INTERIORDesigned to bringsurfaces to lifebe inspired2Finish: Dulux Avista T errazzo Flake FlooringBase Colour: Dulux Avista Chris White in Dulux Avista Waterbased Epoxy ResinFlakes: Dulux AvistaT op Coat:Dulux Avista 2 Pack Urethane Sealer3INSPIRING INTERIORS TRANSFORMING HOMESDulux Avista’s flooring products provide a hard-wearing, seamless surface which gives great strength and durability with fantastic design flexibility.You can create floors to suit your every need – from that cutting edge feature floor, to unique treatments for kitchens, entertainment areas, laundries, rumpus rooms and garages.Waterbased epoxy products provide an easy to use and durable option, while an epoxy flake floor can create a unique new look.Dulux Avista recommends application by a professional applicator.Finish: Dulux Avista T errazzo Flake FlooringBase Colour: Dulux Avista Chris White in Dulux Avista Waterbased Epoxy Resin Flakes: Dulux Avista Ashy Grey T op Coat: Dulux Avista 2 Pack Urethane SealerFinish: Dulux Avista Flake Flooring Base Colour: Dulux Avista White (1L) in Dulux Avista Epoxy ResinFlakes: Dulux Avista Made T o Order T op Coat: Dulux Avista Polyurethane Sealer4SOLID COLOURDURABLE, EASY TO USE AND ECONOMICALWaterbased epoxy flooring provides a durable, protective solid colour coating for your internal concrete floor. Dulux Avista’s waterbased epoxy system is low-odour, quick-drying and provides a hard-wearing, low-sheen finish which can be tinted to a range of practical colours. It is an easy to use two-part system where Part A and Part B are mixed in equal quantities.Dulux Avista’s waterbased epoxy products are ideal for your garage floor or rumpus room and can also be used for light commercial floors.5WATERBASED EPOXY STIPPLED STONE LOOKFor an alternative to a solid floor colour or decorative flake flooring, try Dulux Avista’s Waterbased Epoxy Stippled Stone look. This can be achieved using the tinted Waterbased Epoxy for the base, and also for the stippled effect, which is applied by a professional applicator using a hopper gun.For a hard wearing, scratch resistant, high build finish, add Dulux Avista’s2 Pack Urethane as the top coat.Finish: Dulux Avista Stippled StoneBase Colour: Dulux Avista T runk Grey in Dulux Avista Waterbased Epoxy Resin Fleck Colours: Dulux Avista Black & Dulux Avista White T op Coat: Dulux Avista 2 Pack Urethane Sealer (optional)Finish: Dulux Avista Stippled Stone Base Colour: Dulux Avista Chris White in Dulux Avista Waterbased Epoxy Resin Fleck Colours: Dulux Avista Sandy Pier & Dulux Avista BlackT op Coat: Dulux Avista 2 Pack Urethane Sealer (optional)Finish: Dulux Avista Stippled Stone Base Colour: Dulux Avista T runk Grey in Dulux Avista Waterbased Epoxy Resin Fleck Colours: Dulux Avista Black & Dulux Avista WhiteT op Coat: Dulux Avista 2 Pack Urethane Sealer (optional)6BASE COLOURCHOOSE YOUR PERFECT COLOURIn Store Tint RangeThese colours form the Dulux Avista Waterbased In Store Tint range which can be tinted in DuluxT rade Centres or Inspirations Stores (check the Dulux Avista website for stockist details).The Waterbased Epoxy Part A must be tinted full strength to 5L to achieve the desired colour.Note: Colours represented are indicative only. For solid colour, a third coat may be required. When using white/light colours as a base coat for flakes,a third coat may also be required for better opacity.Note: Dulux Avista Waterbased In Store Tint Range is tinted in store, therefore has no SKU code.*1 to 2 x 400ml Black Tints can be used as required to achieve a darker colour.TRUNK GREYPORTOBELLO FIELD BEIGE TUSKCHRIS WHITE ENDLESS GREY SANDY PIERDulux Colour TintsThe Dulux Avista Waterbased Epoxy Part A can be tinted using any Dulux colour tint with a white base, however, due to the white base the resulting colour will always be a few shades lighter than it appears on a Dulux colour card or Dulux colour chip/sample.Waterbased Colour Tint 400ml RangeThe Dulux Avista Waterbased Colour Tint 400ml range can be found on shelf in your local stockist.Dulux Avista Waterbased Colour Tints change colour once mixed with Dulux Avista Waterbased Epoxy due to its white base. The images below show the tint colours after being mixed with Dulux AvistaWaterbased Epoxy.BRIGHT YELLOWFD178170-400MLBRIGHT REDFD178171-400MLBRIGHT GREENFD178172-400MLBRIGHT BLUEFD178173-400MLWHITEFD178168-400MLBLACK*FD178169-400MLSIL VER GREYFD178082-400MLFD478094-1L BLACKFD478096-1L GREYFD478095-1L7DECORATIVE FLAKE FLOORINGSOPHISTICATED TRANSFORMATIONSCreate your own designer look with a hard wearing epoxy floor coating incorporating Dulux Avista decorative flakes. A decorative flake floor provides a great alternative to other types of floor coatings and allows you to create your own look. It is a durable seamless finish for internal concrete floors and can be used for both domestic and commercial applications.AfterFinish: Dulux Avista Flake FlooringBase Colour: Dulux Avista Grey (1L) in Dulux Avista Epoxy ResinFlakes: Dulux Avista Made T o OrderT op Coat: Dulux Avista Polyurethane SealerBeforeEPOXY RESIN BASE COAT COLOURSThe Dulux Avista epoxy resin base coat tints are designed to be used with the 10L Epoxy Resin Kit. These tints cannot be used with the Dulux Avista Waterbased Epoxy Resin (refer to page 6 for waterbased colour tints).8Dulux Avista Waterbased Epoxy Resin• Pot life 2-3 hours • Recoat time 4 hours • Water clean up• C an be put down immediately after acid etching and pressure cleaning Tint colours: Black, White, Bright Yellow, Bright Red, Bright Green, Bright Blue, Silver Grey, plus the In Store Tint Range and any Dulux colour tint with a white base**.Dulux Avista DecorativeFlakes• S uitable for garage floors, rumpus rooms, laundries and commercial applications.T op Designer Flake colours (6mm size): Ashy Grey, Deep Granite, Midnight Stone, Grey Clouds, T awny Sand, Navy Granite.Natural Stone Look Flake colours: Dalmatian Stone, Harvard Grey, Night Fall, Anchor Bay, Rocky Ridge, Swan.Dulux Avista 2 Pack Urethane• UV and chemical resistant • Long pot life approx. 3-4 hours • Recoat time 3-24 hours • Solvent clean upOROR 3. Top CoatDulux Avista Epoxy Resin ***• Pot life 25 minutes • Recoat time 10-12 hours • Solvent clean upTint colours: White, Black, GreyDulux AvistaPolyurethane Sealer• E xtremely durable and hard wearing • Ideal for high traffic areas• P ot life 1 hour, depending on humidity present• Recoat time 8-18 hours • Solvent clean upEPOXY FLAKE FLOORING SYSTEMDulux Avista Decorative Flakes are a range of coloured vinyl flakes in various colour blends. The Dulux Avista Epoxy Flake Flooring System is comprised of the Base Coat * (plus colour tint), followed by Dulux Avista Decorative Flakes, and finished with the top coat.There are a few possible flake systems to choose from:Pick your base coat Pick your flakes Pick your top coat *Please refer to the relevant TDS for full flake process in detail, including substrate preparation.**See page 6 for details. ***Dulux Avista Epoxy Resin should not be used as a Base Coat for the Natural Stone Look Flakes9FLAKESDulux Avista Decorative Flakes are multi-coloured polymer flakes that are available in a range of blend combinations. The flakes are available pre-packaged in six popular designer colours and are also available in a range of other colours, blends and sizes as a custom made to order.TOP DESIGNER COLOURSAvailable in 6mm size flakes in 5kg boxes.ASHY GREY (FD400476-5KG) ON CHRIS WHITE GREY CLOUDS (FD400479-5KG) ON SANDY PIER DEEP GRANITE (FD400477-5KG) ON PORTOBELLO FIELDTAWNY SAND (FD400480-5KG) ON BEIGE TUSK MIDNIGHT STONE (FD400478-5KG) ON BLACK (WATERBASED 400ML)NAVY GRANITE (FD400481-5KG ) ON CHRIS WHITEFinish: Dulux Avista Flake Flooring Base Colour: Dulux Avista White (1L) in Dulux Avista Epoxy ResinFlakes: Dulux Avista Made T o OrderT op Coat: Dulux Avista Polyurethane Sealer10TERRAZZO LOOKWhat is terrazzo?T errazzo is a flooring material consisting of chips of marble or granite set in concrete and polished to give a smooth surface. The terrazzo look can be achieved with Dulux Avista products by using a partial flake application, often at a fraction of the cost.Many different terrazzo looks can be achieved by choosing different base colours to combine with various flake blends.POPULAR TERRAZZO LOOKSASHY GREY (FD400476-5KG) ON CHRIS WHITE MIDNIGHT STONE (FD400478-5KG) ON BLACK (WATERBASED 400ML)ASHY GREY (FD400476-5KG) ON TRUNK GREYNAVY GRANITE (FD400481-5KG) ON ENDLESS GREY GREY CLOUDS (FD400479-5KG) ON SANDY PIER DEEP GRANITE (FD400477-5KG) ON PORTOBELLO FIELDTAWNY SAND (FD400480-5KG) ON BEIGE TUSKFinish: Dulux Avista T errazzo Flake Flooring Base Colour: Dulux Avista Chris White in Dulux Avista Waterbased Epoxy Resin Flakes: Dulux Avista Ashy GreyT op Coat: Dulux Avista 2 Pack Urethane Sealer11NATURAL STONE LOOK FLAKESDulux Avista Natural Stone Look Flakes consist of multiple flake sizes resulting in a premium, natural stone look when applied. These flakes are perfect to create a sophisticated and stylish decorative flooring finish that is also extremely durable.NATURAL STONE LOOK COLOURSSWAN (FD400492-5KG) ON CHRIS WHITE HARVARD GREY (FD400488-5KG) ON CHRIS WHITE ROCKY RIDGE (FD400491-5KG) ON CHRIS WHITE DALMATIAN STONE (FD400487-5KG) ON PORTOBELLO FIELD NIGHT FALL (FD400489-5KG) ON ENDLESS GREYANCHOR BAY (FD400490-5KG) ON PORTOBELLO FIELDFinish: Natural Stone Look FlakesBase Colour: Dulux Avista Portobello Field in Dulux Avista Epoxy ResinFlakes: Dulux Avista Dalmatian StoneT op Coat: Dulux Avista Polyurethane Sealer12MADE TO ORDER FLAKESLooking for something a bit different and unique? Choose from our Made T o Order options. The Stone blendsare a premixed offering, or choose your own combination from the selection of individual flake colours below.Minimum two 5kg box quantity for all Made T o Order flakes.STONE MADE TO ORDER BLENDSAvailable in 6mm and 3mm size flakes in 5kg boxes.SKU FD400484-5KG for all Stone Flake Blends Small 3mmINDIVIDUAL FLAKE COLOURS FOR CUSTOM MADE TO ORDER BLENDSAvailable in 6mm and 3mm size flakes in 5kg boxes.SKU FD400486-5KG Custom Made T o Order Blends Small 3mmNATURAL STONE LOOK MADE TO ORDER BLENDSAvailable in 5kg boxes.OUTBACKFD400493-5KGSTONEY CREEKFD400494-5KGDARK BLUE BLACKTIDAL WAVEFD400495-5KGLIGHT BEIGE BEIGE LIGHT BROWN EARTHY BROWNAUBURN RUSTIC RED BROWN DARK COCOA NATURAL WHITE COLD GREYLIGHT GREY MEDIUM GREY CONCRETE GREY STONE GREYDARK GREY BLUE GREY GRAPHITE CHARCOAL BRIGHT BLUETAUPE CALCITE LIMESTONE SMOKY QUARTZ OATMEALVisit .au/mto-flakes-order-request andfill out our order form to orderyour custom blend. Noteadditional lead times may applyfor custom orders and youmust be a Dulux Avista accountholder. Please call or emailCustomer Service for details.Colours shown in this brochure are intendedas a guide only. Colours may vary from batchto batch. Variations in colour and shading mayalso occur depending on the job conditions,chosen texture and finishing practicesemployed by your concrete contractor.13POLISHED CONCRETET o achieve a sophisticated polished concrete finish, it is possible to grind and seal a concrete floor surface. This is done mechanically by a professional with a concrete grinder, until the surface is ground back to achieve the desired result. Dulux Avista offers various sealers that can be used as a top coat to provide a gloss finish.Dulux AvistaWaterbased SealerA semi gloss, low odour sealerdesigned to give a more natural look.Dulux Avista2 Pack Urethane SealerA two pack sealer with good wear and chemical resistance, with a high gloss appearance.Dulux AvistaPolyurethane SealerA high gloss, high abrasion resistant, high build coating, for a high performance finish in high traffic areas.Image is a representation of the types of projects that these products can be used for.PRODUCT INFORMATIONEpoxy2 PackUrethane Sealer*Tinting only available in Dulux T rade Centres and Dulux Inspirations stores.14Call our Customer Service T eam on 1800 801 108 to get moreinformation on Dulux Avista products or to find a contractor in your area. .au®Avista is a registered trade mark.®Dulux is a registered trade mark of DuluxGroup (Australia) Pty Ltd.Dulux Avista1956 Dandenong Rd Clayton VIC 3168 ABN 80 069 961 968Distributed in New Zealand by: Concrete Plus Limited150 Hutt Park Road, Gracefield T elephone: 0800 657 156Colours shown in this brochure are intended as a guide only. Colours may vary from batch to batch. Variations in colour and shading may also occur depending on the job conditions, chosen texture and finishing practices employed by your concrete contractor.A V -I N T 04/21Front CoverFinish: Dulux Avista Flake FlooringBase Colour: Dulux Stone Monument in Dulux Avista Waterbased Epoxy Resin Flakes: Dulux Avista Grey CloudsT op Coat: Dulux Avista 2 Pack Urethane Sealer。
Domanda di visto per gli Stati Schengen Application for Schengen Visa 申 申根国家签证申请表格 (只能用英文填写)Modulo gratuito This application form is free 免费表格1. Cognome/cognomi S urname(s) (family name/s)Surname(s) (family name/s) 姓 A D USO ESCLUSIVO DELL ’AMBASCIATA O DEL CONSOLATO F OR E MBASSY / C ONSULATE USE ONLY办公室保留 2. Cognome/cognomi alla nascita (cognome /cognomi precedenti) Surname(s) at birth (earlier family name-s) 出生时姓 (其它姓氏其它姓氏) Data della domanda : Numero Pratica: 3. Nome G iven name(s) Given name(s) 名 4. Data di nascita (anno-mese- giorno) Date of birth (year-month-day) 出生日期 (年-月-日) 5. Numero di carta d’identità (facoltativo)Id-Number (optional) 身份证号(也可不填) Tipologia Visto: Codice Pratica: 6. Luogo di nascita e Stato. Place and country of birth. 出生地点和国家出生地点和国家7. Cittadinanza/cittadinanze attuali Current nationality/ies 现国籍8.Cittadinanza di origine (cittadinanza alla nascita) Original nationality (nationality at birth) 出生时国籍出生时国籍Documenti giustificativi : o Passaporto valido o Mezzi di sostentamento 9. Sesso S ex Sex 性别 o Maschile Male 男 o Femminile F emale Female 女10. Stato civile M arital Status Marital Status 婚姻状况 o Non coniugato Single 未婚 o Coniugato M arried Married 己婚 o Separato S eparated Separated 分居 o Divorziato D ivorced Divorced 离婚 o Vedovo Widow(er) 丧偶 o Altro: Other: 其它:o Invito o Mezzi di trasporto o Assicurazione malattia o Di altro tipo: 11. Cognome del padre Father’s name 父亲姓名12. Cognome della madre Mother’s name 母亲姓名母亲姓名Visto: o Rifiutato o Concesso 13. Tipo di passaporto: Type of passport: 护照类别护照类别:o Passaporto nazionale National passport 普通护照 o Passaporto diplomatico Diplomatic passport 外交护照 o Passaporto di servizio Service passport 公务护照公务护照o Documento di viaggio (Convenzione del 1951) Travel document (1951 Convention) 旅行证 (1951年协议规定) o Passaporto per stranieri s passp Alien’s passport ort 外国人护照 o Passaporto per marittimi Seaman’s passport 海员证o Documento di viaggio di altro tipo (specificare): Other travel document (please specify): 其它种类的旅行证(说明): o VTL o A o B o C o D o D + C Numero di ingressi 1 o 2 o Mult oValido dal ..........................Valido gg .......................... Firma responsabile:14.Numero del passaporto: Number of passport: 护照号码 15. Rilasciato da: I ssued b y:Issued b y: 签发机关:Sigla operatore: 16. Data del rilascio: Date of issue: 签发日期17. Valido fino al:... Valid until:... 有效期至:… Firma funzionario: Foto Photo 照片Embassy of Italy Beijing 18 .Se soggiorna in uno Stato diverso dallo Stato di origine è autorizzato a rientrare in detto Stato?If you reside in a country other than your country of origin, have you permission to return to that country? 若在其它国家居留是否具有再次入境该国的许可证?o No 无 o Sì (numero e validità) Y es,(number Yes,(number and validity) 如果有如果有,许可证种类和有效期：许可证种类和有效期： ........................................................................................................................................................................................ * 19. Occupazione attuale Current occupation 现职业现职业:* 20. Datore di lavoro, indirizzo e numero di telefono. Per gli studenti nome e indirizzo dell'istituto di insegnamento Employer and employer’s address and telephone number. For students, name and address of school 雇主姓名和地址和电话. 学生应该填写学校的名称,地址和电话21. Destinazione principale Main destination 主要目的地 22. Tipo di visto: Type of visa 所申请签证的类别:o Transito aeroportuale Airport transit 机场过境机场过境 o Transito Transit 过境过境 o Soggiorni di breve durata Short stay 短期停留o Soggiorni di lunga durata Long stay 长期停留长期停留23. Visto: V isa Visa : 签证签证: o Individuale individual 个人签证o Collettivo Collective 团体签证24. Numero di ingressi richiesti Number of entries requested 申请入境次数申请入境次数o Uno One entry 一次一次 o Due Two Entries 两次两次 o Multiplo Multiple entries 多次25. Durata del soggiorno Duration of stay 停留时间留时间Visto chiesto per: .........................giorni Visa is requested for:……………..days 申请签证的天数................ 26. Altri visti (rilasciati negli ultimi tre anni) e rispettivo periodo di validità Other visas (issued during the past three years) and their period of validity 签发停留的时间和有效期(三年之内签发的) 27. In caso di transito, è titolare dell'autorizzazione di ingresso per lo Stato di destinazione finale?In the case of transit, have you an entry permit for the final country of destination? 如属过境签证,是否具有目的地国发出的入境许可证? o No 无 o Sì, valido fino a: , valido fino a: Yes, valid until: 如果有如果有,许可证有效期至: Autorità che rilascia: Issuing authority: 签发机关:……………………………………………………………………………………..* 28. Precedenti soggiorni nel presente Stato o in altri Stati Schengen Previous stays in this or other Schengen states 是否曾经在意大利或其它申根国家停留过?29. Scopo del viaggio Purpose of travel 旅行目的旅行目的o Turismo T ourism Tourism 旅游 o Affari Business 商务 o Soggiorno presso la famiglia o amici Visit to Family or Friends 探亲或访问朋友 o Cultura/Sport Cultural/Sport 文化/体育活动 o Ufficiale Official 官方访问 o Motivi sanitari Medical reasons 医疗 o Di altro tipo (specificare): Other (please specify): 其它种类(说明):):…………………….…………………….………………………………………………………………………………………………………………………………………………………………………..30. Data di arrivo . .D ate Date of arrival 到达日期到达日期* 31. D ata Data di partenza . .D ate Date of departure 出境日期 *32. Frontiera dello Stato del primo ingresso o rotta di transito. Border of first entry or transit route 首次入境地点或过境地点首次入境地点或过境地点* 33. M ezzi Mezzi di trasporto M eans Means of transport 交通工具* 34. Cognome dell'ospite o nome dell'impresa negli Stati Schengen e persona di contatto dell'impresa ospite. Altrimenti indicare il nomedell'albergo o l'indirizzo provvisorio negli Stati SchengenName of host or company in the Schengen states and contact person in host company. If not applicable, give name of hotel or temporary address Schengen states 在申根国家邀请人姓名或邀请公司名称. 在申根国家居住的饭店地址在申根国家居住的饭店地址或短期停留期间住址. Cognome dell'ospite o nome dell'impresa : Name: 邀请人姓名或邀请公司名称邀请人姓名或邀请公司名称:Telefono e fax:Telephone and telefax:................................................................电话和传真:……………………………………… Indirizzo completo : Full Address: 完全地址完全地址: ................................................................................................. ................................................................................................. Indirizzo di posta elettronica E-mail address 电子信箱地址电子信箱地址 .................................................................... * 35. A carico di chi sono le spese di viaggio e le spese di soggiorno?Who is paying for your cost of travelling and for your costs of living during your stay? 交通和停留住宿费用承担情况交通和停留住宿费用承担情况交通和停留住宿费用承担情况 o Mio M yself 本人本人 o Ospite/ospiti Host person/s 邀请人邀请人 o Impresa ospite Host company 邀请公司 Dichiarare le modalità e presentare i documenti giustificativi: e presentare i documenti giustificativi: State who and how and present corresponding documentation : 提供方式的证明材料: ………………………………………………………………………………………………………………………………………..............................................………………………………………………………………………………………………………………………………………………………………………* 36. Mezzi di finanziamento durante il soggiorno Means of support during your stay 停留期间的经济担保方式 o Contanti C ash Cash 现金 o Travellers’ cheques 旅行支票 o Carte di credito Credit Cards 国际信用卡 o Alloggio A ccomodation 住宿 o Di altro tipo: Other:其它种类: o Assicurazione di viaggio e/o malattia. Valida fino a : Travel and/or health insurance. Valid until: 人身意外保险.保险有效期至:............. ……37．Cognome del coniuge Spouse’s family name 配偶姓38. Cognome del coniuge alla nascita Spouse’s family name at birth 配偶出生时所用姓名39. Nome del coniuge Spouse’s name 配偶名40. Data di nascita del coniuge Spouse’s dat e e of birth 配偶出生日期41. Luogo di nascita del coniuge Spouse’s place of birth 配偶出生地点42. Figli (Le domande devono essere presentate separatamente per ciascun passaporto) (Le domande devono essere presentate separatamente per ciascun passaporto) Children (Application must be submitted separately for each passport) 子女(如果子女各有护照必须分别申请签证) Cognome S urname Surname 姓 Nome First Name 名 Data di nascita Date of birth 出生日期1 …………………………. ……………………………. …………………………………………….....2 …………………………. ……………………………. …………………………………………….....3 …………………………. ……………………………. …………………………………………….....43. Dati anagrafici del cittadino dell'UE o SEE di cui è a carico. Alla domanda rispondono soltanto i familiari dei cittadini dell'UE o SEEPersonal data of the EU or EEA citizen you depend on. This question should be answered only by family members of EU or EEA citizens. 欧盟或欧洲经济处公民的直系亲属的情况. 上述个人情况由与欧盟或欧洲经济处公民有直系亲属关系的申请人填写Cognome Surname 姓Nome First Name 名 Data di nascita Date of birth 出生日期出生日期Cittadinanza Nationality 国籍Numero del passaporto Number of passport 护照号码护照号码Vincolo familiare: del cittadino dell'UE o SEE Family Relationship: of an EU or EEA citizen 与欧盟或欧洲经济处公民具有何种亲属关系:44. Sono informato del fatto e accetto che i miei dati anagrafici che figurano nel presente modulo di domanda di visto siano comunicati alle auto competenti competenti degli degli degli Stati Stati Stati Schengen Schengen Schengen e, e, e, se se se necessario, necessario, necessario, trattati trattati trattati dalle dalle dalle stesse, stesse, stesse, ai ai ai fini fini fini dell'esame dell'esame dell'esame della della della mia mia mia domanda domanda domanda di di di visto. visto. visto. Tali Tali Tali dati dati potranno potranno essere essere essere introdotti introdotti introdotti e e archiviati in basi di dati alle quali possono avere accesso le autorità competenti dei singoli Stati Schengen. Su mia richiesta espressa, l'autorità consolare che esamina la mia domanda m'informerà di come esercitare il mio diritto a verificare i miei dati anagrafici e a modificarli o sopprimerli, in particolare, qualora fossero inesatti, in conformità del diritto nazionale dello Stato interessato. Dichiaro che a quanto mi consta tutti i dati da me forniti sono completi ed esatti. Sono consapevole che dichiarazioni false comporteranno il respingimento della domanda o l'annullamento del visto già concesso nonché possono comportare possono comportare azioni giudiziarie ai sensi della legislazione dello Stato Schengen che ha in trattazione la domanda. Mi impegno a lasciare il territorio degli Stati Schengen allo scadere del visto, se concesso. Sono informato che il possesso di un visto è soltanto una delle condizioni necessarie per l'ingresso nel territorio europeo degli Stati Schengen. La mera concessione del visto non mi dà diritto ad indennizzo qualora non soddisfi le condizioni previste dall'articolo 5, paragrafo 1, della convenzione di applicazione di Schengen e mi venga pertanto rifiutato l'ingresso. Il rispetto delle condizioni d'ingresso sarà verificato ancora all'atto dell'ingresso nel territorio europeo degli Stati Schengen. I am aware of and consent to the following: any personal data concerning me which appear on this visa application form will be supplied relevant authorities in the Schengen states and processed by those authorities, if necessary, for the purposes of a decision on my visa application. Such may be input into, and stored in, databases accessible to the relevant authorities in the various Schengen states.At my express request, the consular authority processing my application will inform me of the manner in which I may exercise my right to check the data concerning me and have them altered or deleted, in particular, should they be inaccurate, in accordance with the national law of the state concerned. I declare that to the best of my knowledge all particulars supplied by me are correct and complete.I am aware that any false statements will lead to my application being rejected or to the annulment of a visa already granted and may also render prosecution under the law of the Schengen state which deals with the application.I undertake to leave the territory of the Schengen states upon the expiry of the visa, if granted.I have been informed that possession of a visa is only one of the prerequisites for entry into the European territory of the Schengen states. The mere visa has been granted to me does not mean that I will be entitled to compensation if I fail to comply with the relevant provisions of Article 5.1 of Implementing Convention and am thus refused entry. The prerequisites for entry will be checked again on entry into the European territory of the states 我了解并接受将我在此签证申请表格中填写的个人情况资料通报给申根国家主管当局作为签证申请之用. 这些资料可以由申根国家的主管当局使用并由他们存档. 根据我的要求, 领事当局审查我的申请表时将告知根据该国国民权利, 如果发现我的材料不准确时应及时通知我更改或取消. 我非常清楚, 所提供材料完全正确. 我知道, 如果提供虚假材料, 将导致申请不被接受; 如已签证, 可能会被取消; 按照申根国家的法律, 也可能被指控. 如果签证, 本人保证将在签证到期之日前离开申根国家. 我明白, 获得签证只是进入申根国家的前提条件, 根据申根协定第五条第一款, 如被拒入境, 本人将不要求任何赔偿. 入境申根国家时有关机构可以检查我是否遵守入境规定. 45. Domicilio d'origine A pplicant’s Applicant’s home address 申请人地址46. Telefono Telephone number 电话号码电话号码ANNOTAZIONI 47. Luogo e data P lace Place ad date 申请地点和日期48. Firma (per i minori firma del titolare dell'affidamento, del tutore)Signature (for minors, signature of custodian/guardian ) 申请人签名(未成年者由监护人签名)。
