Host Declaration Italy Form

Host Declaration

To the Visa Office of the Consulate General of Italy in Philadelphia

I, the undersigned

Date of birth   Place of birth

Nationality   resident in

Prov/Region   Address   No.

ZIP/Post code   tel.   occupation/profession

(For Companies or Organizations only)

Commercial activity/Name

Located in   Prov/Region

Address   No.   ZIP/Post code   tel.

Name of the Legal Guardian/Holder

Date of birth   Place of birth   Nationality

Resident in   Prov/Region

Address   No.   ZIP/Post code   tel.

Am aware of the consequences envisaged by Art. 12.1 of Legislative Decree 286 of 25 July 1998 (Consolidated Text of provisions governing immigration and rules on the status of foreign nationals) and subsequent amendments.

with the present document declare that I wish to invite

The foreign national (name) (surname)

Date of birth   place of birth

Nationality   resident in

Prov/Region   Address   n.   ZIP/Post Code   tel.

For the period from   to

for reasons of:

I, the undersigned, also declare

1) that my relationship with the person in question is one of family / friendship / other (specify)

2) that I know with certainty that the person in question, in his/her own country:

is employed in the following occupation :

is not in employment and has the following means of support:

3) that I will cover the living expenses of the applicant during his/her stay

4) that I have the financial means and sufficient accommodation to accommodate the above-mentioned foreign national

5) (optional) that I have already made available on behalf of the above-mentioned person, as financial guarantee and in the form of bank security, the sum of euros in the following bank:

Name of bank:   branch no.   address

If the visa application submitted by the foreign national is successful, I, the undersigned will

1) provide him/her with accommodation in my own home, located in

address:   no.   ZIP/Post Code   tel

2) assume any costs resulting from recourse to health or medical care or treatment by the foreign national, where he or she does not have their own health-care cover (insurance policy or bilateral agreement between Italy and their country of origin)

3) notify the local police headquarters of the presence of the foreign national in my home, no more than 48 hours from the time the foreign national enters Italian territory, in accordance with Art. 7 of Legislative Decree 286/1998 and subsequent amendments.

4) ensure that the foreign national returns to his/her country of origin by the date envisaged by his/her entry visa, in accordance with Art. 1 (1) of Law 68 of 28 May 2007.

Information:

Copy of declarant’s Identity Document attached