Application for a United Kingdom Emergency Travel Document
Please supply the following: > Passport sized photograph > Police report (for lost and stolen passports) > Correct fee > Form of personal identification Please complete in black ink in block capitals 1 Applicant details Title Forenames Place of birth
(city and country)
Surname Date of birth
House name/number & street name Town/City Country Contact tel no. Postcode Email address Home tel no. No
Is or has the Applicant been known by any other name? Yes
(if you answered Yes, please provide other names below)
Forenames Forenames Forenames
Surname Surname Surname
2 Why are you making this application for an Emergency Travel Document? The Passport is (tick one of the following) If Other please supply further information 3 Details of the lost, stolen, expired or (other) passport Was the Passport issued in the UK? Yes No Country and City
(Complete if passport issued outside the UK)
Lost
Stolen
Expired
Other
Passport number (If known) Nationality
(State Nationality shown on passport if known)
Date of issue (If known)
If you are not the applicant named above please provide your details below Title Forenames Place of birth Relationship to applicant
FCO007v4
Surname Date of birth Country of birth
(If you are applying for an ETD on behalf of the applicant, please indicate your relationship to them)
4 Details of where and when lost/stolen passport last seen Place of loss/theft
(e.g. airport name, town)
Date of loss/theft
Country of loss/theft Circumstances of loss/theft Have local police been notified? If Yes, please provide details Police station Details
If Yes, please provide details
Yes
No
Date reported to Police
Police Report Number Yes No
Have you previously reported your/any passport lost or stolen?
5 Details of journey to your required destination Departure date Countries transited Mode(s) of transport
(tick all that apply)
Arrival date at destination Plane Train Boat Car Coach Other
If Other please supply further information Country of final destination 6 Declaration
You are warned that the making of an untrue statement for the purpose of procuring a passport is a criminal offence I am 16 years or over, I understand and declare that: 1 The person named in section 1 has not previously held a passport or other travel document of any description, or been included in one, other than that stated on this application 2 This application does not break the terms of any court order in any jurisdiction 3 No one included in this application owes money to Her Majestys Government for repatriation or similar relief 4 The person named in section 1 has not been adopted outside the United Kingdom (or a qualifying territory), unless mentioned on this application 5 The person named in section 1 is a British citizen, or British National (Overseas), or British Overseas Territories citizen, 6 or British Overseas citizen, or British subject, or British protected person or an EU national or Commonwealth national and has not lost or renounced this status 7 I, or the person named in section 1 of this application (if different), understand that by voluntarily applying for a British passport, the person named in section 1 may lose citizenship of another country 8 If the person named in section 1 is under 16 years old, they do not hold a valid certificate of entitlement to the Right of Abode 9 The information on this application form is true to the best of my knowledge and belief and I understand that I shall be liable to prosecution and could face a prison sentence if I include anything that I know to be false or do not believe to be true 10 I understand that completing and returning this application form will result in any lost, stolen or otherwise unavailable passport being cancelled, that it may never be used again and if subsequently found, it should be returned to the Foreign and Commonwealth Office (FCO), nearest Consular Post or Identity and Passport Service (IPS) Regional Office immediately 11 I also understand that the FCO and IPS holds and uses data for purposes notified to the Information Commissioner under the Data Protection Act 1998 (which may be consulted at www.informationcommissioner.gov.uk). Information about the lost or stolen passport may be shared with appropriate public and private sector authorities who can assist in locating and recovering the missing passport and to help prevent the passport being used for criminal purposes 12 The guidance notes and the caution above have been read and understood
Purpose of travel
Signature of applicant: Date: Place:
(sign in box above using black ink if you are the person named in Section 1 and you are aged 12 or over. Otherwise, leave blank)
Signature of Parent/Guardian or person applying on behalf of applicant
FCO007v4
Date:
Place:
Application for a United Kingdom Emergency Travel Document Further Information
7 Applicant Further Information If you are a British National (Overseas) with a Hong Kong permanent identity card, please enter the number
Has the applicant been Naturalised or Registered? (Tick one box)
Yes
No
8 Why are you making this application for an Emergency Travel Document Further Information If you are applying by authority from the court please provide: Court Name Country of Court 9 Other Information Please supply any other information that may affect your application for an Emergency Travel Document:
Signature
FCO007v4
