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Reference:
Two recent
photographs to be
attached here
Transit
Visitor
six months
one year
Two years
five years
Student
Settlement
Long Stay:
Returning resident
Dependant of any applicant in long stay categories
Permit free employment/Retired Person of Independent
Means/Investor
Working Holidaymaker/Work permit holder/Innovator or to
establish a business/Highly Skilled Migrant Programme (HSMP)
Yes
No
4. Sex
5. Place of birth
9. Country of residence
Married
Single
Divorced
Widowed
Separated
Place of issue
Date of expiry
Complete here if dependants included on your passport are travelling with you
Name
Place Of Birth
Page 1
Date Of Birth
Relationship To You
Nationality
Yes
No
Place of issue
Number
Place of issue
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
20. Have you ever been a charge on public funds in the UK?
Yes
No
(1) Private
(2) Business
(3) Family
(4) Other
and relationship to you
Yes
No
Please specify
24. Date of arrival
Yes
Telephone number
No
Date
Drugs Warning
The UK has severe penalties against drug smuggling. Drug traffickers may try to bribe travellers. If
you are travelling to the UK avoid any involvement with drugs.
Issue
Refuse
Tier
Category
Type
Date Effective
Check 1
Date Of Expiry
Check 2
Authorising
ECO
Code
Date
Police Y/N?
Vignette Number