Home Office

UKBorderAglency
APPLICATION A REGISTRATION FOR CERTIFICATE FORA BULGARIAN ROMANIAN OR NATIONAL EXERCISINGTREATY A RIGHT THEUNITED IN KINGDOM

In orderto exercise Treatyright you must be residingin the United a Kingdomat the time of application. This lormmustbe accompanieo by: . Originalvalidpassports lD cafdsfof eachperson or included; and . Two recentpassport-sized phoiogfaphs each personincluded; for and ' Originalvefsions all required documents. of Failureto comply with these requirements may leadto delaysin processing your registration certificate and possible refusal of your application. Onceyou have completed application this formyou shouldsend it alongside rcquired all to: documents UK BorderAgency Bulgariaand Romania Caseworking PO Box 4160 Sheffield 51 gDZ We will returnall your documents recorded to by delivery a UK address only. Please note that recordeddeliverydoes not insure you to ihe full valueofyourpackage it and should become losl.lfyouwantyourpassport otherdocuments returned Special by Delivery whichdoes insure full the value,you will needto provide suitably Delivery a sizedSpecial envelope with the correctpre-paidpostage. Documentsreturned to an overseas address will not be returned by recordedspecial / delivery return be at yourownrisk.lfyouwishlo and will your application, please receiveacknowledgement we have received ihat include stamped, a self-addressed sizedenvelope. 44

page1 of 15 BR(1) Version 06/20'11

Quick guidancefor applicants which sectionsof the form do I needto complete? please and notes Bulgarian for Forfullguidance refer the guidance to permission workin the UK (available Romanian nationals obtaining on to from our website omania/ www. ukba. homeoffi ggv.uldworkingintheuldeea/buloariaf ce. applyinq

1 A l l a p p l i c a n t m u s tc o m p l e t e e c t i o n s , 2 , 8 , 9 , 1 0 a n d 1 1 . s s please individual, alsocomplete lf you are applying a self-employed as section 3. 4. alsocornplete section lf you afe applying a student,please as

please individual, alsocomplete lf you are applying a self-sufficient as section 5. please Stateworkerauthorisation, lf you are exempt fromAccession complete relevant below: the section Regislraiion If you are applying yourfamily and member holds cuffent a please your your include Ceriificate is sponsoring application, and sDonsor's details section in 2. of lf you are the spouseor civilpartner a Britishcitizenor personsettledin please section 6. the United Kingdom, alsocomplete Kingdom for lf you havebeenlegally wo*ing as an employee the United in please period 12 months 2006, also a of ending or after31 December on comoiete 7. section Act lf you hadleaveto enteror remain underthe lmmjgration 1971on 31 on December 2006andthatleave doesnot placeanyrestrictions iaking employment the United in Kingdom havebeengivensuchleaveafter or thatdate.olease alsocomolete section 7. (spouse civilpartnef, childunder lf you arethe direct member or family withan 21 of dependent) a Bulgarian Romanian or national issued of 7. Accession WorkerCard. alsocomplete section olease (spouse civilpartner, childunder lf you are the direct member or family who hasleave io 21 or dependent) a Bulgarian Romanian of or national themio 1971 Actwhich allows femain the United in Kingdom underthe work.olease alsocornolete section 7

page2 of 15 BR(1)Version 06/2011

Your personaldetailsshould be enteredat 1.1 to 1.9. Where family membersare includedin the application, and they are personaldetailsshould be enteredat also EEA nationals, their section2.1.lf your familymembersare not EEA nationals, they should complete form BRs. you with ls a rcpfesentaiive assisting yo!r application? Are you contentfof ihe UK Border yourfepresentative Agencyto contact if we require further information?

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Attachapplicant's here Fhotographs

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lf yes please insert your representative's OISCRegistration Number lhey haveone. il

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Title(Mr,l\,4rs, Miss,l\ls,Other)
Fullnameas shownon lD card or passport Surname

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Family nameot anyoinernames by whichyouhavebeenknown

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Nationality Dateof Birih Day

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HomeOfficereference numberif known Passport number lD cardnumber or UK address Please inform immediaielylhis us if changes Postcode 1.7 1.8
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The address whichyouwoud likeus to to yourdocumenis sendany letters return and aboutyourapplication,different if fromthat at1.6 Postcode

1.9

Are you,or do you intend be,employed to in the United Kingdom?

Yes

No

page3 of 15 BR(1) Version 06/2011

please give in be family mernbers included thisapplication, lf youwish thalyourEEAnational Card wishing apply a Residence to for family mernbers theifdetails below.NonEEAnational ete should comD formBR5. members the UK in family 2.1 (a) Do you haveanyEEAnaiional on applying yourdependant thisapplication? as NO Yes iX in family members theIJK 2.1(b) Doyouhave anyEEAnational ir. st (J rru ,r'g u 'rr ir,rtrrr ur Yes No givethe detai of yourEEAfamily members yes s 2.'t lf you haveansweled to queslion please please givetheirdetails and photographs on you havemorethanthreefamily members below lf ii a separate sheetand provide withyourapplication. evidence lf parents'details not shown in the child'spassportof ID card,documentary are for of relationship should be providedi,e.full birth certificate eachchild. partneror parenUchild brotheror e.g. lf the relationship otherthan spouse/civil is (e.9.original provideappropriate the relationship evidence confirm io cousin,please that your familymember certificates) evidence and birth,marriage civil partnership or you. For more information familymemberspleaserefer on on is financially dependant on to nationals obtainingpe.mission and Romanian to the guidancenoles for Bulgarian work in the UK.

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Family member's name full Nationality

Dateof Birth

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Relationship you to (if HomeOfficereference known) Family member's name full Nationality Dateof Bidh Gendef Day Month

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Relationship you to (if HomeOfficereference known) Family rnember's name full Nationallty Daieof Birth Day -I-t l Mn N,4onth Year Attach family member's photographs here

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Relaiionship you to (if Horneoffice reference known) 06/201 page4 of 15 1 BR(T Version )

pleasecompletethis sectionand lf you are applyingon the basisof self employment, providelhe evidence requested. beforetaking up selfIt should be notedthat you are not required hold this certificate to employment, althoughyou must be ableto proveyour status if yo rafechallenged. The .r wiil confirmthat you are an EEA national exercising Treatyright as a selfcertificate 3i?tus. employerj i.dividual. lt doe: lot confirmcrnployment Your businessdetails 3.1 occupation as; I am established business/fol in owinga self-employed Nameof business Business add[ess

Postcode Telephone numbef to Evidence self-employment/businessbe provided. Pleaseticktheboxesnext of you are providing: to the relevantitemsto show the documents provide following: Youshould the payment services. include the Invoices for Theseshould showlng number the clieni. of address telephone and Theseshould (including freelance wo.k)to provide services. Contracts include addfess telephone and number eachclient. of lhe

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yourclient's (please include Letters recommendation clients from of address telephone and number we willcheckfeferences) as as In additionpleasesend as many of the followingpiecesof evidence possible: or, statemenis, Recent bankstatemenis. Thesecanbe originals if online b\/ andsigned thebanhor accompanied by musteither sia.nped be andthatthe fromthe bankconfifminq account the delails a letter

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information coffect. is Proo ol Na-iond Insura.cereg;s'ralio.

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special reference Evidence fromHN,4RC National of Insurance number contr;bulions Evidence fromHMRCof National Insurance for Evidence from lll\/1RC registration lax ol Industry Scheme Evidence tax payrnenl of under Constfuction the Details yourpremises of lisls Client

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yourbusiness Details howyouadvertise of provideoriginalevidence any licenceswhich are of You must als6 be ableto or we requisite your particular to self-employment business. For example, will for licences taxi drivers,GasSafeRegist.ation gas fitters, for needto see driving for and environment healthregistration food services. Failure providethe evidencelistedabovemay leadto delaysin the processing lo with the evidence of your application, leadto refusalif we a.e unsatisfied or supplied. sections8, 9.1,9,2,10 and 11 Please now complete 5 B R ( 1 ) V e r s i o n / 2 0 1p a g e o f 1 5 06 1

lf you are applyingon the basisof beinga studentpleasecomplete this sectionand youi coursellefcrre providethe evidencerequested.Pleasenote - yoL!must havesia!1eci we will issueyou a Registr?tion Cerlificate. 4.1 (see educationa eslablishment the Register of Nameand address lhe appfoved of Education Providers and Training W!t{.qLba.horneotfice.gov.uk/emploi/ers/points/

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Datecourse studysiarted of Datecourse studywilend of

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qf You are requiredto pfovidethe followingdocumentary evidence your course pleasereferto the guidanceon our of study and funds: (for furtherinformation, websiteat@ enrolmentand the A school, college univefsity or etter confirrning r orp e-io"ddteoI lheco-rse pfovethatyou Documentary evidence suchas thoselisted below.to not a on havesuffcient resources to become burden the UK'ssocial yourtimeas a sludent assistance system during Recent Thesecanbe originals if online of, banksiatements. statements, musteilhefbe stamped signed lhe bankof and by details fromthe bankconfirming account the accompanied a leiter by andthatthe inlormation co.rect; is or fronr parenl, a relative Evidence sponsorship funding; a letter of or e.g. you, withtheir or friend, theyare supporling sponsoring along if or grant; a or fecent bankstatements; a ettefconfiming maintenance or by for to A declaration witnessed a commissioner Oaths., statethat you,as the applicant, not become burden thestate. on will a * A Commissioner oaths has the powerto certifythe oath of for anotherover documents Pleasengw complte sections8, 9.1,9.2,10 and 11 page6 of 15 06/2011 BR(1)Ve.sion

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pleaseprovidethe lf you are applyingon the basisof beingeconomically self-sufficient evidencereouested. yourself anyfamiLy members included to and in Evidence fundssufficient maintain of you intend reside thisbasis.These fundscan the to on thisapplicalion during time or of members comefromthe laMulernpioyment self-employmenlanyof youffamily you. residing lhe UK with in

yoursewhilst theUK. *_ f in Documentary evidence your of abilily maintain to

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Unlessotherwisestated, word 'partner'in this sectionmeansyour spouseor civil the partner. Yourpariner's name full Nationality Date of Birth Gender Day Month Yea.

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Please tick a box belowto show us the categoryin which you are applying

present Spouse a person of and t: settled theUK in 6.1 6.2

andsetted in the UK

present I of Civilpartner a person

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Please stalethe place yourwedding of or civil partnefship ceremony. partnership youbeenma.ried in a civil Have of (il complete seciion 9.3)? before yes,please

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partnershipYes in or Hasyourpartner been a marriage civil (if 9.3)? before yes,please complete section
Whef didyoumeetyourparlner?

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Wheredidyoumeetyourpartner? Whendidyoudecide marryand to forma civiipafinership?

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6.8 Whendidyoustartliving together? Pleasenow complete sections8,9,1,9.3,10 and 11 page7 of '15 BR(1)Version 06/2011

lf you had currentleavetq enler or remainin the UnitedKingdomunderthe 1971 lmmigration Act you may be exemptfrom AccessionStatewofker authorisation. you lf ryes'to any of the followingquestions, you may be issuedwith a registration can answer certificate confirmthat vou can work in the UK withoutrestrictions, to 7.'l Afe youa Bulgarian Rornanian or national who hadleave to enteror remain the UK on 31 Decembef in 2006(or have Yesn beengivensuchleave afterthatdate)underthe lmmigration Act and that leavewas not subjectto any condition restricting employment? Are youa Bulgarian Romanian or national wasworking who (not selfwith valid leaveto remainas an employee employed) the United December 2006 in Kingdom 31 on and had beenlegally working the United in Kingdom without interruption the previous monihs? for 12 Are youa Bulgarian Romanian or national was who (not working withvalidleave remain an employee to as self.employed) the United in Kingdom without interruption partly wholly fof a period 12 months, falling or after31 of December 2006? FamilyMembers 7.4 who is the direct Are you a Bulgarian Romanian or national family member a Bulgarian Romanian of or national an with workcard). Accession Worker Card(also known.as purple a SeeGuidance Notes definition. for Are you a Bulgarian Romanian who is the direcl or national family national who has member a Bulgarian Romanian of of leaveio enterof remain the United in Kingdom under the 1971 thatallows Kingdom. Act themto workin the United Pleasenow complete sections8, 9.1,9.3,10 and 11

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family You should answerall the questionsin th;s sectionorr behalfof yourseliand z,nlr be membersincludedln this application.lnformatiorlwi!l cilecKqd Wllh oth ha/e 8 . 1 to you or anydependanls udedin thisappication inc in the UK or anyothefcountry yes anycriminal convictions to judgements (lncluding nade traffic offences) any civi or you? against please ivedelaiis lf you havea nswered lo question 1 above, Yes 8belov/ each for O Lf sentence starting withthe moslfecent onefirsi- butI fsl see Note1 beLJVr'.youor jncluded thisappicalion you havefeceived mofethantwo sentences anydependants in go No shoud continue anolher on sheet. lf youhaveanswefed please 10Question-(L2. of Aci.1974neednot Note 1: Convictions spent under the Rehabilitation Offendefs be disclosed. Moreinformation aboutthis Act is qiven at 8.7.

Firstsentence
Name person of sentenced f
Natureof offence l\4onih Datesentenced given Sentence Country wheresentenced
l

Year

S e c o n ds e n t e n c e
Name of personsenienced Nature of oflence

Day
Dale sentenced Sentencegiven Countrywhere sentenced

Nlonlh

Year

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8.2

8.3

8.4

Haveyou or anydependanls. included thisapplcal on everbeen in with or inside outside United or the Kingdom a charged indicted inc cfiminaL offence whichyouor anydependants udedin this for application havenotyet beentriedjn courl? included thisapplication ln ever Haveyou or anydependants preparation organsation of beeninvolved the commlssion, in or For waf crimes, crimes against humanily genocide? help in or which answeringthis questionpleasereadthe information follows 8.7 in To yourknowledge, haveyou or any dependants included this in\est.gat"6 appicalioa everbeensuspecir.d. rsed. ac, in crimes or for orosecuted convicted invovernent warcflmes, "16.9ed. this againsi humanity genocide? or For help in answering questionpleasereadthe information which follows8.7 incllrded thisappllcal everbeen if on Haveyou or anydependants preparing,nancing instigatlng f of involved actsof committing, in others commii, to terrorism actsof encouraging induclng or or p . e p a r e i n s r i g a Le r r o i s r ro r t l ' e a u e r r po f a r / s u c ' a ' t s . o re either withinor outside UK? Of haveyouor anydependants the of included thisapplication beena member supportef an in ever o. in organisaiion whichhaspeeetfated supporled of lerrorism or acts furtherance its aims? of pageI of '15 06/2011 BR(1) Version

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Haveyou or anydependants included ihisapplicatlon if ergaged in anyotheractjvlties whichmight reievant thequestion be of to Yes you whetLrer or a.y depelddn.s inLl-dpd .l-i. appli, In dlio^a"e
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qivefurther lf you haveyou of answered to anyqueslion Yes between to 8.6please 8.1 deiaisin ihe spaceprovided below.lf you needmofespace, conlinue a !eperate on sneeL

REHABILITATION OFFENDERS OF ACT 1974 The Rehabilita{ion Offenders 1974enables of Act criminal convjctions become'spenl' 10 period'. or ignored period aftera 'rehabilitation The length the rehabi of itation depends on given. For a custodiaL lhe sentence (prison) period decided senlence rehabiljtation the is by the o ginalsentence, the tirnes(.ved. Prison not sentences motethantwo and a of halfyeafscan neverbecome spentand should always disclosed. be Further information periods on rehabiitation can be foundat Nacro's Resettlement Helpline 0207840 Plus on 6464 or by obiaininga free copyof their eaflelon 0207840 6427. DEFINITIONS questions and 8.4,the fo lowinginformation For the purposes answering provides of 8.3 guidance actionswhich may constitute genocide, on crimesagainst humanity and waf crimes. you answer This guidance not exhaustive. is Before thesequestions behalf yourself on of you and any dependants included this application shouldconsider full definitions in the of war crimes, cfimesagainst humanily and genocide whichcan be foundin Schedule I of the Internalional Criminal CourtAct 2001 at the following websitei www.opsi,qov.ukl acts/acts2oo1/20010017.htm. Alternatively, copies be purchased The Staijonery can from Office, telephone 08706005522. yourself you are familiar It is yourresponsibility satisfy to that wilh ihe deflnitions can and questions youfself anydependants answer the accurately behalf on of and included this in aDDlication. Genocide Actscommitted ;ntent deslfoy, wholeor in part,a national, with to in ethnical, racial of group. religious Crimesaoainsthumanitv jusi during Actscommitled anytime(not at armedcoff ict)as parlof a widespread or population knowledge the attack. systemalic attack, directed against civilian any with of Thiswo!ld include offences suchas murder, torture, rape,severe deprivation libedy of in violation fundarnental of international andenfofced of rules law disappearance peisons. of War Crimes Gravebreaches the Geneva of Convenlions committed during armedconflict. an This includes internaL an armedconflict an international and armedconflict. Theiypesof acts thai may constitute war crimeinclude a wilfulkiiling, exiensive torlure, destruction of property justified military noi by necessity, unlawful deportation, international the targeting of civilians the taking hostages. and of page10 of 15 BR(1)Vefsion 06/2011

Thedocuments photographs and needed s!pportof an application forrr't in BR1are listed on Youshouldprovide below. ihoselvhich relevanl you. caseandthe casesof anyfamily are t,) members included the application. in 9.1 You should attachall photoqraphs sections1 and 2 ofthe forn! in the soaces to provided. The Bulgarian guidancenotescontainnroreinfdrmation an-d Remanian about photographs. Please the boxesnexlto the i'elevant tick ilemslo sf ow tl'le dccuments photoqraphs and yoLr providing. are AllApFlicants phologfaphs yourself yoLir Two recentpassport-size of with nam-o wriiten the on
P r u r u g rd P r L .

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photographs eachfamiy member whoma Two recentpassporl-size for of registration certificate required theirnamewrilten the backof the is with on
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Yourcurrentpassporl lD card. lf you ast eniered UK on a pfevious or the passport travel please or docun'rent, alsoprovide document you havert. this if passport(s) lD card(s) eachfarnily Current member whoma reg:stration or for for certificale required. is Birthand marriage certificales eachapplicant for whereappropriate 92

lf y.ou.are applyingfor a registration certificate a Self-employed, as Studenlor Selfperson: sulTlcrent lf section hasbeencompleted, 3 evidence showyouare selfemployed to including: Invoices including and number clienis of addfesses contacl Contfacts including addresses contact and numbers clients of References including addresses contact and numbers clienis of Recent bankstatements. Thesecanbe originals if on inesiatements, or, must eitherbe stamped signed the bankor accompanied a letter and by by fromthe bankconfrrming accounl the details thaithe informaUoncorrecl. and is Registration Hl\,4RC with lf section (students) beencompleted, Lelte. 4 has confrming enromenton a a course study of whichis provided an organisatjon whichis included by on the Department Education Skills' for and Register Education Training of and Providers. Evidence prove to thatyouhavesufficient resources to become burden not a on the UK'ssocial assistance sysien du ng youriimeas a student suchas: App icani'srecent bankslatemenls. Thesecanbe oriqina or, if online s stateme.ts, musteithe.be slamped siqned the bankor accompanied and by by a letterfromthe bankconfrminothe accouitdetails thalthe information and rs correct:or Evidence sponsorship of including letter a frorn parent, a felallve friend, they or if you, are supporling sponsoring along or withtheifrecent bankstatements; or A declaration, witnessed a Commissioner Oaths, staiethalthe by for to applicant notbecome burden the state; will a on or Official document confrming receipt a grantof scholafship. the of

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lf sections (Students) 5 (Sef sufficieni) havebec.n completed: evidence 4 and of comprehensive insurance coverin the UK andfu rds10showyorl sickness are econom y se f-suff ical cieni,e.g a|anksfatenent lfthesefunds con]e froma familymember, of be evidence iheifempoymerlor fundsshould supplied. (CSl) Evidence the applicant Cornprehenslve that fras Sickness InsL.rrance as (Errropean required undeftne lmnigration Economic Area)Reguations 20C6. gives holder A E!ropeanHealth lnsurance Card(FHIC) the fights heathcare to thatbecomes necessary during tempofary to EEA(European a visit Economic Afea)countries Switzerland. or lf you are usingEHlC as evidence CSl,please of include letter statethat a to yourstayin the United Kingdom onlytemporary. is Evidence showthaiyouare economica self-sufficient if funded a ly or, by to familymember, evidence theiremployment funds. of or Vocational Students giving Letief fromproposed employer/college detai of workplacement s suchas salary. 9.3(a) Familymembersand those exemptfrom WorkerAuthorisation lf you are applyingas the Spouseor Civil Partnerof a BritishNational a or personsettledin the UnitedKingdom Docurnent(s) ls Nationa a or showing yourspouse civilpartner a Brilish that or pefson settled UK (seeNote1) in Note 1 - the document(s) mustbe either: passport; Yourpartner's cuffent ol lf yourpartner a Brilish without passport, his/her bifthcertificate full is Citizen a (shcjwing parents'names), accompanied ai leastoneotherformal by the document evidence ordinary as of fesidence the UK for the lasithreeyears. in The following ex,-rmples are offorma documents maybe provided thai as years: evidence o.dinary of residence the lastll]ree for notice lncome of tax passbooldbank coding, drjving license, building society statemenis, National Insurance National or Health Service registralion issued the Department by for heallh Work& Pensions, Department Social of Security a loca or authority. Listanysuchdocument(s) thisbox(continue another in on sheetif necessary)

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page12 ol 15 BR(1) Version 0612011

certjficate Yourmarfiage certifcale civilpartne.ship or you yes showing wete lf you haveanswered to queslion document(s) 6.3, yourprescnt with freeto marry spouseor forma clvilpadnefship yourpfesenl padner(seenote2). Lislany suchdocument(s) thisbox. 1n

suchas a dectceabsolute Note 2: The docume,lt(s) mustbe fofmaldocumcnts (orotherconflrrnalion the legaldissolutlon the of of or a finaldissolution ofder relationshio) a deathcedificate. or yes showing you.partner that 6.4, lf you haveanswered to quesiion ciocun'rents with was free to marryyou or form a civil partnership you (seenote2). Listany suchdocument(s) thisbox. in

as or e.3 lf you are applyingfor a registration certificate a Bulgarian Romanian {b) or nationalwho is the directfamilymemeber a Bulgarian Romanian of nationalwith an AccessionWorkerCard,or applyingas a directfamily who has leaveto remainin lhe memberof a Bulgarian Romanian or national to UnltedKingdomunderthe 1971Acl that givesthem permission worl. (if Docurnentafy evidence thefollowing appropriate): for certificale Yourmarriagecertiflcate civil parntership or you yes 6.3, showing werefree lf you haveanswered to question document(s) padner with sposeof forma civilpar-ntership youfpresent to marryyourp.esent (seenote2). Listanysuchdocument(s) thisbox. in

suchas a decree absolute Note2: The document(s) mustbe formal documents of of or a finaldissolution order(orotherconflrmaiion the legaldissolution the relationship) a deathcerlificate. or yes that 6.4, showing yourpartner lf you haveanswered to question documenls youor forma civilpadnerchip you (seenote2). Lisiany wjih wasfreeto marry in suchdocumenl(s) ihis box.

you (if to Birthce'lificate adoption and cerlificate appropriate) establish are a o. of chid unde.2' of yourBulqariar Rontald t spo^sor. of lf you c aimthatyou afe a dependent direct descendent yourRomanian parents/grandpafents), birth in line or Bulgarian sponsor the ascending (e.9. relationship. Yccertificates showing claimed the certificates and;'or marriage you are a dependent willa so needto provide nancial f fecords eslablishing Examples suchrecords of or yourBulgarian Romanian or national sponsor. banktransfer invoices, utility s. Listanysuch bil include: bankstatements, document(s) this box. in

page13 of 15 Version 06/2011 BR(1)

9.3(c) lf you are applyingfor a .egistration cef(ificate a Bulgarian as or Romanian nationalwhohas leaveto enteror remainin the UK and is not subjectto any conditionrestricting employment: Evidence showyou hadcurrent to leave remain the UKwithno to in 2006or havebeengivensuchleave employrneni resirictions 31 Decer.ber on passport daie e.g.an endorsed aflerthat Evidence showyou havebeenworking to legally the UK e.g.wageslips in 9.3(d) lf you are applying for a registration certificateas a Bulgarian or 12 Romanian nationalwhohas complted months'continuouslawful employment the UK: in Wageslipscovering last'12months the Contracts employment of covering last12 months the your Lelter(s) fromemploye(s) confirming employment covering iasi 12 the monlns yourtrealyrightas a Students: Evidence you haveconiinued exercise that to siudent Please tick the boxesnextto the relevantitemsto show the documents you are providing and photographs

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page14 of 15 Versjon BR(1) 06/2011

'i0.1 l-lave you or anydependants include.l thisaplrlication in previous madeany applications the UK Bodr,fAgoncy? io

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madean appljcalion, bul numb{jr havepfevicusly lf yau do nol havea referencc I lease givedetails below

Pleasenow readand sign the declaration or and I ot by a representative other 11.1 lt should be signedby you (the applicant) person actingon your behalf, lf you are under 18,your parentor guardianmay sign. or for ceriifjcale myrelfandanyBulgarian Romanian I hereby applyfor a registration in thisfofm. nalional family members listed and is The informalionhavegivenir,thisforrn conrplete ls trueto the beslof my I knowJedge. ar-a-lrtre'llke,re5srFyself ld - - ' o{ a . - ' .-+-deslafe-+haf{h wilh this-form + photogfaphs subrnitled form,as named the bdckof each on members included lhe applicalion in anyfarnily photograpl-. in thereis a material change my is I confirrn if,before application decided, this that available, lwill becomes relevant lhis applicalion to circumstances new information of inform UK BorderAgency. the provided me to the UK BorderAgency be tfeated \vill by I understand aLl that information aOencies, to departm.rnts, in confjdence thatit may be disclosed othergovernment but governments otheibodies inlmigralion and for the foreign local suthorilies, police, purpdses to enable theirlunctions. or ihemto perform pfovided for may me that I understand the UK BorderAgency alsousethe information
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