{
  "url": "https://openlegislation.uk/eu-regulation-2019-1155/annex-III",
  "json_url": "https://openlegislation.uk/eu-regulation-2019-1155/annex-III.json",
  "legislation": "eur/2019/1155",
  "legislation_title": "Regulation (EU) 2019/1155 of the European Parliament and of the Council of 20 June 2019 amending Regulation (EC) No 810/2009 establishing a Community Code on Visas (Visa Code)",
  "legislation_url": "https://openlegislation.uk/eu-regulation-2019-1155",
  "path": "annex/III",
  "kind": "annex",
  "number": "III",
  "heading": null,
  "text": "‘ANNEX VI\nSTANDARD FORM FOR NOTIFYING REASONS FOR REFUSAL, ANNULMENT OR REVOCATION OF A VISA\nREFUSAL/ANNULMENT/REVOCATION OF VISA\nMs/Mr …,\n☐\nThe … embassy/consulate-general/consulate/[other competent authority] in … [on behalf of (name of represented Member State)];\n☐\n[Other competent authority] of …;\n☐\nThe authorities responsible for checks on persons at …\nhas/have\n☐\nexamined your application;\n☐\nexamined your visa, number: …, issued: … [date/month/year].\n☐\nThe visa has been refused\n☐\nThe visa has been annulled\n☐\nThe visa has been revoked\nThis decision is based on the following reason(s):\n1.. ☐ a false/counterfeit/forged travel document was presented\n2.. ☐ justification for the purpose and conditions of the intended stay was not provided\n3.. ☐ you have not provided proof of sufficient means of subsistence, for the duration of the intended stay or for the return to the country of origin or residence, or for the transit to a third country into which you are certain to be admitted\n4.. ☐ you have not provided proof that you are in a position to lawfully acquire sufficient means of subsistence, for the duration of the intended stay or for the return to the country of origin or residence, or for the transit to a third country into which you are certain to be admitted\n5.. ☐ you have already stayed for 90 days during the current 180-day period on the territory of the Member States on the basis of a uniform visa or a visa with limited territorial validity\n6.. ☐ an alert has been issued in the Schengen Information System (SIS) for the purpose of refusing entry by … (indication of Member State)\n7.. ☐ one or more Member States consider you to be a threat to public policy or internal security\n8.. ☐ one or more Member States consider you to be a threat to public health as defined in point (21) of Article 2 of Regulation (EU) No 2016/399 (Schengen Borders Code)\n9.. ☐ one or more Member States consider you to be a threat to their international relations\n10.. ☐ the information submitted regarding the justification for the purpose and conditions of the intended stay was not reliable\n11.. ☐ there are reasonable doubts as to the reliability of the statements made as regards … (please specify)\n12.. ☐ there are reasonable doubts as to the reliability, as to the authenticity of the supporting documents submitted or as to the veracity of their contents\n13.. ☐ there are reasonable doubts as to your intention to leave the territory of the Member States before the expiry of the visa\n14.. ☐ sufficient proof that you have not been in a position to apply for a visa in advance, justifying application for a visa at the border, was not provided\n15.. ☐ justification for the purpose and conditions of the intended airport transit was not provided\n16. ☐ you have not provided proof of possession of adequate and valid travel medical insurance\n17.. ☐ revocation of the visa was requested by the visa holder.\nAdditional remarks:\n…\n…\n…\n…\n…\nYou may appeal against the decision to refuse/annul/revoke a visa.\nThe rules on appeal against decisions on refusal/annulment/revocation of a visa are set out in (reference to national law):\n…\nCompetent authority with which an appeal may be lodged (contact details):\n…\nInformation on the procedure to follow can be found at (contact details):\n…\nAn appeal must be lodged within (indication of time-limit):\n…\nDate and stamp of embassy/consulate-general/consulate/of the authorities responsible for checks on persons/of other competent authorities:\nSignature of person concerned: …’.",
  "extent": "E+W+S+N.I.",
  "status": null,
  "version": "current",
  "annotations": [
    {
      "type": "footnote",
      "label": "f1",
      "text": "No logo is required for Norway, Iceland, Liechtenstein and Switzerland."
    },
    {
      "type": "footnote",
      "label": "f2",
      "text": "Revocation of a visa based on this reason is not subject to the right of appeal."
    },
    {
      "type": "footnote",
      "label": "f3",
      "text": "If required by national law."
    }
  ],
  "outstanding_effects": [],
  "provenance": {
    "source": "legislation.gov.uk",
    "source_url": "https://www.legislation.gov.uk/eur/2019/1155/annex/III",
    "retrieved_at": "2026-11-01T14:43:14.410924+00:00"
  },
  "licence": "Open Government Licence v3.0",
  "licence_url": "https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/",
  "attribution": "Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives."
}