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The form guides the completion of Section 1 (personal details), Section 2 (authorised representative details), and Section 3 (the permitted actions such as submitting applications, objections, notifications, complaints, and collecting residence documents). It details required supporting documents, including passport/ID copies and, where applicable, a doctor’s note, and outlines signing and post-signature submission or in-person collection at the IND desk.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/authorisation-declaration-personal-data-processing-and-signing-instructions/283727/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/authorisation-declaration-personal-data-processing-and-signing-instructions/283727.png","ImageObject",442,249,{"name":88,"@type":89},"Liam","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-20","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",10,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What information is required in Section 1 of the authorisation declaration?","Question",{"text":109,"@type":110},"Section 1 requires the authorising person’s details, such as name, surname, first names, V-number (if known), sex, date of birth, place of birth, country of birth, and contact telephone number.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What can the authorised representative do under Section 3?",{"text":114,"@type":110},"The authorised representative may be authorised to submit an application, request, file an objection, submit a notification, file a complaint, file a notice of default, and collect a residence document or residence endorsement sticker on the person’s behalf.",{"name":116,"@type":107,"acceptedAnswer":117},"Which supporting documents must be attached, and when is a doctor’s note required?",{"text":118,"@type":110},"A copy of the specific passport or identity-card page showing identity details must be attached to verify the signature. If medical circumstances prevent travel to the IND desk for a long time (and not accompanied), a doctor’s note is required showing the inability to travel for a long period.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},283727,1791218488,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":9},8796095461564,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Authorisation declaration  \nWith this Authorisation declaration, you authorise someone else to act for you. Is that other person your lawyer? Then an authorisation is not necessary.  \nIn section 1 you enter your details.  \nIn section 2 you enter the details of the person you want to authorise.  \nIn section 3 you indicate what the authorised person may do for you.  \nIn section 4 you can read which documents you need to enclose with your Authorisation Declaration.  \nPlease note! Complete this authorisation truthfully. Not doing so is a criminal offence. The IND will report this in all cases.  \nProcessing of personal data  \nThe IND records your data in the IND systems to perform legal duties. The IND uses and secures your personal data carefully and based on the requirements of privacy laws. You can read how the IND uses your personal data on[ind.nl/en/privacy](ind.nl/en/privacy).  \n1 Details of you Write in block letters  \n1.1  \nName (as stated  \nin your passport)  \nSurname  \nFirst names  \n1.2  \n1.3  \n1.4  \nV-number (if known) Sex  \nDate of birth  \n􀂆 Male  \n􀂆 Female  \nDay Month Year  \n\n|  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n\n1.5  \n1.6  \n1.7  \nPlace of birth  \nCountry of birth  \n(as stated in your passport)  \nTelephone number  \n2 Details of authorised representative Write in block letters  \n2.1 Company name  \n(if applicable)  \n2.2 Name of authorised  \nrepresentative  \n2.3 Name of contact person    \n2.4 Postal address Street Number  \n[P.O. box](P.O. box) (if applicable)  \nPostcode  \nTown  \n2.5  \n2.6  \nTelephone number  \nE-mail  \n\n|  |  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n|  |  |  |  |  |  |  |  |  |  |  |\n\n3 Declaration Write in block letters  \n> Please tick here what you authorise the other person for.  \nI hereby authorise the person mentioned under section 2 to, on my behalf:  \n􀂆  \n􀂆  \n􀂆  \n􀂆  \n􀂆  \n􀂆  \n􀂆  \n􀂆  \nsubmit an application.  \nsubmit a request.  \nfile an objection.  \nsubmit a notification.  \nfile a complaint.  \nfile a notice of default.  \nto collect my residence document or residence endorsement sticker. Please note: you can only authorise someone to do for this for you if your medical situation prevents you from travelling to the IND desk for a longtime (and also not accompanied) . The authorised representative must bring this Authorisation declaration and a doctor's note. This doctor’s note must clearly show that you cannot travel for a long time.  \nIn all other cases, you must always collect your residence document or residence endorsement sticker yourself.  \nother, namely  \n4 Supporting documents Write in block letters  \nPlease attach the following supporting documents to this Authorisation declaration:  \n• A copy of the specific page of your passport or identity card including the identity details.  \nThis is to verify that the signature on the authorization form is truly yours.  \nIf your medical situation prevents you from travelling to the IND desk, also include:  \n• A doctor's note clearly showing that you are unable to travel for a long time, also not accompanied.  \nPlease note! The authorised representative must bring your original valid passport to the IND desk. A copy isnot sufficient because a residence endorsement sticker may be placed in your travel document.  \n5 Signing  \n5.1 Place and date Place  \nDay Month Year  \n\n|  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n\n5.2  \nYour signature  \n6 After signing  \nWill the authorised representative visit the IND desk? For example, to collect a residence permit? Or to have a sticker placed in your passport? If so, please ask the authorised representative to bring this Authorisation  \ndeclaration to the IND desk.  \nWill the authorised representative not be visiting the IND desk? Are you authorising someone to fill in a form, for example? If so, please enclose the Authorisation declaration with the form. Alternatively, send it separately by post ","cbCaidv19ZXQqb67","https://ap.wps.com/l/cbCaidv19ZXQqb67","pdf",199641,"English","# Authorisation declaration\n## Completion sections (1-4)\n## Declaration and permitted actions\n## Supporting documents\n## Signing and after signing steps","[{\"question\":\"What information is required in Section 1 of the authorisation declaration?\",\"answer\":\"Section 1 requires the authorising person’s details, such as name, surname, first names, V-number (if known), sex, date of birth, place of birth, country of birth, and contact telephone number.\"},{\"question\":\"What can the authorised representative do under Section 3?\",\"answer\":\"The authorised representative may be authorised to submit an application, request, file an objection, submit a notification, file a complaint, file a notice of default, and collect a residence document or residence endorsement sticker on the person’s behalf.\"},{\"question\":\"Which supporting documents must be attached, and when is a doctor’s note required?\",\"answer\":\"A copy of the specific passport or identity-card page showing identity details must be attached to verify the signature. If medical circumstances prevent travel to the IND desk for a long time (and not accompanied), a doctor’s note is required showing the inability to travel for a long period.\"}]","Authorisation declaration - Personal data processing and signing instructions | PDF",1789618162]