FOR OFFICIAL USE ONLY
Registered in GBA / RNI
Yes
No
First Time Request?
Yes
No
Current Passport
Handed in
Valid returned
Will be handed in
Invalid returned
Handed in
Valid returned
Will be handed in
Invalid returned
Current Dutch ID Card /
Emergency Passport /
Laissez-passer
Missing
Missing
Travel Document Application Form
The fee for the document must be paid when submitting the application.
Date of application 14-12-2023
Surname(s)
Kortay
Given name(s)
Betül
Phone number
+905437658558
Email address
bkortay@yahoo.com
Decision via email Yes
Contact address
Esentepe mahallesi, Sancak 1.
sokak, Yıldırımkent sitesi
Bahar blok 6 kat2 daire 9
59850
Tekirdağ/Çorlu
Turkiye
Placeholder Photo Card
For official use only
New Travel Documents and Identity
Country of application
Turkiye
Applying for document(s)
Passport
Gender
Female
Height in cm
160
Dutch citizen service number (BSN)
236729214
Date of birth
20-04-1973
Place of birth
Nijmegen
Country of birth
Netherlands
Marital status
Divorced
Front Office
Initials employee
1
Personal Details
Back Office
Initials employee
Back Office
Initials coordinator
992374
Partner Details
Personal Details
Has the name of your (former) spouse / No
registered partner been registered on
any of your Dutch travel documents
before?
Current Address
Personal Details
Address
Esentepe mahallesi, Sancak 1. sokak, Yıldırımkent sitesi
Additional address information
Bahar blok 6 kat2 daire 9
Postal Code
59850
City
Tekirdağ/Çorlu
Country
Turkiye
Is this your current country of
residence?
Yes
Since when do you live in Turkiye?
01-05-2017
Do you have a residence permit for or Yes, I have citizenship
a citizenship of Turkiye?
Previous Residency in the Netherlands
Personal Details
Did you ever live in the Netherlands, in Yes: Utrecht
what municipality?
Did you deregister?
Yes
What year did you leave the
Netherlands?
2017
Dutch Nationality
Dutch Nationality
Specify how you obtained the Dutch
nationality
Naturalisation
Date nationality obtained
15-05-2003
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992374
Current Dutch Documents
Dutch Nationality
Are there valid Dutch travel documents Yes
on your name?
Any of these documents stolen / lost / No
at a different location?
Passport
Dutch Nationality
Document number
NP76HP991
Date of issue
20-03-2014
Authority
burgemeester van Utrecht
Other Nationalities
Do you hold any other nationalities
besides the Dutch nationality?
Other Nationalities
Yes: Turkish
Turkish Nationality
Nationality obtained via?
Other Nationalities
Birth
Do you have a document to prove this Yes: Identity Card
nationality?
Authority
minnisterie van binnenlandse zaken
Another travel document?
No
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Signature
I, the undersigned, hereby explicitly declare that the information I have provided above is truthful and that the
photo submitted bears a true, current likeness to me. I also hereby explicitly declare that I have not lost my Dutch
nationality by voluntarily acquiring another nationality, or in any other way that I am aware of, and that to the best
of my knowledge I hold Dutch nationality.
By signing this form I agree that my personal data may be shared with other government agencies in order to
confirm my nationality and identity for the purposes of issuing a Dutch travel document.
I agree to any correspondence relating to this application being sent to the email address I provided on the first
page of the application form.
I am aware that the fees paid are non refundable.
Declaration of consent for the decision on your application to be sent by email
If your passport application is not processed or is rejected, you will receive a decision in writing, to which you can
lodge an objection. If you wish to receive the decision by email, you need to make this known. You should use an
email address which you access on a regular basis.
I agree for the decision on my passport application to be sent to the email address as provided by me.
The Ministry of Foreign Affairs accepts no responsibility for any email messages that fail to reach you or are
delayed. The Ministry of Foreign Affairs cannot guarantee the reliability of sending or receiving messages by email,
or the confidentiality and integrity of email correspondence sent over the internet.
Place and date
4
Signature
992374
Privacy declaration: Travel document or Dutch ID-card application
The Ministry of Foreign Affairs handles the personal data in your travel document application with the utmost care.
Personal data is information that can be traced to an individual, such as names, postal addresses and email
addresses. Fingerprints are also personal data. Personal data is protected under the General Data Protection
Regulation(GDPR).
Processing of personal data
The Ministry of Foreign Affairs processes personal data in order to carry out its public tasks. The ministry is
responsible for ensuring that your personal data is processed in accordance with the GDPR.
Data sharing
When carrying out tasks under the Passport Act and the Passport Regulations (Embassies and Consulates) 2001,
including article 85 of the latter, the Ministry of Foreign Affairs may be required to share information, including your
personal data, with other organisations
For example, the Ministry of Foreign Affairs may share data with the manufacturer of your passport or identity
card, the National Office for Identity Data or investigators. This is necessary for your application to be processed. It
may also be necessary for the purpose of examining travel document irregularities or in the context of a criminal
investigation.
It is possible that your data may be requested by and passed on to local authorities, for instance in connection with
a subsequent application or registration with the municipality. In addition, commercial postal companies are used
to transfer documents and files relating to travel document applications.
Protecting personal data
The Ministry of Foreign Affairs will ensure that your personal data is appropriately protected.
Retention period for personal data
The Ministry of Foreign Affairs will retain your personal data for no longer than is necessary for the purpose
concerned, and in accordance with the Passport Act and the Passport Regulations (Embassies and Consulates)
2001.
Your privacy rights
You can submit a request in any of the following situations:
If you wish to know which personal data of yours the ministry is processing
If you wish to amend your personal data
If you wish to have your personal data deleted
If you wish us to limit the processing of your personal data
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992374