Tier 1 or 5 PBS Dependant - GOV.UK

This form is specified for applications made on or after 6 April 2017

You will only be considered for leave as a Tier 1 or 5 Dependant. You will not be considered for any other type of leave to remain. You must use a different form if you want to stay for another reason.

In accordance with paragraph 34 of the Immigration Rules, this form is specified for applications made on or after 6 April 2017. Please check on the website at www.gov.uk/browse/visas-immigration/work-visas that this is the current form for use on the date that you apply.

You are advised to read the help text and separate guidance notes that are available to help with this form. Please read them before making your application. If you do not already have them, you can download them from our website.

Applications made on this form may be made by post, courier or in person at one of our Premium Service Centres. To apply in person you must make an appointment. Details of our Premium Service Centres can be found on our website:https://www.gov.uk/ukvi-premium-service-centres

Application for a Grant of Leave and Biometric Immigration Document as a

Tier 1 or 5 Dependant

Tier 1 or 5 PBSDependant

version 04/2017

Please post or courier your application to:Postal address:

Home Office

Tier 1 Dependants

PO Box 496

Durham

DH99 1WQ

Courier address:

Home Office

Tier 1 or 5 Dependants

Wearside House

Riverside Place

Freemans Reach

Durham

DH1 1SL

Postal address:

Home Office

Tier 5 Dependants

PO Box 506

Durham

DH99 1WB

As part of your application you may be required to pay the Immigration Health Surcharge. Before going any further, you should check www.gov.uk/healthcare-immigration-application to confirm if an Immigration Health Surcharge assessment is required as part of your application. You must complete this before making your application and enter the reference number in this application.

https://www.gov.uk/browse/visas-immigration/work-visas

https://www.gov.uk/ukvi-premium-service-centres

https://www.gov.uk/healthcare-immigration-application

https://www.gov.uk/healthcare-immigration-application

Tier 1 or 5 Dependant Application Form (Version 04/2017) - page 2 of 36

TIer 1 or 5 DePenDAnT APPlICATIon Form

Intentionally Blank



Section A - Payment DetailsA1 Fee Details

Please complete this section in block capitals and black ink. You should complete all questions in this part of the form that apply to you. It is mandatory to complete Section A. If it is not complete, the application will be invalid and returned to you.

You should refer to the Payment Guidance Notes which accompany this application form.

Section A - Application Details

A1. Tick appropriate box below. If you do not select a fee then we cannot take a payment and your application will be rejected as invalid.

Tier 1 - General £1,806

Tier 1 – Entrepreneur £1,228

Tier 1 – Investor £1,561

Tier 1 – Exceptional Talent £585

Tier 1 – Exceptional Talent Extension £585

Tier 1 – Graduate Entrepreneur standard £474

Tier 5 – standard £235



A2.1 Correspondence address

A2 Application Details

Postcode

You should refer to the Payment Guidance notes which accompany this application form. Please complete this section in block capitals and black ink.

A2.3

Day Month Year

A2.2 Contact name in the UK if different to that of the dependant.

Your full name

Your date of birthA2.4

main Applicant’s full nameA2.5

Day Month Yearmain Applicant’s date of birthA2.6

United Kingdom postal order (payable to ‘Home Office’) - go to part BCheque (payable to ‘Home Office’) - go to question A2.8

Debit or credit card - go to question A2.9

Banker’s draft - go to question A2.8

Please select the method of payment from the list belowA2.7

Account number Cheque number

Paying by cardVisa / Electron

MasterCard/Amex

Delta Maestro/ Solo

Sort codePaying by cheque - please give cheque details belowA2.8

A2.9Which card are you using for payment? Please tick a box and complete A2.10 - A2.14 below.

Name on card

A2.10

A2.11 Card number

Valid from Expiry date Security No - CVVA2.12 Card

detailsIssue

No. (where

available)

Day Month YearDateA2.14

3 digit number (or 4 digit

number for Amex)

Cardholder’s signatureA2.13



If you are producing a double-sided copy of this application form, please include this page and make

sure it falls on the reverse of the payment details page in the two-sided copy.

For administrative reasons, it is important that the rest of the form begins with Section B -

Your Personal Details facing upwards



You must complete all of the sections and questions in this form that apply to you.

The form will not be valid if it is not fully completed.

There is a separate help text leaflet available with this form. Where a question in this form has information available in the help text leaflet it will be marked with “(ht)”.

Section B – Your personal detailsIn this section you will be asked to provide information about your personal situation, for example your name, date of birth and nationality as well as information about any other names you have used, or other nationalities you have held.PhotographsFor your application to be valid, you must provide two recent identical passport-size photographs of yourself with your full name written on the back of each one. The photographs must be in the format specified in the separate photograph guidance, including the mandatory requirements, which can be found on our website at https://www.gov.uk/photos-for-passportsPlease ensure that you place the photographs in a small sealed envelope attached to this part of the form – and without allowing any staples, clips, pins or anything else to mark or damage the photographs. The photographs will be checked against the images taken when your biometric features are recorded

I have enclosed the required photographs as outlined above.

B1; What is your name, as given in your passport or travel document? (ht)

Title - please select from the following list:

Mr Mrs Miss Ms Dr Other

First name(s) or given name(s):

Last name(s) or family name(s):

B2; What is your gender? B3; What is your date of birth?

Male Female D D m m Y Y Y Y

B4; What is your relationship status? (ht)

Married Dissolved Civil Partnership

Civil Partner Surviving Civil Partner

Single Unmarried Partner

Divorced Separated

Widow/Widower Separation Order

https://www.gov.uk/photos-for-passports



B5; What village, town or city were you born in?

B6; What is your country of birth?

B7; What is your current nationality? (ht)

B8; If you currently hold or have ever held any other nationality, please provide details in the box below: (ht)

What Nationality did you or do you hold? Date held from: Date held to:

Please tick to confirm that you are submitting the required evidence relating to this other Nationality with this application

B9; If you are currently known by or have ever been known by any other name, please provide details in the box below: (ht)What name are you or were you known by? Date of Birth

when using this name:

Dates that you used this name from:

Dates that you used this name to:

Please tick to confirm that you are submitting the required evidence relating to this other name with this application

B10. Please provide your Immigration Health Surcharge reference number (IHS):

I H S

Now go to Section C



Section C – Details about the PBS main applicant you are dependent on

In this section you will asked questions about the PBS main applicant that you are dependent on.

C1; What is the full name of the PBS main applicant you are dependent on, as stated in their passport or travel document?

Mr Mrs Miss Ms Dr Other

First name(s) or given name(s):

Last name(s) or family name(s):

C2; What is the date of birth of the PBS main applicant you are dependent on, as stated in their passport or travel document?

D D m m Y Y Y Y

C3; What is the nationality of the PBS main applicant you are dependent on, as stated in their passport or travel document?

C4; What is the reference number for the most recent application of the PBS main applicant you are dependent on? (ht)

C5; Have you previously been granted leave to enter or remain as the dependant of the PBS main applicant on which you are dependent?

Yes No

Now go to Section D



Section D – Details of your representativeIn this section you will be asked to provide information about your representative such as their name, address and contact details. It also asks whether or not they are appropriately registered or regulated to provide immigration advice. D1; Do you have a representative acting on your behalf on this application?

Yes go to D2 No go to Section E

D2; What is the name of your representative? (ht)

D3; What is the name of your representative’s organisation? (ht)

D4; Is your representative based in the UK?

Yes go to D5 No go to D6

D5; What is their UK Address?

House number/name

Address line 1

Address line 2

Address line 3

Town/City

Postcode

Now go to D7

D6; What is their overseas address?

House number/name

Address line 1

Address line 2

Address line 3

Town/City

County/District

Country

Postcode



D7; Please provide your representative’s contact details:

Work telephone number

Mobile telephone number

Email address line 1


Fax number

D8; Is your representative regulated by the office of the Immigration Services Commissioner (oISC)? (ht)

Yes go to D9 No go to D10

D9; What is their oISC registration number?

Now go to D11

D10; What is the reason that they are not oISC registered?

They are authorised by designated professional body or regulator

They are registered or authorised in an EEA State

They are supervised

They are exempt or employed or supervised by exempt person

They are specified by an order

I don’t know

Now go to Section E



Section e - Your Contact Details in the UKIn this section you will be asked to provide information about how we can contact you, including your correspondence address in the UK, contact telephone numbers, email address, etce1; Do you live at the same address as the PBS main applicant that you are dependant on? (ht)Yes go to E3 No go to E2

e2; Why do you not live at the same address as the PBS main applicant that you are dependant on?

e3; What is your current address? (ht)

House number/name

Address line 1

Address line 2

Address line 3

Town/City

County/District

Country

Postcode

e4; What date did you move to this address? (ht)

D D m m Y Y Y Y

e5; Is your correspondence address the same as your current address (as given above)? (ht)Yes go to E7 No go to E6

e6; What is your correspondence address?

House number/name

Address line 1

Address line 2

Address line 3

Town/City

County/District

Country

Postcode



e7; Please provide the following contact details:Work telephone number

Home telephone number

Mobile telephone number

Fax number



e8; Please tick to indicate what your preferred contact telephone number is:

Work

Home

Mobile

Now go to Section F



Section F - Your reference numbersIn this section you will be asked to provide information about any Home Office reference numbers that you might have. These can be found on documents and correspondence we have previously sent to you. You will also be asked to provide any current and any previous National Insurance number.

F1; Have you ever had a Home office reference number assigned to you? (ht)

Yes go to F2 No go to F3

F2; What is/are your Home office reference number(s)?

You may enter up to 3 reference number below:Reference number 1

Reference number 2

Reference number 3

F3; Do you currently have a national Insurance number? (ht)

Yes go to F4 No go to F5

F4; What is your national Insurance number? (ht)

F5; Have you previously had a national Insurance number? (ht)

Yes go to F6 No go to Section G

F6; What was your previous national Insurance number? (ht)

Now go to Section G



Section G - About your Passport or Travel DocumentIn this section you will be asked to provide information about your current and previous passports or travel documents. If you have lost or had any passports or travel documents stolen then you should have reported this to the Police and you will be asked to provide information about this.

G1; Please provide the following details: (ht)

Current Passport or Travel Document

What is your current passport or travel document number?

What is the nation-ality on the passport?

What is the issue date?

What is the expiry date?

What is the place of issue?

Is the passport or travel document enclosed?

If the passport or travel document is not enclosed, please indicate why:

Yes - Lost - go to G2

go to G4

Stolen - go to G3No -

go to next column

Expired and returned to national authorities - go to G4

Already with The Home Office - go to G4

G2; Please explain how you lost your passport: (ht)


What was the Police report number?

What was the crime reference number?

Which police station was this reported at?

What date was this reported to the Police on?



G4: Have you had a previous Passport or Travel Document? (ht)

Yes go to G5 No go to Section H


Previous Passport or Travel DocumentWhat is the passport or travel document number?

What is the nationality on the passport?



What is the place of issue?

Is the passport or travel document enclosed?

If the passport or travel document is not enclosed, please indicate why:

Yes - Lost - go to G6

go to Section H Stolen - go to

G7

No - Expired and returned to national authorities go to Section H

go to next column

Already with The Home Office

G6; Please explain how you lost your passport: (ht)








Section H - About your Biometric residence PermitIn this section you will asked to provide information about any Biometric Residence Permit(s) that have previously been issued to youH1. Do you have a BrP?

Yes go to H2 No go to H7

H2. Please provide the following details: (ht)

Biometric residence Permit

What is your BrP number?

What is your nationality on the BrP?



Is your BrP enclosed with this application?

If the BrP is not enclosed please indicate why:

Yes - go to H7

Lost - go to H3

Stolen - to go H4No - go

to next column Expired and

returned to national authorities - go to H7Already with The Home Office - go to H7

H3. Please explain how you lost your BrP: (ht)

H4. Please provide the following details: (ht)





H5. Have you reported this to the The Home office card management service? (ht)

Yes go to H6 No go to H7

H6. What date did you report this? (ht)

D D M M Y Y Y Y


TIer 1 or 5 DePenDAnT APPlICATIon FormH7. Which age group do you belong to (at the date of submitting your application)?

15 years & under go to H8 16 years & over go to Section I

H8. What is the title of the person accompanying you to have your biometric details taken?

Mr Mrs Miss Ms Other (please state)

H9. First name(s) or given name(s)

H10. last name(s) or family name(s)

H11. Their date of birth D D m m Y Y Y Y

H12. Their place of birth

H13. Relationship to you

H14. Is this person your parent or legal guardian

Yes go to Section I No go to H15

H15. Explain why your parent or legal guardian will not be accompanying you

Now go to Section I



Section I - About your Previous AddressesIn this section you will be asked to provide information about any previous addresses in the UK, including Northern Ireland, where you have lived in the last five years.

I1; Have you previously lived in northern Ireland? (ht)

Yes go to I2 No go to I5

I2; What was your address? (ht)

House number/name

Address line 1

Address line 2

Address line 3

Town/City

County/District

Country

Postcode

I3; What date did you move to this address? (ht)

D D M M Y Y Y Y

I4; What date did you move from this address? (ht)

D D M M Y Y Y YIf you have lived at more than one address in Northern Ireland, please continue on a separate sheet.

I5; Have you lived at any other addresses in the UK within the last 5 years? (ht)

Yes go to I6 No go to Section J

I6; What was your address?

House number/name

Address line 1

Address line 2

Address line 3

Town/City

County/District

Postcode

I7; What date did you move to this address?

D D M M Y Y Y Y



I8; What date did you move from this address?

D D M M Y Y Y Y

If you have lived at more than one address in the last five years, please continue on a separate sheet.

Now go to Section J



Section J - About your Personal HistoryIn this section you will be asked to provide information about any criminal convictions you have, any civil judgements or immigration civil penalties against you and details of any involvement you may have had in war crimes, genocide, crimes against humanity or terrorism.

J1; Have you ever been convicted of a criminal offence either in the UK or in another country? (ht)Yes go to J2 No go to J7

J2; What was the offence?

J3; What was the sentence given?

J4; If you were sentenced to a period of imprisonment, what was the length of the prison sentence in months?

J5; What date were you sentenced on?

D D M M Y Y Y Y

J6; Which country were you convicted in?

J7; Have you ever had any civil judgements issued against you or received a civil penalty under the UK Immigration Acts? (ht)

Yes go to J8 No go to J11

J8; Please provide details of the judgement or civil penalty:



J9; Date of the judgement or civil penaltyD D M M Y Y Y Y

J10; Which country was the judgement issued in?

J11; Have you ever been charged or indicted in any country with a criminal offence for which you have not yet been tried in court?


J12; Please provide details of the offence:

J13; In either peace or war time, have you ever been involved in, or suspected of involvement in, war crimes, crimes against humanity or genocide? (ht)


J14; Please provide details:

J15; Have you ever been involved in, supported or encouraged terrorist activities in any country? (ht)





J17; Have you ever been a member of, or given support to an organisation which has been concerned with or involved in terrorism? (ht)



J19; Have you, by any means or medium, expressed views that justify or glorify terrorist violence or that may encourage others to commit terrorists acts or activities or other serious criminal activities? (ht)

Yes go to J20 No to to Section K


Now go to Section K



Section K - About your Immigration HistoryIn this section you will be asked to provide information about your current and previous immigration status in the UK, including previous applications that you have made.

K1; What is your current immigration status?

• I have leave to enter / remain for a limited period - Go to K4

• I am an EU national / family member of an EU national - Go to K4

• I am exempt from immigration control - Go to K4

• I have leave which has been extended by section 3C of the Immigration Rules – Go to K4

• I had leave to enter / remain for a limited period, which has now expired - Go to K2

• I am applying following the refusal of a previous application for leave which was made in-time or for which the Secretary of State considered there was a good reason why it could not be made in-time – Go to K2

• I am applying after the expiry date of the time limit for making an in-time application for administrative review or appeal in relation to the refusal of a previous application for leave – Go to K2

• I am applying following an administrative review or appeal being concluded, withdrawn abandoned or lapsing - Go to K2

• None of the above - go to K4

K2; Are you applying within 14 days of;

• Your leave to enter or remain expiring?

Yes – Go to K2ANo – If you wish to apply to continue your stay in the UK, you should leave the UK and reapply for a visa from overseas

K2A; Is there a good reason beyond your/your representative’s control why the application could not be made in time?

Yes – Go to K2B

No – If you wish to apply to continue your stay in the UK, you should leave the UK and reapply for a visa from overseas.

K2B; Are you applying within 14 days of;

• the refusal of a previous application for leave which was made in-time or for which the Secretary of State considered there was a good reason why it could not be made in-time, or

• the expiry of any leave extended by section 3 of the Immigration Act 1971, or

• the expiry date of the time limit for making an in-time application for administrative review or appeal in relation to the refusal of a previous application for leave, or

• an administrative review or appeal being concluded, withdrawn abandoned or lapsing?

Yes – Go to K3

No – If you wish to apply to continue your stay in the UK, you should leave the UK and reapply for a visa from overseas.



K3; I am submitting evidence of there being good reason beyond my/my representative’s control which prevented me from submitting my application in-time.

Tick to confirm

K4; Were you required to register with the Police as a condition of your previous leave? (ht)

Yes No

K5; Did you have a visa or entry clearance when you came to the UK? (ht)

Yes go to K6 No go to K10

K6; In which country did you obtain your visa or entry clearance? (ht)

K7; What is the reference number of the visa or entry clearance? (ht)

K8; What date was your visa or entry clearance valid from? (ht)

D D M M Y Y Y Y

K9; What date was your visa or entry clearance valid to? (ht)

D D M M Y Y Y Y

K10; How did you enter the UK? (ht)

By air

By sea

By the Channel Tunnel

Travelling overland via the Republic of Ireland

K11; At which port did you enter the UK? (ht)

K12; What was your ticket booking or reference number? (ht)

K13; What was the name of your transport operator? (ht)

K14; Have you ever stayed in the United Kingdom beyond the expiry date of your period of leave? (ht)Yes go to K15 No go to K16



K15; Please provide details: (ht)

K16; Have you ever knowingly used deception when seeking leave to enter or remain, entered the United Kingdom illegally or worked in the United Kingdom without immigration permission to do so (contrary to your conditions of stay)? (ht)Yes go to K17 No go to K18


K18; Have you ever been refused entry clearance, leave to enter or leave to remain in the UK? (ht)



K20; Have you ever been removed, required to leave or deported from the UK? (ht)

Yes go to K21 No go K22


K22; Do you currently have any other applications with the Home office on which you are awaiting a decision? (ht)





K24; Do you currently have an immigration appeal before the Tribunal which has not yet been finally determined? (ht)Yes go to K25 No go to Section L


Now go to Section L



Section l - Public FundsIn this section you will be asked to provide information about whether or not you have claimed public funds (benefits and housing) in the UK and details about any claims you have made.

l1; Have you ever claimed any public funds? (ht)

Yes go to L2 No go to Section M

l2; Have you claimed Attendance Allowance?

Yes No

l3; Have you claimed Carer’s Allowance?

Yes No

l4; Have you claimed Child Benefit?

Yes No

l5; Have you claimed Tax Credit?

Yes No

l6; Have you claimed Council Tax Benefit?

Yes No

l7; Have you claimed Disability living Allowance?

Yes No

l8; Have you claimed Housing or Homelessness Assistance?

Yes go to L9 No go to L10

l9; What is the name of the local housing authority or housing association that provided this?

l10; Have you claimed Housing Benefit?

Yes No



l11; Have you claimed Income-based Jobseekers Allowance?

Yes No

l12; Have you claimed Income Support?

Yes No

l13; Have you claimed Severe Disablement Allowance?

Yes No

l14; Have you claimed Social Fund Payments?

Yes No

l15; Have you claimed State Pension Credit?

Yes No

l16; Have you claimed Working Tax Credit?

Yes No

l17; Have you claimed Income-related employment and Support Allowance?

Yes No

l18; Is your housing provided by a local authority or housing authority as part of an agreement between your employer and a housing authority? (ht)Yes No

l19; Have you claimed Council Tax reduction?

Yes No

l20; Have you claimed Personal Independence Payment?

Yes No

l21; Have you claimed Universal Credit?

Yes No

Now go to Section M



Section m - About your maintenanceIn this section you will be asked to provide information about maintenance which is the money you will need for your living costs in the UK.

It is essential that you ensure that the information you provide in this section is accurate. We use this information to advise you of the amount of money you will need for maintenance. m1; Are you applying for leave at the same time as the PBS main applicant that you are dependant upon?

Yes go to M2 No go to M4

m2; Under which category of the Points Based System is the main applicant applying?

Tier 1 (General) - go to M6

Tier 1 (Entrepreneurs) - go to M7

Tier 1 (Graduate Entrepreneur) - go to M10

Tier 1 (Exceptional Talent) - go to Section N

Tier 1 (Investors) - go to Section N

Tier 1 (Post Study Work) - go to M7

Tier 5 (Temporary Worker) - All categories - go to Section M11

m3; Is the PBS main applicant making:

An initial switching application - go to M11

An application for an extension of their existing leave - go to section N

An application following a change of employment - go to Section N

m4; Has the PBS main applicant received notification that their application has been successful? (ht)

Yes No

m5; Under which category of the Points Based System has the main applicant applied?

Tier 1 (General) - go to M6

Tier 1 (Entrepreneurs) - go to M7

Tier 1 (Graduate Entrepreneur) - go to M10

Tier 1 (Exceptional Talent) - go to Section N

Tier 1 (Investors) - go to Section N

Tier 1 (Post Study Work) - go to M7

Tier 5 (Temporary Worker) - All categories - go to M10A



m6; Has the PBS main applicant’s application been assessed in accordance with paragraphs 39 to 42 of the HSmP Forum ltd. Judicial review Policy Document?Yes No

m7; How long has the PBS main applicant been in the UK for?

Less than 12 months - go to M8

More than 12 months - go to M9

m8; Please tick the box below:

I can confirm that I am providing evidence of having £1890 in available funds.

Go to M12

m9; Please tick the box below:

I can confirm that I am providing evidence of having £630 in available funds.

Go to M12

m10; How are you able to demonstrate that you have sufficient funds available to you?

I am providing an endorsement letter confirming that UK Trade and Investment (UKTI) has awarded funding to cover the required maintenance - go to section N

Where PBS migrant has been in the UK less than 12 monthsI am providing evidence of having £1260 in available funds - go to M12

Where PBS migrant has been in the UK more than 12 months

I am providing evidence of having £630 in available funds - go to M12

m10A; Is the main applicant’s sponsor certifying your maintenance?

Yes Go to M10B No Go to M11

m10B; How is the main applicant’s sponsor certifying your maintenance?

On the main applicant’s certificate of sponsorship

In a letter

Go to Section n

m11; How are you able to demonstrate that you have sufficient funds available to you?

I am providing evidence of having £630 in available funds - go to M12



m12; You must provide evidence that you have access to available funds in order to support yourself. Please tick the relevant box to confirm what evidence you are supplying:

Personal bank or building society statements covering a consecutive 90 day period

A building society pass book covering a consecutive 90 day period

A letter from a bank or building society confirming the funds and that they have been held for a consecutive 90 day period

A letter from a financial institution regulated by either the Financial Conduct Authority, the Prudential Regulatory Authority or, in the case of overseas accounts, the home regulator (official regulatory body for the country in which the institution operates and the funds are located) for the purpose of personal savings accounts, confirming the funds and that they cover a consecutive 90 day period.

Now go to Section N



Section n - About your Personal Circumstances/attributesIn this section you will be asked about your relationship with the PBS main applicant that you are dependent upon.

n1; What is your relationship to the PBS main applicant that you are dependent on?

Spouse - go to N2

Civil Partner - go to N2

Unmarried Partner - go to N2

Same-Sex Partner - go to N2

Dependent Child under 18 - go to N7

Dependent Child 18 or over - go to N7

n2; Is your relationship with your Spouse/Civil Partner subsisting?

Yes No

n3; Do you intend to live with your Spouse/Civil Partner throughout your time in the UK?

Yes No

n4; Do you intend to remain in the UK beyond the period of leave that your Spouse/Civil Partner has or may be given?Yes No

n5; Do you intend to live with them throughout your stay in the UK?

Yes No

n6; Was your last grant of leave to enter or remain as the spouse/civil partner of the PBS main applicant?

Yes No

Now go to the next sectionn7; Have you previously been granted leave as the dependent child of the PBS main applicant?Yes No

n8; Are you married or in a civil partnership?

Yes No



n9; Have you formed an independent family unit from your parent or are you living an independent life?Yes No

n10; Do you intend to remain in the UK beyond any period of leave your parent (the PBS main applicant) has or may be given?Yes No

n11; Are both of your parents lawfully present in the UK?

Yes No

n12; Are both of your parents applying for leave at the same time as you?

Yes go to the next section No go to N13

n13; Is the PBS main applicant that you are dependent upon your sole surviving parent?

Yes go to the next section No go to N14

n14; Has the PBS main applicant you are dependent upon had, and still has, sole responsibility for your upbringing?Yes go to next section No go to N15

n15; Is your other parent in the UK?

Yes No

Now go to the next section



Section o - Your DeclarationYou must complete part O. If it is not complete, then your application will be invalid and will be returned to you.

You must sign below to show that you have read and understood the following declaration. It must be authorised by you and not by a representative or other person acting on your behalf. If you are under 18, your parent or legal guardian may sign.

The information given in my application is complete and is true to the best of my knowledge and belief.

The photographs I have submitted with my application are a true likeness of me.

The documents I have submitted in support of my application are complete and correct to the best of my knowledge and belief.

I agree to co-operate with Home Office officials, or any other person charged by the

Secretary of State for the Home Office with conducting pre-issue and post-issue checks in relation to this application.

If there is a material change in my circumstances or any new information relevant to this application becomes available before it is decided, I will inform the Home Office.

I am aware that the rules and requirements for applications may change in the future and that I should not assume the current rules and requirements will continue to apply.

I agree to the Home Office using the data provided in this application in accordance with its Information Charter.

I understand that my details may in certain circumstances be passed to fraud prevention agencies to prevent and detect fraud and money laundering. I also understand that such agencies may provide the Home Office with information about me. Further details explaining when information may be passed to or from fraud prevention agencies and how that information may be used can be obtained from the Home Office website.

I understand that if I am informing the Home Office that I have changed my gender, these details may in certain circumstances be shared with other Home Office colleagues. I consent to this, where necessary and understand that this information will only be shared in limited circumstances relating to identity and security in line with Section 22 of the Gender Recognition Act. I am aware they will otherwise be treated in confidence and that my rights under the Equality Act 2010, Data Protection Act 1998 and Article 8 of the European Convention on Human Rights will be unaffected.

Name

Signature Date

D D M M Y Y Y Y



Section P - representatives Declaration

If you are a representative acting in relation to this application you must complete the declaration below to show you have read and understood the representative’s declaration and to confirm that you are authorised to act on behalf of the applicant(s).

I have been appointed by the applicant(s) to act on their behalf in relation to this application which has been submitted online to the Home Office.

I confirm that I am aware of the contents of this application, including its supporting documents, and that the application is, to the best of my knowledge and belief, true and correct.

I confirm that I will promptly give the applicant all correspondence I receive from the Home Office about this application.

I am permitted to give immigration advice and immigration services by virtue of section 84 of the Immigration and Asylum Act 1999.

I am aware that it is an offence to do an act which facilitates a person who is not a citizen of the European Union to commit a breach of immigration law, knowing or having reasonable cause to believe that the act has this effect.

Name

Signature Date

D D m m Y Y Y Y

Name of your organisation:

Your position within the organisation:



Section Q - Supporting Documents

Fill in this part of the form to help us make sure that we have received your documents and to keep a record of them while they are with us.

From list “A”, tell us how many of each of the listed documents you have sent with this application. This is a standard list, you should only send in the documents from this list that are required for your application. At “B”, list any other documents you have sent and state how many in each case. Continue on a separate sheet if necessary.

A. Type of document How many? B. listed items How

many?

Passports

Biometric Residence Permit and/or travel documents

Police registration certificates

Evidence of care arrangements if you are under 18 years old

Passport Photographs

Marriage/civil partnership certificate (where not previously granted as dependant)

Full Birth certificates (applicants under 18 not previously granted as dependants)

Utility bills (water, Gas, Electric)

Bank statements

Council tax bill

Tier 1 or 5 PBS Dependant - GOV.UK

Documents

Transcript of Tier 1 or 5 PBS Dependant - GOV.UK