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Application Summary

FOR OFFICIAL USE ONLY

Application Reference / Transaction Number:

12490132

Type of Visa:

Short Stay

Journey Type:

Single Journey

Visa Category:

Visit Family/Friend

Surname:

Monsalve Ortiz

Forename:

Elisa Maria

Other names:
Date of Birth:

21/10/1966

Gender:

Female

Nationality:

Colombia

Passport / Travel Document Number:

AO230317

Issue Date:

20/12/2012

Expiry Date:

20/12/2022

Dates of Travel From:

20/06/2013

Dates of Travel To:

24/06/2013

Please note the address/contact details of the Irish Embassy/Consulate/Visa Office to

which your application has been sent.
Embassy of Ireland, 76 Cda.Boulevard Avila Camacho
Pis 03, Col. Lomas de Chapultepec
C.P.11000 Mexico D.F
Mexico
Phone No : 00 5255 5520 5803
Email : mexicovisa@dfa.ie
Website : http://www.irishembassy.com.mx
Please check above website for details of where you should now submit the following
documentation, together with the relevant visa fee. Documents must be submitted within
30 days of completing your online application.
1. Printed and signed application summary sheet
2. Original passport (See 'www.inis.gov.ie' under Visas in 'Documents Required' for minimum
validity)
3. Passport sized colour photograph which meets the requirements set out on 'www.inis.gov.ie'
4. Supporting documents as outlined under the relevant visa category on 'www.inis.gov.ie'
under Visas in 'Documents Required'. NOTE: If you are applying to the Visa Office in Abuja,
https://www.visas.inis.gov.ie/AVATS/SummaryDetails.aspx

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Application Summary

Abu Dhabi, Beijing, London, Moscow or New Delhi, please check the website of the relevant
office, as given above, for full details of their requirements, which may differ slightly to those
contained on www.inis.gov.ie.
5. All supporting documentation must be in English or accompanied by a notorised translation
6. Visa Fee: Current details of the fee required for various visa types are available on the
website of the Visa Office/Embassy/Consulate given above
Please note that your application will be held online for 30 days and it can be retrieved and
printed any time during this period. However, it will not be possible for you to make
changes to any of the details you have provided. If you need to advise us of anything you
have omitted or incorrectly entered, you should submit this information in writing to the
Embassy/Consulate or Visa Office shown above, with your supporting documentation.
DECLARATION BY APPLICANT
You must now read the declaration below and sign it. This must be signed by the applicant
personally.
An application for a person under the age of 18 should be completed by the parent or legal
guardian.
DECLARATION
I hereby apply for a visa to Ireland. The information I have given is complete and is true to the best of
my knowledge. I also declare that the photograph submitted with this form is a true likeness of me, the
applicant. I confirm that if, before the application is decided, there is a material change in my
circumstances or new information relevant to this application becomes available, I will inform the
Embassy/Consulate/Visa Office at which I have applied.
I understand that additional information and/or data, such as fingerprints, may be required before my
application can be processed. I understand that failure to provide such data, if requested to do so by
the Visa Office, may result in the refusal of my application. I also understand that any false or
misleading information, or false supporting documentation, may result in the refusal of my application
without the right of appeal, and that this may result in me being prevented from making further visa
applications for a period of five years.
The Irish Naturalisation and Immigration Service, Department of Justice, Equality and Law
Reform/Department of Foreign Affairs will process the personal data on this application and related
data for the purposes of promoting the interests of Ireland and its citizens.
I agree that the data in my application, and/or any further data supplied, including any fingerprints
and the results of database searches, may be disclosed to other Irish Government Departments
and/or Agencies, including An Garda Sochna (Irish Police), as well as to public authorities of the
Member States of the European Union/EEA and/or other States, including for the purpose of
confirming identity and/or immigration history.
I agree also that the application form and supporting documentation, or copies thereof, may be
conveyed to the Irish deciding authority by reasonable means as considered appropriate by the
receiving office, including commercial courier (in sealed package) or other postal or electronic means.

Applicant's Signature

https://www.visas.inis.gov.ie/AVATS/SummaryDetails.aspx

Date

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