THE APPLICATION TO ISSUE A TEMPORARY RESIDENCE PERMIT
1.Name(s)
2.Surname(s)
3.Former surname(s)
4.Place of birth
(country and place - data from the passport about the place of birth)
5.Citizenship(s)
6.Former Citizenship
7.Marital status
8.Full date of marriage
(year, month, day)
9.If divorced - full date of divorce
(year, month, day)
10.Residence address in the country You are coming from (full address: country, region, city/district, village, street, house, apartment)
11. Your contact details
Phone No (full number with country code): +9779867479069
viber: +9779867479069; whatsapp: +9779867479069
email address email: nkhanal522@gmail.com (Email must be up-to-date, you will receive a notification from the migration)
Additional information about you:
12.Do you have any disease(s) that may pose a threat to public health?
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13.Please indicate Your education. When and what school(s) did you graduate from? Full name of the completed educational institution (in full words):
14. Your education (please mark ☑):
15.Please indicate the year of graduation
16.Please indicate obtained specialty and/or qualification
17.Please indicate Your actual places of residence for the last 10 years (countries, exact addresses)
1. BANGAIN, KAPILVASTU 11, KAPILVASTU, NEPAL
2. GULBENES PILSĒTA, GULBENE MUNICIPALITY, LV-4401, LATVIA
18.Have you been deprived of citizenship?
19.Have You been convicted of a crime?
20.Have you been charged with a crime against peace, a crime against humanity, or a war crime, an incitement to commit such crimes or participation in such crimes, or convicted of such acts?
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21.Have you been issued a visa or residence permit for the last 5 years?
If yes, specify:
22. List the states that issued you visas and residence permits over the past 5 years
Государство State
Document (visa or temporary residence permit)
Year, since
Year, by
Государство State
Document (visa or temporary residence permit)
Year, since
Year, by
Государство State
Document (visa or temporary residence permit)
Year, since
Year, by
23.Have you been denied a visa or residence permit or banned from entering a foreign country?
24.Have you applied for asylum to the relevant foreign authorities?
25.Do you have (had) relations with the intelligence, security and / or military services of the country of origin or other country (except the Republic of Lithuania) (are you working (have worked) for such services, provided them with information, executed their orders or otherwise cooperated)?
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26.Do you have (had) contacts with persons residing in the Republic of Lithuania (including citizens of other countries residing in the Republic of Lithuania)?
27. When and in what foreign countries? (visited, lived) before arriving in the Republic of Lithuania, all non-EU countries, including your country of residence
EXAMPLE: Uzbekistan (period 1985 – 2023)
1. NEPAL / period (1993 – 2025)
2. SAUDI ARABIA / period (2017 – 2022)
Please confirm that:
28.You know that a foreigner with a temporary residence permit, if he changes his identity or citizenship documents or his place of residence or his family situation changes, he must notify the Migration Department within 7 days through the Lithuanian Migration Information System (MIGRIS).
29.You are aware of your duty to inform about any other changes relevant to the decision on your application.
30.You are aware that you are liable for the submission of false data according to the laws of the Republic of Lithuania.
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