a trainee agreement;
• the completed and signed appendix ‘Declaration by sponsor (employment)’.
 work experience for employment purposes (apprentice) (643)
Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• means of evidence showing that the employment will take place within the framework of an EU action
programme;
• a scholarship statement;
• the appendix ‘Gegevens (over noodzaak) van lerend werken in het kader van arbeid (praktikant)’ (only
available in Dutch), completed and signed by the employer, completed with a trainee agreement and a
return statement, supplemented by the supporting documents listed in the appendix;
• the completed and signed appendix ‘Declaration by sponsor (employment)’.

G  Paid employment as non-privileged soldier or as non-privileged civilian personnel (460)

Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• a copy of your proof of military identification that was issued by the country which posted you;
• a copy of the Travel Order or an equivalent document.

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H  Paid employment on a Dutch seagoing vessel (372)
Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• a copy of your employment contract;
• an employer’s declaration; and
• means of evidence of your employment history, showing that you have worked for at least 7 years on board
a Dutch seagoing vessel or a mining installation on a continental shelf. Examples of these means of
evidence include a copy of your seaman’s book or an employment contract. Is there a break in the
employment history? Then you must submit means of evidence showing the duration and reason for this
break. Did you receive benefit payments during this period? Submit means of evidence of this as well.

I  Waiting for recovery from illness and resumption of paid employment on board a Dutch seagoing
vessel or mining installation on a continental shelf (381)
Please enclose the following means of evidence with the application:
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• a copy of your employment contract;
• a decision of benefits to be awarded by the benefits agency showing that you will receive benefits on
grounds of the Sickness Benefits Act (ZW).
• specification of benefits received/benefits slip showing the level of the benefits.

J  Looking for paid employment on board a Dutch seagoing vessel or mining installation on a
continental shelf (382)
Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• means of evidence of your employment history, showing that you have worked for at least 7 years on board
a Dutch seagoing vessel or a mining installation on a continental shelf. Examples of these means of
evidence include a copy of your seaman’s book or an employment contract. Is there a break in the
employment history? Then you must submit means of evidence showing the duration and reason for this
break. Did you receive benefit payments during this period? Submit means of evidence of this as well;
• a decision of benefits to be awarded by the benefits agency showing that you will receive benefits on
grounds of the Unemployment Insurance Act (WW); and
• specification of benefits received/benefits slip showing the level of the benefits.

K  Paid employment in a mining installation on a continental shelf (383)

Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• a copy of your employment contract; and
• an employer’s declaration.

L  Cross-border service provision (500)

Choose this option if you do not have an EU/EEA nationality, but do live and work in an EU/EEA country and will
be carrying out temporary services under assignment from an employer in the Netherlands. Please enclose the
following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• a copy of your residence permit and of your work permit showing that you have a right of residence in the
country of your employer and that you are allowed to perform work there as an employee of your employer.
• a copy of the employment contract with the employer for whom you will be providing services in the
Netherlands temporarily.

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M  Labour on grounds of a Headquarters Agreement (509)
Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• a declaration from the Ministry of Foreign Affairs showing that you fall under the scope of the Headquarters
Agreement between the International Criminal Court and the Host Country or that the you fall under the
scope of the letter of 21 December 2007 from the Permanent Representative of the Kingdom of the
Netherlands and the United Nations concerning the Seat of the Special Tribunal for Lebanon.

N  International Trade Regulation (425)

Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• the decision of the Employee Insurance Agency showing that your employer is admitted to the International
Trade Regulation;
• means of evidence showing your registration at the Employee Insurance Agency (UWV).

O  Intra-company transferee other than Intra Corporate Transferee under Directive ICT
2014/66/EU) (GVVA 519)
Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• the completed and signed appendix ‘Gegevens toekomstig woonadres in Nederland’ (only available in
Dutch);
• the completed and signed appendix ‘Gegevens arbeidsplaats’ (only available in Dutch);
• the completed and signed appendix ‘Gegevens concernoverplaatsing’ (only available in Dutch).

P  Carrying out work as a spiritual counsellor (GVVA 642)

Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• a copy of the employment contract with your employer;
• the completed and signed appendix ‘Gegevens arbeidsplaats’ (only available in Dutch);
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• the completed and signed appendix ‘Gegevens geestelijk bedienaar’ (only available in Dutch);
• if the institution is not registered in the Commercial Register because this is not mandatory. Please enclose
with your application: the surname, first names, date of birth, place of birth, nationality, citizenservice
number and the position of all company directors or legal person;
• if the organisation is a religious organisation that forms part of an umbrella organization. Please enclose
details indicating the legal form and articles of association with your application;
• an employer’s declaration containing a description of the nature of the work showing the religious or
ideological nature of the activities;
• a copy of the proof showing that you have passed the civic integration examination abroad. This does not
apply if your work exclusively refers to work as a contemplative, board member or as an internal official at
a religious or ideological organisation. See the appendix 'Basic Civic Integration Examination Abroad'.a
declaration of compliance with fiscal obligations (Verklaring betalingsgedrag nakoming fiscale
verplichtingen). This declaration is issued by the Netherlands’ Tax and Customs Administration
(Belastingdienst); and

• financial statements of the closed financial year approved by an accountant; or

• a report of findings from an accountant about the continuity and solvency of the organization; or
• a bank statement showing that the continuity and solvency of the religious or philosophical organization in
the Netherlands are sufficiently guaranteed.

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Q  Supply of goods to a foreign company (GVVA 388) Supply of goods from a foreign company
(GVVA 389)
Please enclose the following means of evidence with the application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty pages;
• a signed and completed appendix ‘Antecedents certificate’;
• a copy of the employment contract;
• the completed and signed appendix ‘Gegevens arbeidsplaats’ (only available in Dutch);
• the completed and signed appendix ‘Gegevens bij levering door of aan een buitenlands bedrijf’ (only
available in Dutch);
• the completed and signed appendix ‘Declaration by sponsor (employment)’.

R  Seasonal labour (GVVA 644)

Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty
pages;
• a signed and completed appendix ‘Antecedents certificate’;
• a copy of the employment contract;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• the completed and signed appendix ‘Gegevens arbeidsplaats’ (only available in Dutch);
• the completed and signed appendix ‘Gegevens toekomstig woonadres in Nederland’ (only available in
Dutch);
• the completed and signed appendix ‘Gegevens vacaturevoorziening’ (only available in Dutch).

S  Employment as essential start-up personnel (478)

Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty
pages;
• a signed and completed appendix ‘Antecedents certificate’;
• an employment contract indicating the nature of the work and the salary;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• a contract signed by you and the start-up company indicating the form, the percentage, and the
conditions of the employee participation and the associated participation scheme;
• an anonymised printout of the collective payroll statement that is not older than 3 months at the time the
application is assessed;
• evidence of the employee participation.
There are several options:
Shares:
▪ the company's Articles of Association;
▪ the Shareholders' Agreement; and
▪ the Shareholders' register.
Share options:
▪ the company's articles of association; and
▪ option agreement.
Depositary receipts for shares held in a Trust Office Foundation:
▪ Articles of Association of the company that has certified shares;
▪ Articles of Association of the Trust Office Foundation
▪ Trust Conditions of the Trust Office Foundation; and
▪ Register of the depositary receipt holders.
Share in the profits of a limited partnership:
▪ Partnership Agreement.
• evidence that the company is a start-up and innovative company with scalable business activities (see
also section 5.8 of this form):
a. With regard to the organisation of the company:
▪ CVs of its incorporators, management board members or executive directors, and the essential
personnel;
▪ diplomas and references of its incorporators, management board members or executive directors, and
the essential personnel, or other proof of knowledge and/or competencies;
▪ proof of registration of the company in the Commercial Register of the Chamber of Commerce.

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 b. With regard to the growth of the company*:
▪ company documentation, e.g., a business plan, demonstrating:
o that the company is innovative and shapes scalable business activities;
o what activities or steps the company is taking to achieve growth;
o which essential role the prospective employee will play within the company in order to achieve
growth.
c. With regard to the financing of the company**:
▪ the latest financial statements, including (opening) balance sheet, P&L account, and notes;
▪ agreements with/guarantees by financiers and/or audit opinions and/or bank statements and
substantiating financial forecasts consisting of projected balance sheets, P&L accounts, and cash flow
statements;
▪ VAT, corporation tax, and income tax returns and decisions
▪ if available and applicable: term sheets and/or letters of intent from financiers for future financing
rounds if mentioned in the financial projections.

* Please note! Suppose you have an ongoing agreement with a facilitator, or the supervision agreement
expired no more than 18 months ago, and the facilitator is still demonstrably and actively involved in your
start-up company. In that case, you only need to provide company documentation that demonstrates the
essential role that the prospective staff member will play within the company to achieve growth. Company
documentation demonstrating that the company is innovative with scalable business activities and what
steps the company is taking to achieve growth do not need to be attached.

** Please note! Suppose you can prove that you have a financing agreement of at least € 100,000 with
an investor or a Dutch bank. In that case, you do not have to submit any evidence about the financing of
the company.

T  Work as highly skilled migrant (396)

Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty
pages;
• a signed and completed appendix ‘Antecedents certificate’;
• a recent Employer’s Declaration;
• copies of your diplomas and/or certificates which have been valued by Nuffic;
In case you do not have diplomas and/or certificates: documents showing that you have the right
experience for working as a highly skilled migrant (such as testimonials, employment contract(s) and
references of former employment(s))
• your curriculum vitae showing the academic and professional accomplishments;
• Have your employer fully complete and sign the 'Statement due to European sanctions against Russia and
Belarus'.

In case of secondment/payroll
Please also enclose the following means of evidence with your application:
• a loan-in agreement;
• an employment contract;
• a job description.

In case you are going to work in the Netherlands as a scientific researcher (396)
Please also enclose the following means of evidence with your application:
• an employment contract; or
• an appointment decision.

In case you are going to work in the Netherlands as a guest lecturer (396)
Please also enclose the following means of evidence with your application:
• an appointment decision; or
• a hosting agreement.

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 In case you are going to work in the Netherlands as a trainee doctor (396).
Please also enclose the following means of evidence with your application:
• proof of registration in the training register of the Medical Specialists Registration Committee (MSRC),
Social Medical Specialists Registration Committee (SGRC) or General Practitioners and Nursing Home
Doctors Registration Committee (HVRC).

U  Researcher within the meaning of Directive (EU) 2016/801 (498)

Please enclose a hosting agreement from a research institution together with your application showing:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty
pages;
• a signed and completed appendix ‘Antecedents certificate’;
• that the research project has been approved by the research institution;
• that you have a suitable diploma relating to higher education;
• what the legal relationship and the terms and conditions of employment are; and
• that you have long-term independent means of existence.
Also enclose the following documents in case of inbound long-term mobility for researchers:
• a copy of the valid residence permit for research as issued by the first Member State;
• a certificate from the research institute showing that the conditions for admission of long-term mobility
researchers have been met.

V  Holder of a European blue card (640)

Please enclose the following means of evidence with your application:
• a copy of your passport. Make copies of all the pages with travel stamps as well. Do not copy empty
pages;
• a signed and completed appendix ‘Antecedents certificate’;
• a copy of the employment contract/appointment decision showing that you will work in paid employment
for at least 6 months;
• the completed and signed appendix Employer's Declaration European blue card;
• the completed and signed appendix ‘Declaration by sponsor (employment)’;
• a copy of the salary slips over the past 3 months (if possible);
• if you have a Dutch diploma for higher education that is in line with the profession or relevant sector to
which the application relates: a certified copy of the diploma.
• if you have a foreign diploma for higher education that is in line with the profession or relevant sector to
which the application relates: a copy of the diploma and the original credential evaluation from the
Netherlands organisation for international cooperation in higher education (Nuffic).
• in case of a (regulated) profession: evidence showing that you have the required professional
qualifications in order to practise the (regulated) profession.
If you do not have a higher education diploma and you work as an ICT manager or ICT professional:
• a personal statement showing that you have at least 3 years of relevant work experience in the period of 7
years prior to this application.
If you have lived in one of the EU/EEA countries with asylum status prior to this application:
• a copy of your asylum permit from the other EU/EEA country.

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6 Payment of fees

Before your application can be assessed, you must pay a fee. Please check Fees: Costs of an application
([Link]) for the fee applicable to your situation. The application is free of charge for citizens of San Marino and
Israel.

Please transfer the fee for the application to the bank account of the IND referred to below and send a proof of
payment to the IND.

As a payment reference, you must fill in your V-number, which you receive from the Dutch
embassy/consulate where you submit your application. If you do not do this, your payment may not
be processed properly.

Bank ING
IBAN NL31INGB0705005356
Name Min. van Justitie en Veiligheid 601/IND LEGES Storting Bank
SWIFT code INGBNL2A
Address Postbus 85449
Postcode 2508 CC
City Den Haag
Payment reference V-number

You must transfer the fee within three weeks after the date on top of this form (filled in by the Netherlands
embassy or consulate). Your application will only be assessed when the whole amount has been received by the
IND. Please check whether your bank deducts a fee from the amount being transferred.

If the assessment of your application shows that you do not qualify for a residence permit in the Netherlands,
you will not receive a refund.

7 Declaration of consent

The IND will assess and decide on your application. If you wish communication with the IND to take place by
e-mail (instead of by post), you must consent to this first.
You can email with the IND by using Zivver. Zivver is a means of securely emailing and exchanging files.
Read more about emailing securely with Zivver at [Link]/en/send-documents.

> Please check either one of the following two boxes

 I agree that communication with the IND will take place by e-mail. I want the email address I provided
above to be used for this (section 1.13). I access this email address on a regular basis.

 I do not agree that communication with the IND will take place by e-mail. I want correspondence to be
sent to the address I provided above (section 1.11).

Please note! The IND accepts no responsibility for any email messages that fail to reach you or are delayed.
The IND cannot guarantee the reliability of sending or receiving messages by email, or the confidentiality and
integrity of email correspondence sent over the internet.

8 What will happen with your application?

After receipt of your application, your documents and fee, the IND will assess your application. You will be
contacted by the IND if your payment or your documents are not received. You will also be informed once the
assessment of your application has been finalised. If your application is granted, you will also receive
information about the follow-up procedure.

9 MVV and residence permit

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 In case your application is granted you will receive an MVV (entry visa) from the Dutch embassy/consulate.
When your application is granted you can make an appointment to collect your MVV via
[Link]/mvv. The IND aims to have your residence permit ready within a few weeks
following your arrival in the Netherlands. The IND will send you a letter indicating when you can collect your
residence permit. For this, you have to make an appointment online at the IND desk stated in the letter.
9.1
Intended date of departure Day Month Year
to the Netherlands

9.2 Please indicate below where you will collect the residence permit:

 Amsterdam  Goes  ’s-Hertogenbosch (Den Bosch)  Den Haag

 Maastricht  Zwolle

10 Registering in the Netherlands

You need your birth certificate (legalised and translated if necessary, please check [Link]) for registering
in the Personal Records Database (BRP) at your local municipality after arriving in the Netherlands. This is a
mandatory procedure. When you are registered in the BRP, you will automatically obtain a citizen service
number (BSN), unless you already have this.

11 Signing

Signing this form will bring you rights and obligations. If you do not know what these rights and obligations
are, then visit the website [Link].

✓ I declare I have completed this form truthfully.

✓ I know that the personal details supplied will be processed in connection with the Aliens Act 2000 and will
be passed on to authorities that need these personal details for that purpose.
✓ I will pass on any changes to my situation, which will affect my right of residence, within 4 weeks to the
IND with the ‘Reporting form for foreign nationals’. I am aware that if I do not do this, it may affect my
right of residence as foreign national. I know that I may incur an administrative fine.
✓ I know what my rights and obligations are.

11.1 I submit this form and (number) of appendices/documents in evidence.

11.2 Name

11.3 Place and Date Place

Day Month Year

11.4 Signature

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12 Submitting this form with the necessary documents

Sign and send the completed form, a proof of payment, the appendices and the requested documents to the
IND in the Netherlands by post. Never send any original documents. You must send clearly readable and full
copies of the original documents. Do not use any staples or paperclips. Do not send any USB sticks, CD’s,
DVDs and suchlike. Put all the documents in a sufficiently stamped envelope. Send this to the following
address:

Immigration and Naturalisation Service (IND)

P.O. Box 5
9560 AA TER APEL
The Netherlands

Alternatively, you can send copies of your documents by email. You can do that by using Zivver. Zivver is a
means of securely emailing and exchanging files. Read more about emailing securely with Zivver at
[Link]/en/send-documents.

Processing of personal data

The IND records your data in the IND systems to be able to carry out legal tasks. The IND uses and secures your
personal data carefully and on the basis of the requirements of the privacy legislation. Read how the IND handles your
personal data on [Link]/en/privacy.

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