ANEXO

ANEXO

Instrucciones

Este impreso debe cumplimentarse con letra mayúscula legible, utilizando una casilla para cada letra o número.

(a) Señale con X el documento que presenta.

Los ciudadanos de Estados parte en el Acuerdo sobre el Espacio Económico Europeo podrán acreditar su identidad, además de con la tarjeta de identidad de extranjero, con el documento nacional de identidad de su País de origen. Los ciudadanos del resto de países deberán acreditar siempre su identidad con la tarjeta de identidad de extranjero. En cualquier caso tendrán que aportar fotocopia del documento.

(b) Título académico más alto alcanzado: 1. No sabe leer ni escribir; 2. Inferior a Graduado Escolar; 3. Graduado escolar o equivalente; 4. Superior a Graduado Escolar.

(c) El tiempo de residencia legal en España se acreditará con un certificado expedido por la comisaría de policía cuando no se pueda deducir de la tarjeta de identidad de extranjero, si esta fuera aportada.

ENGLISH

Instructions

This form should be completed using legible capital letters, using one letter or number per box.

(a) Mark the document presented with an X:

Citizens of States that are party to the Agreement regarding the European Economic Area may document their identity, in addition to using the Foreign Resident ID Card, with the national ID card from their country of origin. Citzens of all other countries must confirm their identity using the Foreign Resident ID Card. In all cases, a photocopy of the document presented must be provided.

(b) Highest educational qualifications awarded: 1. Cannot read or write; 2. Did not obtain high school certificate; 3. High school certificate or equivalent; 4. Aboye high school certificate.

(c) Time of legal residence in Spain shall be confirmed with a certificate issued by a police station when this information cannot be obtained from the foreign resident ID card (if presented).

(1) Electoral Roll of citizens, residing in Spain, from countries with agreements regarding the municipal elections of 22 May 2011

(2) Registration application (see instructions)

(3) Province

(4) Municipality

(5) First sumame

(6) Second surname, where applicable

(7) Name

(8) Sex (H=male; M=female)

(9) Birth Data

(10) Date

(11) Country

(12)Country of nationality

(13)Foreign Resident ID Card

(14)National ID card or passport (citizens of States that are party to the Agreement regarding the European Economic Area only, if foreign resident ID card is not available)

(15)Educational qualifications

(16)Address in Spain

(17)Type of roadway

(18)Name of roadway

(19)Number

(20)Descrip.

(21) Km

(22)Hm.

(23)Building

(24) Entrance

(25)Stair

(26) Floor

(27) Door

(28) Postcode

(29)Collective population district

(30)Singular population district

(31)Disseminated nucleus

(32)Pseudoroute/P0 box/postbox

(33)Legal, consecutive residence in Spain since

(34)Provides photocopy of

(35) Provides

(36)Residence certificate issued from your local police station

(37) Declaration

(38)The applicant states that all the information is accurate and that he/she meets the conditions specified in the Agreement between Spain and his/her country of nationality.

(39)Applicant’s signature

Redactado conforme a la corrección de errores publicada en BOE núm. 271 de 8 de noviembre de 2014. BOE-A-2014-11599.