ANNEX V

When refusing entry, the competent border guard shall: fill in the standard form for refusing entry, as shown in Part B. The third-country national concerned shall sign the form and shall be given a copy of the signed form. Where the third-country national refuses to sign, the border guard shall indicate this refusal in the form under the section ‘comments’; affix an entry stamp on the passport, cancelled by a cross in indelible black ink, and write opposite it on the right-hand side, also in indelible ink, the letter(s) corresponding to the reason(s) for refusing entry, the list of which is given on the abovementioned standard form for refusing entry; cancel the visa by applying a stamp stating ‘CANCELLED’ in the cases referred to in paragraph 2. In such a case the optically variable feature of the visa sticker, the security feature ‘latent image effect’ as well as the term ‘visa’ shall be destroyed by crossing it out so as to prevent any later misuse. The border guard shall inform his/her central authorities of this decision forthwith; record every refusal of entry in a register or on a list stating the identity and nationality of the third-country national concerned, the references of the document authorising the third-country national to cross the border and the reason for, and date of, refusal of entry; The visa shall be cancelled in the following cases: if the holder of the visa is the subject of an alert in the SIS for the purposes of being refused entry unless he or she holds a visa or re-entry visa issued by one of the Member States and wishes to enter for transit purposes in order to reach the territory of the Member State which issued the document; if there are serious grounds to believe that the visa was obtained in a fraudulent way. However, the failure of the third-country national to produce, at the border, one or more of the supporting documents referred to in Article 5(2), shall not automatically lead to a decision to cancel the visa. If a third-country national who has been refused entry is brought to the border by a carrier, the authority responsible locally shall: order the carrier to take charge of the third-country national and transport him or her without delay to the third country from which he or she was brought, to the third country which issued the document authorising him or her to cross the border, or to any other third country where he or she is guaranteed admittance, or to find means of onward transportation in accordance with Article 26 of the Schengen Convention and Council Directive 2001/51/EC of 28 June 2001 supplementing the provisions of Article 26 of the Convention implementing the Schengen Agreement of 14 June 1985 OJ L 187, 10.7.2001, p. 45. ; pending onward transportation, take appropriate measures, in compliance with national law and having regard to local circumstances, to prevent third-country nationals who have been refused entry from entering illegally. If there are grounds both for refusing entry to a third-country national and arresting him or her, the border guard shall contact the authorities responsible to decide on the action to be taken in accordance with national law. Name of State Logo of State (Name of Office) (1) REFUSAL OF ENTRY AT THE BORDER On at (time) at the border crossing point We, the undersigned, have before us: Surname First name Date of birth Place of birth Sex Nationality Resident in Type of identity document number Issued in on Visa number type issued by valid from until For a period of days on the following grounds: Coming from by means of (indicate means of transport used, e.g. flight number), he/she is hereby informed that he/she is refused entry into the country pursuant to (indicate references to the national law in force), for the following reasons: (A) has no valid travel document(s) (B) has a false/counterfeit/forged travel document (C) has no valid visa or residence permit (D) has a false/counterfeit/forged visa or residence permit (E) has no appropriate documentation justifying the purpose and conditions of stay. The following document(s) could not be provided: (F) has already stayed for three months during a six-month period on the territory of the Member States of the European Union (G) does not have sufficient means of subsistence in relation to the period and form of stay, or the means to return to the country of origin or transit (H) is a person for whom an alert has been issued for the purposes of refusing entry in the SIS in the national register (I) is considered to be a threat to public policy, internal security, public health or the international relations of one or more of the Member States of the European Union (each State must indicate the references to national law relating to such cases of refusal of entry). Comments The person concerned may appeal against the decision to refuse entry as provided for in national law. The person concerned receives a copy of this document (each State must indicate the references to the national law and procedure relating to the right of appeal). Person concerned Officer responsible for checks (1) No logo is required for Norway and Iceland.

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Source: EUR-Lex (Cellar) · retrieved 2026-11-14 · Text as adopted (Official Journal); later amendments are not incorporated in this text.