ANNEX IVSupplementary provisions
ANNEX IV FORM B FOR NOTIFYING REVOCATION OF AN ETIAS TRAVEL AUTHORISATION (self-revocation) in accordance with Regulation (EU) 2018/1240 Application number: _______________ Dear ________________, [In case of a minor, the person exercising permanent or temporary parental authority or legal guardianship is to be added: Dear ________________,] The [name of ETIAS National Unit] in [address of ETIAS National Unit] has received [name of applicant [optional: additional personal data of applicant]]’s request for revocation of travel authorisation [with limited territorial validity]. The travel authorisation has been revoked , in accordance with Article 41(8) of Regulation (EU) 2018/1240. Additional information Please note that a valid ETIAS travel authorisation is required for the entire duration of a short stay in the Schengen Area. In accordance with Article 41(8) of Regulation (EU) 2018/1240: — if you revoked the travel authorisation during your stay in the Schengen Area, the revocation will not become effective until you exit the Schengen Area; — no appeal is possible against a revocation at the request of the applicant. Your rights with regard to the processing of personal data For information, you have the rights to access, rectify, erase and restrict the processing of personal data stored in ETIAS in accordance with Articles 17 to 20 of Regulation (EU) 2018/1725 and Articles 15 to 18 of Regulation (EU) 2016/679. In case you wish to make use of these rights, please find below the relevant contacts: European Border and Coast Guard Agency Data protection officer [email address] European Data Protection Supervisor [contact details] National supervisory authority of the Member State responsible for your application [Member State-specific information] [Date and place of decision] [Name and signature of decision-maker]