5 The address of the person named in 1. 8 Tick one of the boxes to show method of payment. 11 Tick the fee which you are paying.

(1)

FFLLRR((OO)) VVeerrssiioonn 0022//22000088 -- ppaaggee 11 ooff 1122

VViissiittoorr

OOvveerrsseeaass qquuaalliiffiieedd nnuurrssee oorr mmiiddwwiiffee

PPoossttggrraadduuaattee ddooccttoorr oorr ddeennttiisstt

AAuu ppaaiirr

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FFLLRR((OO))

TThhiiss ffoorrmm iiss vvaalliidd oonnllyy ffoorr aapppplliiccaattiioonnss mmaaddee oonn oorr aafftteerr

2299 FFeebbrruuaarryy 22000088

AA PP PP LL II CC AA TT II OO NN FF OO RR AA NN

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aa ssppeecciiffiieedd ffoorrm

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muusstt bbee uusseedd ffoorr aallll aapppplliiccaattiioonnss ffoorr tthhee ppuurrppoosseess

ssttaatteedd oonn tthhiiss ppaaggee aanndd lliisstteedd iinn sseeccttiioonn 33 m

maaddee oonn oorr aafftteerr tthhaatt ddaattee..

YYoouu aallssoo nneeeedd tthhee sseeppaarraattee gguuiiddaannccee nnootteess ffoorr tthhiiss ffoorrm

m.. PPlleeaassee rreeaadd

tthheem

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maakkiinngg yyoouurr aapppplliiccaattiioonn.. IIff yyoouu ddoo nnoott aallrreeaaddyy hhaavvee tthheem

m,,

yyoouu ccaann ggeett tthheem

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m oouurr wweebbssiittee aatt wwwwww..bbiiaa..hhoom

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ccaalllliinngg 00887700 224411 00664455..

OOuurr aapppplliiccaattiioonn ffoorrm

mss cchhaannggee ppeerriiooddiiccaallllyy.. IIff yyoouu oobbttaaiinn tthhiiss ffoorrm

m ssoom

mee

ttiim

mee bbeeffoorree aappppllyyiinngg,, pplleeaassee cchheecckk tthhaatt iitt iiss ssttiillll tthhee vveerrssiioonn wwhhiicchh m

muusstt

bbee uusseedd wwhheenn yyoouu aarree rreeaaddyy ttoo aappppllyy..

AApppplliiccaattiioonnss oonn tthhiiss ffoorrm

m m

maayy bbee m

maaddee bbyy ppoosstt oorr iinn ppeerrssoonn aatt oonnee ooff oouurr

ppuubblliicc eennqquuiirryy ooffffiicceess.. TToo aappppllyy iinn ppeerrssoonn,, yyoouu m

muusstt m

maakkee aann

aappppooiinntt--m

meenntt..

IIff yyoouu aappppllyy bbyy ppoosstt,, yyoouu m

muusstt sseenndd yyoouurr aapppplliiccaattiioonn ttoo tthhee ffoolllloowwiinngg

aaddddrreessss::

BBoorrddeerr aanndd IIm

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miiggrraattiioonn AAggeennccyy

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maaiinn -- FFLLRR((OO))

PPOO BBooxx 449955

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WOORRKKIINNGG TTOOGGEETTHHEERR TTOO PPRROOTTEECCTT TTHHEE PPUUBBLLIICC

(2)

TTHHEE FFEEEE

For applications on this form, there is a fee of ££339955 for appli-cations made by post or ££559955 for appliappli-cations made in person at our public enquiry offices. Applying by post takes longer. There is only one fee per application form.

You may include your spouse, civil partner, unmarried or same sex partner and/or children under the age of 18 for no addi-tional fee if they are applying as your dependants. But they must pay the prescribed fee if they apply separately. In the vviissiittoorr,, aauu ppaaiirr and pprriivvaattee mmeeddiiccaall ttrreeaattmmeenntt

categories, the immigration rules do not allow dependants, so their application(s) will be refused if you include them in your application. See the separate guidance notes mentioned on the front of this form for more information.

In the ppoossttggrraadduuaattee ddooccttoorr oorr ddeennttiisstt and ddeeppeennddaannttss ooff eexxeemmpptt HHMM FFoorrcceess categories, the rules only allow spouses or civil partners as partners.

Children aged 18 or over cannot be included. They must apply individually and pay the prescribed fee in each case.

HHOOWW CCAANN YYOOUU PPAAYY??

You must pay by one of the methods specified below: •Cheque

•Postal Order

•Credit card - Visa (including Electron) or MasterCard only •Debit card - Delta, Maestro* or Switch (including Solo) •Banker’s draft

•Cash - but only for applications at a public enquiry office; pplleeaassee ddoonn’’tt sseenndd ccaasshh bbyy ppoosstt.

* MMaaeessttrroo - we will accept any Maestro card if you are apply-ing in person at a public enquiry office but only Maestro cards issued in the UK if you are applying by post.

YYoouurr aapppplliiccaattiioonn iiss iinnvvaalliidd iiff yyoouu ddoo nnoott ppaayy tthhee ffeeee iinn ffuullll oorr iiff yyoouu ppaayy bbyy aannyy mmeetthhoodd ootthheerr tthhaann tthhoossee ssppeecciiffiieedd hheerree.. CCHHEEQQUUEESS AANNDD PPOOSSTTAALL OORRDDEERRSS

You must make the cheque or postal order(s) payable to ‘‘HHoommee OOffffiiccee LLeeaavvee ttoo RReemmaaiinn’’ and cross the cheque or postal order(s) AA//CC PPaayyeeee oonnllyy.

Write the full name, nationality and date of birth of the main applicant on the back of the cheque and/or each postal order and keep the postal order stub(s).

Make sure that the date and the amount (words and figures) are correct and that the cheque is signed properly.

If applying by post, attach your cheque or postal order(s) to the front of the application form.

If applying in person at a public enquiry office and paying by cheque, you must have a cheque guarantee card with a limit sufficient to cover the amount to be paid.

CCOOMMPPLLEETTIINNGG TTHHEE PPAAYYMMEENNTT DDEETTAAIILLSS PPAAGGEE

To ensure that your payment is processed without any delay, please follow the guidance below when completing the next page.

AApppplliiccaanntt’’ss ddeettaaiillss ((11 -- 55))

11 Full name of main applicant as given in his or her passport or travel document.

22 Nationality of main applicant. If more than 25 letters, please abbreviate..

33 Date of birth - for example, 3 January 1980 should be written 03 01 1980 in the spaces provided.

44 Home Office reference if you have one (it should be a letter and seven numbers, such as A1234567). 55 The address of the person named in 1.

NNaammee aanndd aaddddrreessss ffoorr ccoorrrreessppoonnddeennccee iiff ddiiffffeerreenntt ffrroomm tthhoossee ooff tthhee aapppplliiccaanntt ((66 -- 77))

66//77 If a solicitor or other authorised immigration adviser is submitting the application, give their name and address at 6 and 7 for any correspondence about payment issues. The address must be in the UK. M

Meetthhoodd ooff ppaayymmeenntt ((88 -- 1155))

88 Tick one of the boxes to show method of payment. 99 If paying by cheque, enter the cheque number,

account number and bank sort code.

1100 If paying by card, tick one of the 5 boxes to show the type of card.

1111 Tick the fee which you are paying. 1122 Complete 12-15 only if paying by card.

1144 The card security number is a three-digit security code known as the card verification value (CVV). It consists of the last three numbers on the signature strip on the back of the card as shown below.

1155 It is the cardholder named on the credit/debit card who must sign and date.

GGUUIIDDAANNCCEE OONN CCOOM

MPPLLEETTIINNGG PPAAYYM

MEENNTT DDEETTAAIILLSS

3455 123

123

(3)

11

AAPPPPLLIICCAANNTT’’SS DDEETTAAIILLSS

NNAAMMEE AANNDD AADDDDRREESSSS IINN TTHHEE UUKK FFOORR CCOORRRREESSPPOONNDDEENNCCEE IIFF DDIIFFFFEERREENNTT FFRROOMM TTHHOOSSEE OOFF TTHHEE AAPPPPLLIICCAANNTT

M

MEETTHHOODD OOFF PPAAYYMMEENNTT FFuullll nnaammee

NNaattiioonnaalliittyy

DDaattee ooff bbiirrtthh HHoommee OOffffiiccee rreeffeerreennccee iiff yyoouu hhaavvee oonnee

PPoossttaall oorrddeerr CChheeqquuee Account number Cheque number PPaayyiinngg bbyy ccaarrdd AAmmoouunntt NNaammee oonn ccaarrdd CCaarrddhhoollddeerr’’ss ssiiggnnaattuurree M Maaeessttrroo VViissaa //

EElleeccttrroonn MMaasstteerrCCaarrdd DDeellttaa SSwwiittcchh //_SSoolloo

Sort code

DDaattee AAddddrreessss

PPoossttccooddee

PPlleeaassee ccoommpplleettee tthhiiss ppaaggee iinn bblloocckk ccaappiittaallss aanndd bbllaacckk iinnkk..

Day Month Year

DDeebbiitt oorr

ccrreeddiitt ccaarrdd BBaannkkeerr’’ssddrraafftt PPaayymmeenntt mmeetthhoodd -- pplleeaassee ttiicckk

PP AA YY M

M EE NN TT DD EE TT AA II LL SS :: FF LL RR (( OO ))

-- pplleeaassee sseeee gguuiiddaannccee bbeeffoorree ccoommpplleettiinngg

PPaayyiinngg bbyy cchheeqquuee 22 33 44 55 66 77 88 99

11 00 PPlleeaassee ddeebbiitt mmyy::

11 11 11 22 11 33 11 44 11 55 AApppplliiccaanntt’’ss aaddddrreessss

CCaarrdd nnuummbbeerr

CCaarrdd ddeettaaiillss VVaalliidd ffrroomm IIssssuuee NNoo.. ((wwhheerree aavvaaiillaabbllee)) EExxppiirryy ddaattee CCaarrdd sseeccuurriittyy nnuummbbeerr -- CCVVVV PPoossttccooddee

££339955

-- ppoossttaall

££559955

-- pprreemmiiuumm PPlleeaassee ttiicckk tthhee aammoouunntt yyoouu aarree ppaayyiinngg

(4)

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’s important

that the rest of the form begins with

Section 1 - Applicant’s Details facing

upwards.

(5)

Your full name as in your passport or travel document

Surname or family name

Passport or travel document number Home Office reference if you have one 11..33

11..44

11..66

Any other name(s) by which you are or have been known

11..77

National insurance number if you have one

11..88 11..99

11..1100

Nationality

Your UK address - please inform us immediately if this changes

Your daytime telephone number

11..1144

Your e-mail address if you have one

Your mobile telephone number if you have one Postcode

Name and address in the UK for all correspondence about your application if different from 11..1100 11..1133

If you have completed 11..1133 and the address is that of your immigration adviser, please state their Office of the Immigration Services Commissioner (OISC) number

11..1111 11..55

11..1122

FFLLRR((OO))

Your title - please tick

Your date of birth If ootthheerr, what is your title? 11..11

11..22

Day Month Year

SS EE CC TT II OO NN 11 -- AA PP PP LL II CC AA NN TT ’’ SS DD EE TT AA II LL SS

Mr Mrs Miss Ms Other

Your gender - please tick Male Female SSttaappllee hheerree

Attach two identical photographs of you

(the applicant) here with staple or

paper clip DDoo nnoott uussee gglluuee oorr ootthheerr ssttiicckkyy aaddhheessiivvee

TThhiiss ffoorrmm iiss vvaalliidd oonnllyy ffoorr aapppplliiccaattiioonnss mmaaddee oonn oorr aafftteerr

2299 FFeebbrruuaarryy 22000088

Postcode

VViissiittoorr

OOvveerrsseeaass qquuaalliiffiieedd nnuurrssee oorr mmiiddwwiiffee

PPoossttggrraadduuaattee ddooccttoorr oorr ddeennttiisstt

AAuu ppaaiirr

UUKK aanncceessttrryy

EEmmppllooyymmeenntt nnoott rreeqquuiirriinngg aa wwoorrkk ppeerrmmiitt

W

Wrriitteerr,, ccoommppoosseerr oorr aarrttiisstt PPrriivvaattee mmeeddiiccaall ttrreeaattmmeenntt DDeeppeennddaannttss ooff eexxeemmpptt HHMM FFoorrcceess OOtthheerr ppuurrppoosseess// rreeaassoonnss nnoott ccoovveerreedd bbyy ootthheerr aapppplliiccaattiioonn ffoorrmmss

(6)

Your partner’s full name

Nationality

Date of birth Gender

-please tick Relationship to you -please tick Day

SS EE CC TT II OO NN 22 -- DD EE PP EE NN DD AA NN TT SS II NN CC LL UU DD EE DD II NN YY OO UU RR AA PP PP LL II CC AA TT II OO NN

Male Female Year

IIff yyoouu hhaavvee aa ppaarrttnneerr aanndd//oorr aannyy cchhiillddrreenn uunnddeerr 1188 lliivviinngg iinn tthhee UUKK wwhhoo aarree aappppllyyiinngg ffoorr aann eexxtteennssiioonn ooff ssttaayy iinn tthhee UUKK aass yyoouurr ddeeppeennddaannttss,, tthhiiss iiss wwhheerree yyoouu ggiivvee tthheeiirr ddeettaaiillss.. TThhee wwoorrdd ““ppaarrttnneerr”” iinn tthhiiss ffoorrmm mmeeaannss yyoouurr ssppoouussee,, cciivviill ppaarrtt--nneerr,, uunnmmaarrrriieedd oorr ssaammee sseexx ppaarrttnneerr.. IInn tthhee ppoossttggrraadduuaattee ddooccttoorr oorr ddeennttiisstt ccaatteeggoorryy aanndd ffoorr ddeeppeennddaannttss ooff eexxeemmpptt HHMM FFoorrcceess,, oonnllyy aa ssppoouussee oorr cciivviill ppaarrttnneerr mmaayy bbee iinncclluuddeedd aass aa ppaarrttnneerr iinn tthhiiss sseeccttiioonn.. IIff mmoorree tthhaann 33 cchhiillddrreenn aarree aappppllyyiinngg,, pplleeaassee ggiivvee tthheeiirr ddeettaaiillss,, wwiitthh pphhoottooggrraapphhss,, oonn aa pphhoottooccooppyy ooff tthhiiss ppaaggee aanndd eenncclloossee iitt wwiitthh tthhiiss ffoorrmm.. CChhiillddrreenn aaggeedd 1188 oorr oovveerr mmuusstt aappppllyy sseeppaarraatteellyy..

TThhee rruulleess ffoorr tthhee vviissiittoorr,, aauu ppaaiirr aanndd pprriivvaattee mmeeddiiccaall ttrreeaattmmeenntt ccaatteeggoorriieess ddoo nnoott aallllooww ddeeppeennddaannttss -- sseeee gguuiiddaannccee nnootteess..

Child’s full name

Nationality

Date of birth Day Month Year Gender -please tick

Male

Child’s full name

Nationality

Male Female

Child’s full name

Nationality

Male Female Relationship to you - please tick

Relationship to you - please tick

Female Daughter Son Daughter Son Daughter Son

Spouse Civil partner Unmarried partner Same sex partner

Month

Attach two identical photographs of your child here with staple or

paper clip DDoo nnoott uussee gglluuee oorr ootthheerr ssttiicckkyy aaddhheessiivvee Attach two identical

photographs of your partner here with staple or

(7)

PPlleeaassee ttiicckk aa bbooxx bbeellooww ttoo sshhooww uuss tthhee ccaatteeggoorryy iinn wwhhiicchh yyoouu aarree aappppllyyiinngg ffoorr aann eexxtteennssiioonn ooff ssttaayy iinn tthhee UUKK..

Visitor

Employment not requiring a work permit

Writer, composer or artist

UK ancestry

SS EE CC TT II OO NN 33 -- W

W HH II CC HH CC AA TT EE GG OO RR YY ??

Overseas qualified nurse or midwife

Private medical treatment Dependants of exempt HM Forces

Other purposes/reasons not covered by other application forms

SSEETT((OO)) VVeerrssiioonn 0044//22000077 -- ppaaggee 66 ooff 1144

44 .. 22 Do you or your partner, or both, pay any rent or mortgage for your home?

Does a relative or friend of you or your partner, or both of you, regularly give you money?

If so, how much do you receive each month?

44 .. 33 Are you working in the UK? If so, what is your pay each month after income tax and other deductions?

Are you receiving any public funds?

NNoo

YYeess

_££

££

If so, how much do you pay each month?

SS EE CC TT II OO NN 44 -- YY OO UU RR HH OO M

M EE AA NN DD FF II NN AA NN CC EE SS

44 .. 44 44 .. 55 NNoo YYeess NNoo YYeess NNoo YYeess

TThhee ppuubblliicc ffuunnddss wwhhiicchh aarree rreelleevvaanntt ffoorr tthhee ppuurrppoosseess ooff tthhee IImmmmiiggrraattiioonn RRuulleess aarree lliisstteedd bbeellooww.. IIff yyoouu hhaavvee aannsswweerreedd yyeess ttoo qquueessttiioonn 44..55,, yyoouu mmuusstt ttiicckk tthhee rreelleevvaanntt bbooxx((eess)) ttoo sshhooww wwhhiicchh ooff tthheessee aarree bbeeiinngg rreecceeiivveedd.

44 .. 11 a) owned by you? Is your home in the UK: c) privately rented by you? b) rented from a local council or housing association by you? d) owned or rented by a relative or friend? e) other? Give details below Postgraduate doctor or dentist Au pair

If you have ticked the ootthheerr ppuurrppoosseess//rreeaassoonnss category, please explain briefly why you are applying for an extension of stay in the UK. You will also need to provide a letter explaining in more detail why you are applying.

Severe Disablement Allowance

Carer’s Allowance Disability Living

Allowance Income Support Working Tax Credit

Social Fund Payment Council Tax Benefit

Child Benefit

Income-based

Jobseeker’s Allowance

Housing Benefit

State Pension Credit

Child Tax Credit Housing or Homeless-ness assistance Attendance Allowance

(8)

55 .. 11 Do you or any dependants included in this application have any criminal convictions in the UK or

any other country (including traffic offences) or any civil judgments made against you? YYeess NNoo

SS EE CC TT II OO NN 55 -- PP EE RR SS OO NN AA LL HH II SS TT OO RR YY

If you have answered yyeess to question 55..11 above, give details below for each criminal conviction and/or civil judgment, starting with the most recent one - but first see NNoottee 11 about criminal convictions. If you or any dependants included in this application have received more than two convictions and/or civil judgments, give details on a copy of this page and enclose it with this form.

Date of sentence/judgment Details of the sentence or civil judgment (give details on separate sheet if you need more space)

Country where the sentence was passed or the civil judgment was made

55 .. 22 Have you or any dependants included in this application ever been charged in any country with a criminal offence for which you have not yet been tried in court?

YYeess NNoo 55 .. 33 In times of either peace or war have you or any dependants included in this application ever

been involved, or suspected of involvement, in war crimes, crimes against humanity or geno-cide?

Nature of the criminal offence or the civil action (give details on a separate sheet and enclose it with this form if you need more space)

55 .. 44

Have you or any dependants included in this application ever been a member of, or given sup-port to, an organisation which has been concerned in terrorism?

Have you or any dependants included in this application ever, by any means or medium, expressed views that justify or glorify terrorist violence or that may encourage others to ter-rorist acts or other serious criminal acts?

NNaammee ooff ppeerrssoonn ccoonnvviicctteedd oorr aaggaaiinnsstt wwhhoomm aa cciivviill jjuuddggmmeenntt wwaass mmaaddee

NNoottee 11 CCoonnvviiccttiioonnss ssppeenntt uunnddeerr tthhee RReehhaabbiilliittaattiioonn ooff OOffffeennddeerrss AAcctt 11997744 nneeeedd nnoott bbee ddiisscclloosseedd.. MMoorree iinnffoorrmmaattiioonn aabboouutt tthhee AAcctt iiss ggiivveenn ttoowwaarrddss tthhee eenndd ooff tthhiiss sseeccttiioonn..

55 .. 55 YYeess

YYeess

YYeess NNoo

NNoo

NNoo Have you or any dependants included in this application ever been involved in, supported or

encouraged terrorist activities in any country?

YYeess NNoo

55 .. 66

Date of sentence/judgment

Country where the sentence was passed or the civil judgment was made NNaammee ooff ppeerrssoonn ccoonnvviicctteedd oorr aaggaaiinnsstt wwhhoomm aa cciivviill jjuuddggmmeenntt wwaass mmaaddee

Nature of the criminal offence or civil action (give details on separate sheet and enclose it with this form if you need more space)

Details of the sentence or civil judgment (give details on separate sheet if you need more space)

YYoouu mmuusstt aannsswweerr eevveerryy qquueessttiioonn iinn tthhiiss sseeccttiioonn oonn bbeehhaallff ooff yyoouurrsseellff aanndd aannyy ddeeppeennddaannttss iinncclluuddeedd iinn tthhiiss aapppplliiccaattiioonn.. IItt iiss aann ooffffeennccee uunnddeerr SSeeccttiioonn 2266((11))((cc)) ooff tthhee IImmmmiiggrraattiioonn AAcctt 11997711 ttoo mmaakkee aa ssttaatteemmeenntt oorr rreepprreesseennttaattiioonn wwhhiicchh yyoouu kknnooww ttoo bbee ffaallssee oorr ddoo nnoott bbeelliieevvee ttoo bbee ttrruuee.. IInnffoorrmmaattiioonn ggiivveenn wwiillll bbee cchheecckkeedd wwiitthh ootthheerr aaggeenncciieess..

YYoouu mmuusstt aannsswweerr qquueessttiioonnss 55..22 ttoo 55..77 bbeellooww eevveenn iiff yyoouu hhaavvee aannsswweerreedd nnoo ttoo qquueessttiioonn 55..11.. FFoorr hheellpp iinn aannsswweerriinngg tthheessee qquueessttiioonnss,, pplleeaassee sseeee tthhee ddeeffiinniittiioonnss oonn tthhee nneexxtt ppaaggee..

(9)

55 .. 77 Have you or any dependants included in this application ever engaged in any other activities which might indicate that you may not be considered to be persons of good character?

If you have answered yyeess to question 55..22,, 55..33,, 55..44,, 55..55,, 55..66 or 55..77 above, you must give further details in the space provided below. If you need more space, continue on a separate sheet and enclose it with this form.

YYeess NNoo

DDEEFFIINNIITTIIOONNSS

For the purposes of answering questions 55..33 to 55..77,, the following information provides guidance on actions which may constitute war crimes, crimes against humanity, genocide, or terrorist activities.

This guidance is not exhaustive. The full definitions of war crimes, crimes against humanity and genocide can be found in Schedule 8 of the International Criminal Court Act 2001 at wwwwww..ooppssii..ggoovv..uukk//aaccttss//aaccttss22000011//2200001100001177..hhttmm or purchased from The Stationery Office (telephone 00887700 660000 55552222). It is your responsibility to satisfy yourself that you are familiar with the definitions and can answer the questions accurately on behalf of yourself and any dependants included in the application.

W

Waarr ccrriimmeess

Grave breaches of the Geneva Conventions committed during an armed conflict. This includes an internal armed conflict and an international armed conflict. The types of acts that may constitute a war crime include wilful killing, torture, extensive destruction of property not justified by military necessity, unlawful deportation, the intentional targeting of civilians and the taking of hostages. CCrriimmeess aaggaaiinnsstt hhuummaanniittyy

Acts committed at any time (not just during armed conflict) as part of a widespread or systematic attack, directed against any civil-ian population with knowledge of the attack. This would include offences such as murder, torture, rape, severe deprivation of liber-ty in violation of fundamental rules of international law and enforced disappearance of persons.

GGeennoocciiddee

Acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group. TTeerrrroorriisstt aaccttiivviittiieess

Any act committed, or the threat of action, designed to influence a government or intimidate the public and made for the purposes of advancing a political, religious or ideological cause and that involves serious violence against a person; that may endanger anoth-er panoth-erson’s life; creates a sanoth-erious risk to the health or safety of the public; involves sanoth-erious damage to propanoth-erty; is designed to sanoth-eri- seri-ously disrupt or interfere with an electronic system.

OOrrggaanniissaattiioonnss ccoonncceerrnneedd iinn tteerrrroorriissmm

An organisation is concerned in terrorism if it commits or participates in acts of terrorism; prepares for terrorism; promotes or encourages terrorism (including the unlawful glorification of terrorism); or is otherwise concerned in terrorism.

RREEHHAABBIILLIITTAATTIIOONN OOFF OOFFFFEENNDDEERRSS AACCTT 11997744

The Rehabilitation of Offenders Act 1974 enables criminal convictions to become 'spent' or ignored after a 'rehabilitation period'. The length of the rehabilitation period depends on the sentence given. For a custodial (prison) sentence the rehabilitation period is decided by the original sentence, not the time served. Prison sentences of more than two and a half years can never become spent and should always be disclosed. Further information on rehabilitation periods can be found at Nacro's Resettlement Plus Helpline on 002200 77884400 66446644 or by obtaining a free copy of their leaflet on 002200 77884400 66442277.

SS EE CC TT II OO NN 55 -- PP EE RR SS OO NN AA LL HH II SS TT OO RR YY

(10)

NNoottee 22 WWee ddoo nnoott aacccceepptt iinntteerrnneett oorr ccaasshhppooiinntt ssttaatteemmeennttss aass eevviiddeennccee ooff ffiinnaanncceess.. IIff yyoouu ccllaaiimm tthhaatt aa rreellaattiivvee oorr ffrriieenndd iiss pprroovviidd--iinngg yyoouu wwiitthh ffiinnaanncciiaall ssuuppppoorrtt ((sseeee qquueessttiioonn 44..44)),, iinn aaddddiittiioonn ttoo eevviiddeennccee ooff yyoouurr oowwnn ffiinnaanncceess,, yyoouu mmuusstt pprroovviiddee bbaannkk ssttaatteemmeennttss oorr ootthheerr ddooccuummeennttss ooff tthhee kkiinndd ddeessccrriibbeedd aabboovvee aass eevviiddeennccee ooff tthheeiirr ffiinnaanncciiaall rreessoouurrcceess.. TThhee ddooccuummeennttss sshhoowwiinngg tthhee ffiinnaanncceess aavvaaiill--aabbllee ttoo yyoouu aanndd ttoo aannyy ppeerrssoonn ssuuppppoorrttiinngg yyoouu sshhoouulldd ccoovveerr aatt lleeaasstt tthhee llaasstt 33 mmoonntthhss..

EEvviiddeennccee ooff yyoouurr ffiinnaanncceess..

Bank statements, building society savings book, pay slips or other formal documents as evi-dence of your ability to maintain & accommodate yourself and any dependants without recourse to public funds. See NNoottee 22.

YYoouurr ccuurrrreenntt ppaassssppoorrtt oorr ttrraavveell ddooccuum

meenntt..

If you last entered the UK on a previous passport or travel document, please also provide this document if you have it.

CCuurrrreenntt ppaassssppoorrtt((ss)) oorr ttrraavveell ddooccuum

meenntt((ss)) ffoorr eeaacchh ddeeppeennddaanntt

included in section 2 and applying for an extension of stay in the UK with you. If they last entered the UK on previous passport(s) or travel document(s), please also provide these documents if you have them.

YYoouurr ppoolliiccee rreeggiissttrraattiioonn cceerrttiiffiiccaattee

if you have been asked to register with the police.

TThhee ppoolliiccee rreeggiissttrraattiioonn cceerrttiiffiiccaattee((ss)) ooff eeaacchh ddeeppeennddaanntt

included in section 2 and applying for an extension of stay in the UK with you if they have been asked to register with the police.

EEvviiddeennccee tthhaatt yyoouu ccaann mmaaiinnttaaiinn aanndd aaccccoommmmooddaattee yyoouurrsseellff aanndd yyoouurr ddeeppeennddaannttss wwiitthhoouutt rreeccoouurrssee ttoo ppuubblliicc ffuunnddss aanndd wwiitthh--oouutt ttaakkiinngg eemmppllooyymmeenntt.. The evidence must be formal documents such as bank/building society statements or savings book(s), or pay slips from your employment outside the UK (see NNoottee 22). If a relative or friend is sponsoring you, the evidence should be a letter from him/her confirming this, with formal documents showing their financial resources.

CCoonnffiirrmmaattiioonn ffrroomm tthhee NNuurrssiinngg aanndd MMiiddwwiiffeerryy CCoouunncciill ((NNMMCC)) that you have been accepted on the Overseas Nurses Programme, and evidence that you have been offered a supervised practice placement or adaptation training through an education provider that is recognised by the NMC.

VViissiittoorr

If applying as a visitor, you must provide:

NNoottee 33

YYoouu mmuusstt hhaavvee bbeeeenn ggrraanntteedd lleeaavvee aass aa ssttuuddeenntt ffoorr aatt lleeaasstt 22 yyeeaarrss iinn oorrddeerr ttoo ssttuuddyy ffoorr tthhiiss ddeeggrreeee..

PPoossttggrraadduuaattee ddooccttoorr oorr ddeennttiisstt

If applying as a postgraduate doctor or dentist, you must provide:

EEvviiddeennccee tthhaatt yyoouu hhaavvee oobbttaaiinneedd aa rreeccooggnniisseedd UUKK ddeeggrreeee in medicine or dentistry from an appropriate UK institution. See NNoottee 33.

AA lleetttteerr ffrroomm yyoouurr PPoossttggrraadduuaattee DDeeaann confirming that you have a full-time place on a recognised Foundation Programme. AA ddooccuummeenntt ccoonnffiirrmmiinngg tthhaatt yyoouurr ssppoonnssoorr ccoonnsseennttss ttoo yyoouurr ccoonnttiinnuuiinngg ssttaayy iinn tthhee UUKK aass aa ppoossttggrraadduuaattee ddooccttoorr oorr ddeennttiisstt if your studies, at medical or dental school or subsequently, were sponsored by a government or an international sponsorship agency.

AA ssiiggnneedd ssttaatteemmeenntt ffrroomm yyoouu confirming that you know that 3 years is the maximum stay permitted in this category and that you intend to leave the UK no later than 3 years from the date on which you were given leave to enter or remain as a postgrad-uate doctor or dentist, unless you are granted leave in another permitted capacity. See NNoottee 44.

OOvveerrsseeaass qquuaalliiffiieedd nnuurrssee oorr m

miiddwwiiffee

If applying as an overseas qualified nurse or midwife, you must provide: 77 BB

77 CC

SS EE CC TT II OO NN 66 -- PP HH OO TT OO GG RR AA PP HH SS

TTwwoo rreecceenntt ppaassssppoorrtt--ssiizzee pphhoottooggrraapphhss ooff yyoouurrsseellff

with your name written on the back of each photograph. Please see the separate guidance notes for information on what types of photograph are acceptable.

TTwwoo rreecceenntt ppaassssppoorrtt--ssiizzee pphhoottooggrraapphhss ooff eeaacchh ddeeppeennddaanntt

included in section 2 and applying for an extension of stay in the UK with you, with their name written on the back of each photograph.

IItt iiss mmaannddaattoorryy ttoo pprroovviiddee tthhee pphhoottooggrraapphhss ssppeecciiffiieedd bbeellooww.. YYoouurr aapppplliiccaattiioonn wwiillll bbee iinnvvaalliidd iiff yyoouu ddoo nnoott.. TTiicckk tthhee bbooxx((eess)) nneexxtt ttoo tthhee rreelleevvaanntt iitteemmss ttoo sshhooww tthhee pphhoottooggrraapphhss yyoouu aarree pprroovviiddiinngg aanndd aattttaacchh tthheemm ttoo tthhee ssppaacceess iinn sseeccttiioonnss 11 aanndd 22 aass iinnssttrruucctteedd tthheerree..

SS EE CC TT II OO NN 77 -- DD OO CC UU M

M EE NN TT SS

YYoouu mmuusstt pprroovviiddee tthhee ddooccuummeennttss ssppeecciiffiieedd bbeellooww wwhhiicchh aarree rreelleevvaanntt ttoo yyoouurr aapppplliiccaattiioonn.. IIff yyoouu ddoo nnoott,, wwee rreesseerrvvee tthhee rriigghhtt ttoo ddeecciiddee yyoouurr aapppplliiccaattiioonn oonn tthhee bbaassiiss ooff tthhee iinnffoorrmmaattiioonn aanndd ddooccuummeennttss pprroovviiddeedd.. TTiicckk tthhee rreelleevvaanntt bbooxxeess ttoo sshhooww tthhee ddooccuummeennttss yyoouu aarree pprroovviiddiinngg.. TThheeyy mmuusstt bbee oorriiggiinnaallss..

77 AA

AAllll aapppplliiccaannttss

NNoottee 44

TThhiiss ccaatteeggoorryy ddooeess nnoott aallllooww uunnmmaarrrriieedd ppaarrttnneerrss oorr ssaammee sseexx ppaarrttnneerrss ttoo rreemmaaiinn aass ddeeppeennddaannttss..

(11)

77 EE

W

Wrriitteerr,, ccoom

mppoosseerr oorr aarrttiisstt

If applying as a writer, composer or artist, you must provide:

UUKK aanncceessttrryy

If you are a Commonwealth citizen aged 17 or over, one of your grandparents was born in the UK and Islands and you are applying because of your UK ancestry, you must provide:

SS EE CC TT II OO NN 77 -- DD OO CC UU M

M EE NN TT SS

AA lleetttteerr ffrroomm tthhee ffaammiillyy yyoouu aarree ssttaayyiinngg wwiitthh giving details of your employment.

AAuu ppaaiirr

If applying as an au pair, you must provide:

a) Minister of religion, missionary or member of a religious order (see NNootteess 55 and 66) b) Visiting religious worker or a religious worker in a non-pastoral role (see NNoottee 66) c) Representative of an overseas newspaper, news agency or broadcasting organisation d) Private servant in a diplomatic household

e) Overseas government employee

f) Airport based operational staff of an overseas-owned airline g) Domestic worker in a private household (see NNoottee 77)

EEm

mppllooyym

meenntt nnoott rreeqquuiirriinngg aa wwoorrkk ppeerrm

miitt

If you have been given leave to enter or remain in the UK for employ-ment in one of the categories not requiring a work permit listed below, and you are applying for an extension of stay in the same category, you must provide:

77 GG

NNoottee 55

FFoorr mmiinniisstteerrss ooff rreelliiggiioonn,, mmiissssiioonnaarriieess,, oorr mmeemmbbeerrss ooff aa rreelliiggiioouuss oorrddeerr tthhiiss ddooccuummeenntt mmaayy bbee ffrroomm tthhee lleeaaddeerrsshhiipp ooff

yyoouurr cchhuurrcchh oorr tthhee hheeaadd ooff yyoouurr rreelliiggiioouuss oorrddeerr,, rraatthheerr tthhaann yyoouurr eemmppllooyyeerr..

NNoottee 66

IIff yyoouu eenntteerreedd tthhee UUKK wwiitthh aann eennttrryy cclleeaarraannccee aass aa mmiinniisstteerr ooff rreelliiggiioonn oonn oorr aafftteerr 2233 AAuugguusstt 22000044,, oorr iiff yyoouu aarree ssoom

mee--oonnee wwhhoo ddiidd nnoott eenntteerr tthhee UUKK aass aa mmiinniisstteerr ooff rreelliiggiioonn,, yyoouu mmuusstt pprroovviiddee aann IInntteerrnnaattiioonnaall EEnngglliisshh LLaanngguuaaggee TTeessttiinngg SSyysstteemm cceerrttiiffii--ccaattee ddaatteedd nnoo mmoorree tthhaann 22 yyeeaarrss pprriioorr ttoo yyoouurr aapppplliiccaattiioonn ttoo cceerrttiiffyy tthhaatt yyoouu hhaavvee aacchhiieevveedd lleevveell 66 ccoommppeetteennccee iinn ssppookkeenn EEnngglliisshh..

NNoottee 77

DDoommeessttiicc wwoorrkkeerrss aarree rreeqquuiirreedd ttoo pprroovviiddee aa ccuurrrreenntt ssttaatteemmeenntt ooff tthheeiirr tteerrmmss aanndd ccoonnddiittiioonnss ooff eemmppllooyymmeenntt iinncclluuddiinngg ffuullll

ddeettaaiillss ooff tthheeiirr dduuttiieess,, ssiiggnneedd bbyy tthheemmsseellvveess aanndd tthheeiirr eemmppllooyyeerr.. TThheeyy sshhoouulldd aallssoo iinncclluuddee aa lleetttteerr ffrroomm tthheeiirr eemmppllooyyeerr ccoonnffiirrmmiinngg tthhaatt tthhee eemmppllooyymmeenntt iiss ccoonnttiinnuuiinngg aanndd tthhaatt tthhee eemmppllooyymmeenntt ccoommpplliieess wwiitthh UUKK lleeggiissllaattiioonn oonn tthhee NNaattiioonnaall MMiinniimmuumm WWaaggee..

YYoouurr ffuullll bbiirrtthh cceerrttiiffiiccaattee showing your parents’ names.

EEvviiddeennccee tthhaatt oonnee ooff yyoouurr ggrraannddppaarreennttss wwaass bboorrnn iinn tthhee UUKK aanndd IIssllaannddss.. The evidence must be formal documents such as full birth certificates for your parents and grandparent and, where necessary to establish the relationship, marriage certificates and/or adoption papers.

DDooccuummeenntt((ss)) sshhoowwiinngg tthhaatt yyoouu ccaann ssuuppppoorrtt yyoouurrsseellff aanndd aannyy ddeeppeennddaannttss from your own funds without working except as a writer, composer or artist.

PPrriivvaattee m

meeddiiccaall ttrreeaattm

meenntt

If applying as a visitor receiving private medical treatment, you must provide:

DDooccuummeenntt((ss)) ffrroomm aa rreeggiisstteerreedd mmeeddiiccaall pprraaccttiittiioonneerr who holds a National Health Service (NHS) consultant’s post or who appears in the Specialist Register of the General Medical Council, detailing the nature of the illness; showing satisfactory arrangements for private medical consultation or treatment; how long it is likely to last; the frequency of consultations; the likely total cost of the treatment; confirming that all expenses are being met; giving the likely prognosis; and, where treatment has begun, evidence as to its current progress. See NNoottee 88.

NNoottee 88

VViissiittoorrss aarree nnoott aalllloowweedd ttoo ssttaayy iinn tthhee UUKK ttoo rreecceeiivvee ffrreeee mmeeddiiccaall ttrreeaattmmeenntt oonn tthhee NNaattiioonnaall HHeeaalltthh SSeerrvviiccee ((NNHHSS)).. TThhoossee

wwhhoo aarree iinn tthhee UUKK ffoorr tthhee ppuurrppoossee ooff uunnddeerrggooiinngg pprriivvaattee mmeeddiiccaall ttrreeaattmmeenntt wwiillll nnoott bbee eelliiggiibbllee ffoorr ffrreeee NNHHSS hhoossppiittaall ttrreeaattmmeenntt dduurr--iinngg tthheeiirr vviissiitt,, eevveenn aafftteerr aa ssttaayy ooff 1122 mmoonntthhss..

77 FF

77 HH

77 II

RReecceenntt ddooccuummeenntt((ss)) ffrroomm yyoouurr eemmppllooyyeerr confirming that your work is continuing and that you are still needed for the same work.

DDooccuummeenntt((ss)) sshhoowwiinngg tthhaatt yyoouu aarree aabbllee ttoo wwoorrkk and intend to take or seek employment in the UK.

AA ssiiggnneedd ssttaatteemmeenntt that you intend to leave the UK at the end of your treatment. RReecceeiippttss ffoorr ppaayymmeenntt for any treatment you have received.

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I hereby apply for an extension of stay in the UK for myself and any dependants listed in this form. The information I have given in this form is complete and is true to the best of my knowledge. I also declare that the photographs sub-mitted with this form are a true likeness of myself and any dependants included in the application, as named on the back of each photograph.

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

I understand that all information provided by me to the Home Office will be treated in confidence; that it may be dis-closed to other government departments, agencies, local authorities, the police, foreign governments and other bod-ies for immigration purposes or to enable them to perform their functions; and that, if such bodbod-ies provide the Home Office with any information about me which may be relevant for immigration purposes, it may be used in reaching a decision on my application.

I understand that documents provided in support of this application will be checked for authenticity. False documents will be retained and may result in my application being refused and my case being referred to the UK Immigration Service and other relevant authorities for the purposes of my prosecution and subsequent removal from the United Kingdom.

I understand that the Home Office may also use the information provided by me for training purposes.

II aamm aawwaarree tthhaatt iitt iiss aann ooffffeennccee uunnddeerr tthhee IImmmmiiggrraattiioonn AAcctt 11997711,, aass aammeennddeedd bbyy tthhee IImmmmiiggrraattiioonn aanndd AAssyylluumm AAcctt 11999999 aanndd tthhee NNaattiioonnaalliittyy,, IImmmmiiggrraattiioonn aanndd AAssyylluumm AAcctt 22000022,, ttoo mmaakkee ttoo aa ppeerrssoonn aaccttiinngg iinn eexxeeccuuttiioonn ooff aannyy ooff tthhoossee AAccttss aa ssttaatteemmeenntt oorr rreepprreesseennttaattiioonn wwhhiicchh II kknnooww ttoo bbee ffaallssee oorr ddoo nnoott bbeelliieevvee ttoo bbee ttrruuee,, oorr ttoo oobbttaaiinn oorr ttoo sseeeekk ttoo oobbttaaiinn lleeaavvee ttoo rreemmaaiinn iinn tthhee UUnniitteedd KKiinnggddoomm bbyy mmeeaannss wwhhiicchh iinncclluuddee ddeecceeppttiioonn..

IItt iiss mmaannddaattoorryy ttoo ssiiggnn tthhee ddeeccllaarraattiioonn bbeellooww..

YYoouurr aapppplliiccaattiioonn wwiillll bbee iinnvvaalliidd iiff iitt iiss nnoott ssiiggnneedd aass ssppeecciiffiieedd..

SS EE CC TT II OO NN 88 -- DD EE CC LL AA RR AA TT II OO NN

Signature

Date

SS EE CC TT II OO NN 77 -- DD OO CC UU M

M EE NN TT SS

AA lleetttteerr oorr ootthheerr ddooccuummeenntt eexxppllaaiinniinngg wwhhyy yyoouu aarree aappppllyyiinngg ffoorr aann eexxtteennssiioonn ooff ssttaayy,, ttooggeetthheerr wwiitthh aannyy rreelleevvaanntt ddooccuummeennttss iinn ssuuppppoorrtt ooff yyoouurr ccaassee. Please list the documents you are providing.

If applying as the spouse or civil partner (see NNoottee 99) of someone who is exempt from UK immigration control as a member of HM Forces, you must provide aa lleetttteerr ffrroomm yyoouurr ssppoouussee oorr cciivviill ppaarrttnneerr''ss uunniitt ccoonnffiirrmmiinngg tthhee ddaattee tthheeyy eennlliisstteedd aanndd tthheeiirr eexxppeecctteedd ffiinnaall ddaattee ooff sseerrvviiccee wwiitthh HHMM FFoorrcceess..

If applying as the spouse or civil partner (see NNoottee 99) of someone who is exempt from UK immigration control on the basis of their armed forces training, posting or service in the UK or as a member of a designated international headquarters or defence organisation,, you must provide aa lleetttteerr ffrroomm yyoouurr ssppoouussee oorr cciivviill ppaarrttnneerr’’ss uunniitt oorr eemmppllooyyeerr ccoonnffiirrmmiinngg tthhee ssttaarrtt ddaattee ooff tthheeiirr ttrraaiinniinngg,, ppoossttiinngg oorr sseerrvviiccee iinn tthhee UUKK aanndd tthhee eexxppeecctteedd eenndd ddaattee ooff tthhiiss ppeerriioodd ooff ttrraaiinniinngg,, ppoossttiinngg oorr sseerrvviiccee iinn tthhee UUKK..

DDeeppeennddaanntt ooff eexxeem

mpptt m

meem

mbbeerr ooff HHM

M FFoorrcceess

oorr ooff ddeessiiggnnaatteedd iinntteerrnnaattiioonnaall HHQQ oorr ddeeffeennccee oorrggaanniissaattiioonn

OOtthheerr ppuurrppoosseess//rreeaassoonnss nnoott ccoovveerreedd bbyy ootthheerr aapppplliiccaattiioonn ffoorrm

mss

If applying for an extension of stay for other purposes or reasons, you must provide:

NNoottee 99

TThhiiss ccaatteeggoorryy ddooeess nnoott iinncclluuddee uunnmmaarrrriieedd ppaarrttnneerrss oorr ssaammee sseexx ppaarrttnneerrss..

77 JJ

77 KK

YYoouu mmuusstt nnooww rreeaadd tthhee ddeeccllaarraattiioonn bbeellooww aanndd ssiiggnn iitt.. TThhiiss mmuusstt bbee ssiiggnneedd bbyy yyoouu ((tthhee aapppplliiccaanntt)) aanndd nnoott bbee aa rreepprreesseenn--ttaattiivvee oorr ootthheerr ppeerrssoonn aaccttiinngg oonn yyoouurr bbeehhaallff.. IIff yyoouu aarree uunnddeerr 1188,, yyoouurr ppaarreenntt oorr gguuaarrddiiaann mmaayy ssiiggnn..

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PP HH OO TT OO GG RR AA PP HH SS AA NN DD DD OO CC UU M

M EE NN TT SS CC HH EE CC KK LL II SS TT

PPlleeaassee ccoommpplleettee tthhiiss ppaarrtt ooff tthhee ffoorrmm ttoo hheellpp uuss cchheecckk tthhaatt wwee hhaavvee rreecceeiivveedd yyoouurr pphhoottooggrraapphhss aanndd ddooccuummeennttss,, aanndd ttoo kkeeeepp aa rreeccoorrdd ooff tthheemm wwhhiillee tthheeyy aarree wwiitthh uuss.. AAtt ““AA””,, tteellll uuss hhooww mmaannyy ooff eeaacchh ooff tthhee lliisstteedd iitteemmss yyoouu aarree pprroovviiddiinngg wwiitthh yyoouurr aapppplliiccaattiioonn.. AAtt ““BB””,, lliisstt aannyy ootthheerr ddooccuummeennttss pprroovviiddeedd bbyy yyoouu aanndd ssttaattee hhooww mmaannyy iinn eeaacchh ccaassee.. CCoonnttiinnuuee oonn aa sseepp--aarraattee sshheeeett iiff nneecceessssaarryy aanndd eenncclloossee iitt wwiitthh tthhiiss ffoorrmm.. AAllll ddooccuummeennttss mmuusstt bbee oorriiggiinnaallss..

BBoorrddeerr aanndd IIm

mm

miiggrraattiioonn AAggeennccyy

LLeeaavvee ttoo RReem

maaiinn -- FFLLRR((OO))

PPOO BBooxx 449955

DDuurrhhaam

m

DDHH9999 11W

WRR

FF II NN AA LL CC HH EE CC KK SS

Finally, please make sure that the application is addressed exactly as shown below. Is FLR(O) the right form for you and is it valid for use?

See date and notes on front page. Have you completed the payment details page and madethe correct payment? Have you ticked a box in section 3 to show the category

in which you are applying? Have you completed section 5 and the rest of theform as specified?

TToo eennssuurree tthhaatt yyoouurr aapppplliiccaattiioonn iiss vvaalliidd aanndd ccoommpplleettee,, pplleeaassee mmaakkee tthhee ffoolllloowwiinngg ffiinnaall cchheecckkss.. TTiicckk eeaacchh bbooxx tthhaatt iiss rreelleevvaanntt ttoo yyoouurr aapppplliiccaattiioonn..

Have you provided the photographs specified in section 6?

If you are unable to send us any of the documents specified in section 7 which are relevant to your appli-cation, have you given an explanation and said when you will be able to send them?

Have you, or a parent or guardian if you are under 18, signed and dated the declaration in section 8?

Have you provided your current passport(s) or travel doc-ument(s) and all other relevant documents specified in section 7 and they are originals?

Photographs of yourself

Photographs of any dependants applying Passports and/or travel documents Police registration certificates

Letter/documents from your employer Birth certificate

Bank statements

Building society savings books Pay slips