Preparation Form

DATA FOR THE TRC APPLICATION

Disclaimer – Personal Data & Form Usage This form is designed as a practical tool to help you prepare for your consultation and to make completing your application in the MOS 2 system more efficient. Please note that this form functions solely as a template. Any information you enter is not stored, saved, or transmitted through this website. Your data remains entirely under your control and is only used by you to complete, download, or print the document for your own use. While the form may request personal details, your privacy is respected and no data is retained by this site. We encourage you to use this tool to save time, stay organised, and feel fully prepared for both your consultation and application process. Please fill in CAPITAL / PRINT letters.

Personal data

Surname (like in the passport)

Previous surname (if it was changed)

Family name (Maiden name)

Names (like in the passport)

Father’s FIRST name

Mother’s FIRST name

Mother’s maiden name

Date of birth (dd/mm/yyyy)

Sex

Male Female

Place of birth (city/town)

Country of birth

Nationality

Citizenship

Marital status

Current level of obtained education

Height in cm

Colour of eyes

Special marks (if you have it)

PESEL number (if you have it)

Polish phone number for communication

Address in the country of origin

Country

Voivodeship / District / Province / State

County / Region / District / Borough

Municipality

City/Town

Street

House number

Flat number

Postal code

Address in the previous country of residence

Country

Voivodeship / District / Province / State

County / Region / District / Borough

Municipality

City/Town

Street

House number

Flat number

Postal code

Current address in Poland

Voivodeship

District

Municipality

City/Town

Street

House number

Flat number

Postal code

Stay in Poland

Intended purpose of stay in Poland

Do you have valid visa or TRC?

YES Until when? NO

Family members living in Poland (Name and Surname, Sex, Date of birth, Degree of kinship, Citizenship, Place of residence, Is he/she applying for TRC, Is he/she a dependent on you?)

What are your means of subsistence in Poland? (source of money)

What medical insurance do you have?

Exact date of your FIRST time coming to Poland

History of your stay in Poland. From (first entry) to (day before first positive TRC decision) based on visa; from (first positive decision) to now based on TRC; describe non-standard situations with specific dates.)

Exact date of your LAST entry into the territory of the Republic of Poland

Countries visited in the past 5 years

Country	From (date)	To (date)

Legal issues

Did you ever have any issues with the Polish law?

YES NO

Justification of the application

JUSTIFICATION OF THE APPLICATION (why are you applying for the TRC)

Preparation Form

DATA FOR THE TRC APPLICATION

Personal data

Address in the country of origin

Address in the previous country of residence

Current address in Poland

Stay in Poland

Countries visited in the past 5 years

Legal issues

Justification of the application

Services

About us

Services

About us