SET(O)

Version 04/2007

Work permit holder

A P P L I C AT I O N F O R
INDEFINITE LEAVE TO REMAIN IN THE UK
I N O N E O F T H E E M P L OY M E N T O R O T H E R Employment not
C AT E G O R I E S L I S T E D I N T H I S F O R M requiring a work
permit

Writer, composer
or artist

In addition to this application form, you need “Applying on

Form SET(O): Guidance Notes”, which you can get from UK ancestry
our website at www.bia.homeoffice.gov.uk or by calling
0870 241 0645.
Highly skilled
migrant

Ex HM Forces

Long residence in
the UK

Bereaved partner

THE ADDRESS TO WHICH YOU MUST POST

YOUR APPLICATION ON FORM SET(O) IS: Other purposes/
reasons not covered
Border and Immigration Agency by other application
Leave to Remain - SET(O) forms
PO Box 495
Durham
DH99 1WR

This form is
valid only for
applications
BUILDING A SAFE, JUST AND TOLERANT SOCIETY made on or after
2 April 2007
SET(O) Version 04/2007 - page 1 of 13
 G U I D A N C E O N C O M P L E T I N G PAY M E N T D E TA I L S
The fee If applying in person at a Public Enquiry Office and paying by
For applications made on this form, there is a fee of £750 cheque, you must have a cheque guarantee card with a limit
for applications made by post and £950 for applications sufficient to cover the amount to be paid.
made in person at our Public Enquiry Offices. Applying by
post takes longer. Completing the payment details page

You may include your spouse, civil partner, unmarried or To ensure that your payment is processed without any delay,
same sex partner and/or children under the age of 18 for no please follow the guidance below when completing the next
additional fee if they are applying as your dependants. page.ext page.
However, in the long residence in the UK category, the immi-
gration rules do not allow for dependants, so their applica- Applicant’s details (1 to 5)
tion(s) will be refused if you include them in your application.
See the separate guidance notes for more information on 1 Full name of main applicant as given in his or her
this. passport.

2 Nationality of main applicant. If more than 25

In the categories where dependants may be included, they letters, please abbreviate.
must pay the prescribed fee if they apply separately.
3 Date of birth (day/month/year - eg 3 January 1980
Children aged 18 or over cannot be included. They must should be written 03 (day) 01 (month) 1980 (year).
apply individually and pay the prescribed fee in each case.
4 Home Office reference (if you have one).
Fee exemptions. Nationals of states which have ratified the 5 The address of the person named in 1.
Council of Europe Social Charter are exempt from paying the
fee if applying in the work permit or highly skilled migrant Contact details for payment queries (6 to 7)
categories. The countries concerned are Albania, Andorra,
Armenia, Azerbaijan, Croatia, Georgia, Moldova, the former We need the details of the person to contact if we have a
Yugoslav Republic of Macedonia, Turkey and Ukraine. question about the payment. The contact may be different
Nationals of these states must pay the fee in the other cate- from the name given in 1 if an immigration adviser or other
gories. person is making the payment. Complete 6 to 7 as shown
below only if the payer’s name and address are different
How can you pay? from those of the applicant.
You can pay by any of the following methods:
6 The name of the contact.
• Cheque 7 The address of the person named in 6.
• Postal Order
• Credit card - Visa (including Electron) or MasterCard only Method of payment (8 to 15)
• Debit card - Delta, Maestro*, Switch (including Solo)
• Banker’s draft 8 Tick one of the boxes to show method of payment.
• Cash - but only for applications at a Public Enquiry Office;
please don’t send cash by post. 9 If paying by cheque, enter the cheque number,
account number and bank sort code.
We do not accept any other form of payment.
10 If paying by card, tick one of the 5 boxes to show the
* Please note that we will accept any Maestro card if you type of card.
are applying in person at a Public Enquiry Office but only 11 Tick the fee which you are paying.
Maestro cards issued in the UK if you are applying by post.
12 Complete 12-15 only if paying by card.
If submitting more than one application form at the same
time, you must make a separate payment for each form. 14 The card security number is a three-digit security
code known as the card verification value (CVV). It
Cheques and postal orders consists of the last three numbers on the signature
strip on the back of the card as shown below.
You must make the cheque or postal order payable to ‘Home
Office Leave to Remain’ and cross the cheque or postal
order A/C Payee only.

Please write the full name, nationality and date of birth of

the main applicant on the back of each cheque and/or
3455 123 123
postal order and keep the postal order stub(s).
CVV
Please make sure that the date and the amount (words and
figures) are correct and that the cheque is signed properly.
15 It is the person named on the credit/debit card who
If applying by post, please attach your cheque or postal order must sign and date.
to the front of the application form.
SET(O) Version 04/2007 - page 2 of 13
 PAY M E N T D E TA I L S : S E T ( O ) - please see guidance before completing
Please complete this page in block capitals and black ink.
APPLICANT’S DETAILS

1 Full name

2 Nationality

3 Date of birth Day Month Year 4 Home Office reference if you have one

5 Applicant’s contact address

Post code

CONTACT NAME AND ADDRESS FOR PAYMENT QUERIES IF DIFFERENT FROM THOSE OF THE APPLICANT

6 Contact name

7 Contact address

Post code

METHOD OF PAYMENT

8 Payment method - please tick Postal Cheque Debit or Banker’s

order credit card draft
9 Paying by cheque
Cheque number Account number Sort code

10 Paying by Please debit my: Visa / MasterCard Delta Switch / Maestro

card Electron Solo

11 Amount - please tick Postal £750 Premium £950

12 Name on
card

13 Card
number
Valid from Expiry date
14 Card details Card security Issue No.
number - CVV (where
available)

15 Signature (card Date

only)
SET(O) Version 04/2007 - page 3 of 13
If you ar e producing a double-sided copy
of this application form, please include
this page and make sur e it falls on the
r ever se of the pa yment details page in the
two-sided copy.

For administrative r easons, it’s impor tant

that the r est of the form begins with
Section 1 - Applicant’s Details facing
upw ar ds.
 SET(O)
S E C T I O N 1 - A P P L I C A N T ’ S D E TA I L S
Attach two identical Version 04/2007
photographs
1.1 Your title - please tick Mr Mrs Miss Ms Other
of you (the applicant)
here with a staple or
paper clip If other, what is your title? Application for
indefinite leave to
Do not use glue or 1.2 Your date of birth Your gender -please tick remain in the UK
other sticky adhesive Day Month Year Male Female in one of the
following
categories:
1.3 Your full name as in your passport or travel document

Work permit holder

1.4 Surname or family name

Employment not
requiring a work
permit
1.5 Any other name(s) by which you are or have been known

Writer, composer
or artist
1.6 Nationality

UK ancestry
1.7 Passport or travel document number 1.8 Home Office reference if you have one

1.9 National insurance number if you have one Highly skilled

migrant

1.10 Your UK address - please inform us immediately if this changes.

Ex HM Forces

Long residence in
the UK
Post code

1.11 Your daytime telephone number Your mobile telephone number if you have one
Bereaved partner

1.12 Your e-mail address if you have one

Other purposes/
1.13 Name & address for returning documents and letters about your application if different from 1.10 reasons not covered
by other application
forms

This form is
Post code
valid only for
1.14 If you have completed 1.13 and the address is that of your immigration adviser, please state their applications
Office of the Immigration Services Commissioner (OISC) number made on or after
2 April 2007
SET(O) Version 04/2007 - page 4 of 13
 S E C T I O N 2 - D E P E N D A N T S I N C L U D E D I N YO U R A P P L I C AT I O N
Do not complete this section if applying in the long residence in the UK category.

If you have a partner and/or any children under 18 living in the UK and they are applying for indefinite leave to
remain in the UK as your dependants, this is where you give their details. Unless otherwise stated, the word “part-
ner” in this form means your spouse, civil partner, unmarried or same sex partner. If more than 3 children are
applying, please give their details, with photographs, on a copy of this page and enclose it with this form.

Your partner’s full name

Attach two identical

photographs
of your partner
here with a staple or Nationality
paper clip

Do not use glue or Day Month Year Male Female

other sticky adhesive Date of birth Gender -
please tick
Relationship to you - Spouse Civil partner Unmarried partner Same sex partner
please tick

Child’s full name

Attach two identical

photographs
of your child
here with a staple or Nationality
paper clip

Do not use glue or Day Month Year Male Female

other sticky adhesive
Date of birth Gender -
please tick

Relationship to you - please tick Son Daughter

Child’s full name

Attach two identical

photographs
of your child
Nationality
here with a staple or
paper clip

Day Month Year Male Female

Do not use glue or
Date of birth Gender -
other sticky adhesive
please tick

Relationship to you - please tick Son Daughter

Child’s full name

Attach two identical

photographs
of your child Nationality
here with a staple or
paper clip
Day Month Year
Male Female
Do not use glue or Date of birth Gender -
other sticky adhesive please tick

Son Daughter
Relationship to you - please tick
SET(O) Version 04/2007 - page 5 of 13
 S E C T I O N 3 - W H I C H C AT E G O R Y ?
Please tick a box below to show us the category in which you are applying for indefinite leave to remain in the UK.
Work permit holder Highly skilled migrant Long residence in the UK
Complete all sections Complete all sections Complete all sections
except section 5

Employment not requiring UK ancestry Bereaved partner

a work permit Complete all sections Complete all sections
Complete all sections except sections 4, 5 and 6

Writer, composer or artist Ex HM Forces Other purposes/reasons not covered

Complete all sections Complete all sections by other application forms
except sections 4, 5 and 6 Complete all sections
If you have ticked the other purposes/reasons category, please explain briefly why you are applying for indefinite leave to remain
in the UK . You will also need to provide a letter explaining in more detail why you are applying.

SECTION 4 - KNOWLEDGE OF LANGUAGE AND LIFE IN THE UK

Do not complete this section if you are applying in the ex HM Forces category (or as the spouse of such a person) or in the
bereaved partner category.
This section is about the new requirements concerning knowledge of language and life in the UK which you and any depen-
dants have to satisfy to qualify for indefinite leave to remain if you are aged 18-64. If you have not already done so, you should
read the information about these requirements in the separate guidance notes.
4.1 Are you under 18 or aged 65 or over? Yes No
If you have answered no, continue below. If you have answered yes, continue below only if your
partner is included in the application, otherwise go to the next section.

4.2 If your partner is included in the application, is he or she under 18 or aged 65 or over? Yes No
If you have answered no , continue below. If you have answered yes, or if a partner is not included in the
application, continue below only if you have answered no in reply to 4.1, otherwise go to the next section.

4.3 Have you and/or a partner included in this application obtained one of the relevant qualifications listed below to show that
you have sufficient knowledge of the English language and life in the UK? Please tick below and see Note 1.
Relevant qualifications
A pass in the test known as the Life in the UK test; or one of the following You Your partner
English for Speakers of Other Languages (ESOL) qualifications:
Yes No Yes No
An ESOL “Skills for Life” qualification in speaking and listening at Entry
Level or

Two ESOL Units at Access Level under the Scottish Credit and Qualifications
Framework approved by the Scottish Qualifications Authority.

Life in ESOL Life in ESOL

4.4 If you have answered yes to 4.3, tick one or more of the boxes opposite to
the qualifica- the qualifica-
show which qualification(s) (ie Life in the UK test or either of the two relevant UK test tion tion
UK test
ESOL qualifications) you and/or your partner have obtained.

4.5 If you and/or your partner have answered no to question 4.3, are you claiming Yes No Yes No
exemption from this requirement because a physical or other condition pre-
vents you from taking the Life in the UK test or doing an ESOL course? See
Note 1 below.

Note 1 If you are aged 18-64 and have answered “no” to questions 4.3 and 4.5, you should not be applying for indefinite leave
to remain. Please see the separate guidance notes.

If your partner is aged 18-64 and has answered “no” to questions 4.3 and 4.5, his/her application will be refused even if your
application is successful. Please see the separate guidance notes.

If you and/or your partner have answered “no“ to question 4.3 but “yes” to question 4.5, you must provide a doctor’s letter or
similar evidence confirming that you and/or they are unable to take the test or do an ESOL course.
SET(O) Version 04/2007 - page 6 of 13
 S E C T I O N 5 - YO U R H O M E A N D YO U R F I N A N C E S
Do not complete this section if applying in the ex HM Forces, long residence in the UK or bereaved partner
categories.
5.1 Is your a) owned b) rented from c) privately d) owned or e) other -
home in by you? a local authori- rented by rented by a rel- please give
the UK: ty by you? you? ative or friend? details below

5 . 2 Do you or your partner, or both, pay any Yes No If so, how much do you pay each
month?
£
rent or mortgage for your home?

5 . 3 Are you working in the UK? Yes No If so, what is your pay each month after
income tax and other deductions? £

5 . 4 Does a relative or friend of you or your Yes No If so, how much do you receive
partner, or both of you, regularly give each month? £
you money?

5 . 5 Are you receiving any public funds? Yes No

The public funds which are relevant for the purposes of the Immigration Rules are listed below. If you have answered yes to
question 5.5, you must tick the relevant box(es) to show which of these are being received.
Housing or Homeless- Disability Living Council Tax Benefit State Pension
ness assistance Allowance Credit

Attendance Allowance Income Support Child Benefit Child Tax Credit

Severe Disablement Working Tax Credit Income based

Allowance Jobseeker’s Allowance

Carer’s Allowance Social Fund Housing Benefit

payment

SECTION 6 - ABSENCES FROM THE UK

Do not not complete this section if you are applying in the ex HM Forces or bereaved partner categories.
6 . 1 When did you (the main applicant) first enter the UK? This refers to the date Day Month Year
of your first entry into the UK at the beginning of the period of stay on which
this application is based.

6 . 2 Since then have you had any absence(s) from the UK? If yes, give the dates of and reason(s) for the Yes No
absences in the spaces below. List all absences, however short, including all of 3 months or more.

Dates of absence(s) Reason(s) for absence(s)

SET(O) Version 04/2007 - page 7 of 13

 SECTION 7 - PERSONAL HISTORY
You must answer all the questions in this section on behalf of yourself and any dependants included in this appli-
cation. It is an offence under Section 26(1)(c) of the Immigration Act 1971 to make a statement or representation
which you know to be false or do not believe to be true. Information given will be checked with other agencies.

7.1 Do you or any dependants included in this application have any criminal convictions in the UK Yes No
or any other country (including traffic offences) or any civil judgments made against you?

If you have answered yes to question 7.1 above please give details below for each criminal conviction and/or civil judgment, start-
ing with the most recent one - but first see Note 2 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 .

Note 2 Convictions spent under the Rehabilitation of Offenders Act 1974 need not be disclosed. More information about the
Act is given towards the end of this section.

Name of person convicted or against whom a civil judgment was made

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)

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

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

Name of person convicted or against whom a civil judgment was made

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) Date of sentence/judgment

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

For help in answering the questions below, please see the definitions on the next page.

7.2 Have you or any dependants included in this application ever been charged in any country Yes No
with a criminal offence for which you have not yet been tried in court?

7.3 In times of either peace or war have you or any dependants included in this application Yes No
ever been involved, or suspected of involvement, in war crimes, crimes against humanity
or genocide?

7.4 Have you or any dependants included in this application ever been involved in, support- Yes No
ed or encouraged terrorist activities in any country?

7.5 Have you or any dependants included in this application ever been a member of, or given Yes No
support to, an organisation which has been concerned in terrorism?

7.6 Have you or any dependants included in this application ever, by any means or medium, Yes No
expressed views that justify or glorify terrorist violence or that may encourage others to ter-
rorist acts or other serious criminal acts?

SET(O) Version 04/2007 - page 8 of 13

 SECTION 7 - PERSONAL HISTORY(continued)

7.7 Have you or any dependants included in this application ever engaged in any other activities Yes No
which might indicate that you may not be considered to be persons of good character?

If you have answered yes to question 7.2, 7.3, 7.4, 7.5, 7.6 or 7.7 above please give further details in the space provided below.
If you need more space, continue on a separate sheet.

REHABILITATION OF OFFENDERS ACT 1974

The Rehabilitation of Offenders Act 1974 enables criminal convictions to become 'spent' or ignored after a 'rehabilitation peri-
od'. 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 020 7840 6464 or by obtaining a free copy of their leaflet on 020 7840 6427.

DEFINITIONS

For the purposes of answering questions 7.3 to 7.7, the following information provides guidance on actions which may consti-
tute 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 www.opsi.gov.uk/acts/acts2001/20010017.htm or purchased
from The Stationery Office (telephone 0870 600 5522). 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.

War crimes
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 destruc-
tion of property not justified by military necessity, unlawful deportation, the intentional targeting of civilians and the taking of
hostages.

Crimes against humanity

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

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

Terrorist activities
Any act committed, or the threat of action, designed to influence a government or intimidate the public and made for the purpos-
es of advancing a political, religious or ideological cause and that involves serious violence against a person; that may endan-
ger another person’s life; creates a serious risk to the health or safety of the public; involves serious damage to property; is
designed to seriously disrupt or interfere with an electronic system.

Organisations concerned in terrorism

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.

SET(O) Version 04/2007 - page 9 of 13

 SECTION 8 - DOCUMENTS AND PHOTOGRAPHS
For your application to be valid and complete, you must provide the documents and photographs listed in this sec-
tion which are relevant to your application. Tick the boxes next to the relevant items to show the documents and
photographs you are providing. Attach the photographs to the spaces in sections 1 and 2 as instructed there.

8A All categories (unless otherwise indicated)

Two recent passport-size photographs of yourself with your name on the back of each photograph. Please see
the separate guidance notes for advice on what types of photograph are acceptable.

Two recent passport-size photographs of each dependant included in section 2 and applying for indefinite
leave to remain in the UK with you, with their name on the back of each photograph.

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

Current passport(s) or travel document(s) for each dependant included in section 2 and applying for indefi-
nite leave to remain 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.

Your police registration certificate if you have been asked to register with the police.

The police registration certificate(s) of each dependant included in section 2 and applying for indefinite leave
to remain in the UK with you if they have been asked to register with the police.

Evidence of your finances. If you have to complete section 5, bank statements, building society savings book(s), pay
slips or other formal documents as evidence of your ability to maintain and accommodate yourself and any dependants
without recourse to public funds. If a relative or friend is supporting you, a letter from him/her confirming this with bank
statements or other documents of the kind described above as evidence of their financial situation. See Note 3 below.

Note 3 The documents showing the finances available to you and/or to the person supporting you should cover at least the
last 3 months. We do not accept internet or cashpoint statements as evidence of finances.

Knowledge of language and life in the UK If you have to complete section 4 and you and/or a partner included
in the application are aged 18-64, you must provide one of the following documents for each of you.

A Life in the UK test pass notification letter or a relevant ESOL qualification.

or

A medical certificate or similar document if you and/or your partner are claiming exemption from taking the Life in
the UK test or doing an ESOL course because of a medical or other condition.

8B Work permit holder If you are applying as a work permit holder, and have completed, or nearly completed, 5 years’
leave in this category, you must provide the following:

Recent document(s) from the employer named in your current work permit confirming that you are still needed and that
your employment with them is continuing.

8C Employment not requiring a work permit If you have been given leave to enter or remain in the UK for employ-
ment in one of the following categories not requiring a work permit, and have completed, or nearly completed, 5 years’
leave in this category, you must provide the following:
Recent document(s) from your employer confirming that you are still needed for the same work.

a) Minister of religion, missionary or member of a religious order (see Note 4 )

b) Representative of an overseas newspaper, news agency or broadcasting organisation
c) Private servant in a diplomatic household
d) Overseas government employee
e) Airport based operational staff of an overseas-owned airline
f) Domestic worker in a private household
Note 4 For ministers of religion, missionaries, or members of a religious order this document may be from the leadership
of your church or the head of your religious order, rather than your employer.
SET(O) Version 04/2007 - page 10 of 13
 SECTION 8 - DOCUMENTS AND PHOTOGRAPHS (continued)
8D Writer, composer or artist If you are applying as a writer, composer or artist, and have completed, or nearly com-
pleted, 5 years’ leave in this category, you must provide:

Documents(s) showing that you have supported yourself and any dependants from your own funds without working
except as a writer, composer or artist for the last 5 years.

8E UK ancestry If you are applying because of your UK ancestry, and have completed, or nearly completed, 5 years’
leave in this category, you must provide:

Document(s) showing that you are able to work and intend to take or seek employment in the UK.

8F Highly skilled migrant If you are applying under the Highly Skilled Migrant Programme (HSMP), and have complet-
ed, or nearly completed, 5 years’ leave in this category or other appropriate categories, you must provide:

Document(s) showing your economic activity and your personal earnings during your stay in the UK, if you are
employed. If you are self-employed, you should provide evidence of the progress of the business. You may have been
given leave to enter or remain in other categories leading to settlement before being granted permission to stay under
HSMP. If you would like this stay to be considered in connection with your application for indefinite leave to remain, you
should provide details of the categories involved and the periods spent in each of these categories.

8G Ex HM Forces If you are applying following your discharge from HM Forces, you must provide:

Your Certificate of Discharge.

8H Long residence - after 10 years’ continuous lawful residence If you are applying because you have had at
least 10 years’ continuous lawful residence in the UK, you must provide:

All the passports you have held during this time. If you cannot provide them all, you must provide the passports you have
together with any Home Office letter(s) or other document(s) granting you leave to enter and/or remain in the UK.

8I Long residence - after 14 years’ continuous residence If you are applying because you have had at least
14 years’ continuous residence in the UK, documents such as those listed below showing that your stay here has been
continuous for this period.

All the passports you have held during your stay here

Home Office letter(s) or other document(s) granting you leave to enter and/or remain in the UK

Doctor’s letter(s) showing registration for each year of your stay

Council tax letter(s) or bills for each year of your stay

Gas, electricity and water and other domestic bills or statements for each year of your stay

National Insurance contribution records for each year of your stay or P60 forms

Inland Revenue letter(s) and/or P60 statements of income tax paid

Employer(s) letter(s) confirming the dates during which you have been employed

Department for Work and Pensions letter(s)

Full birth certificate(s), ie one which shows the parents’ names, for any of your children born in the UK

Mortgage document(s) showing any property you own in the UK and/or a letter from your landlord confirming the period
of your tenancy

Any other documents which support your application.

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 SECTION 8 - DOCUMENTS AND PHOTOGRAPHS (continued)
8J Bereaved partner If you are applying as a bereaved partner, you must provide:

Your late partner’s death certificate

Evidence that you and your late partner were living together as a couple from the time you were granted leave to
enter or remain in the UK as his or her partner until his or her death, such as letters, bills and other correspondence
from official sources addressed to both or each of you at the same address. Please provide as many as you can.

8K Other reasons/purposes not covered by other forms If you are applying for indefinite leave to remain in the
UK for other purposes or reasons, you must provide:

A letter or other document explaining why you are applying for indefinite leave to remain in the UK, together with any
relevant document(s) in support of your case. Please list the document(s) you are providing.

S E C T I O N 9 - D E C L A R AT I O N
You must now read the declaration below and sign it. This must be signed by you (the applicant) and
not be a representative or other person acting on your behalf. If you are under 18, your parent or
guardian may sign.

I hereby apply for indefinite leave to remain 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 submitted 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 but that
it may be disclosed to other government departments, agencies, local authorities, the police, foreign gov-
ernments and other bodies for immigration purposes or to enable them to perform their functions.

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 subse-
quent removal from the United Kingdom.

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

I am aware that it is an offence under the Immigration Act 1971, as amended by the Immigration and
Asylum Act 1999 and the Nationality, Immigration and Asylum Act 2002, to make to a person acting
in execution of any of those Acts a statement or representation which I know to be false or do not
believe to be true, or to obtain or to seek to obtain leave to remain in the United Kingdom by means
which include deception.

Signed Date
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 DOCUMENT CHECKLIST
Please complete this part of the form. It will help us to make sure that we have received the documents you supplied and to
keep a record of them while they are in our possession. The list is a standard one covering important documents which are
common to most application types. Please state how many of each of the following you have provided.

Passports Police registration Birth Marriage or civil Driving Other

and/or travel certificates certificates partnership cer- licences (please list
documents tificates below)

Marriage certifi-
cates

F O R O F F I C I A L U S E O N LY

Passports Police registration Birth Marriage or civil Driving Other

and/or travel certificates certificates partnership cer- licences (please list
documents tificates below)

Signed Date

APPLICANT’S CHECKLIST
To ensure that your application is valid and complete, please make the following checks before posting
it. Tick each box that is relevant to your application.
Is SET(O) the right Have you completed the Have you ticked a box Have you completed
form for you and is it Payment Details page in section 3 to show the rest of the form as
valid for use? See as required and made the category in which specified?
date on front page. the correct payment? you are applying?

Have you sent the documents specified in section 8 as listed below?

Current passport(s) or Photographs Police registration All other relevant

travel document(s) certificate(s) documents specified
in section 8

Have you, or a parent/guardian if you are under 18, If you are unable to send us any of the documents
signed and dated the declaration in section 9? specified in section 8 which are relevant to your appli-
cation, have you given an explanation and said when
you will be able to send them?

Finally, please make sure that the application is addressed exactly as shown below.

Border and Immigration Agency

Leave to Remain - SET(O)
PO Box 495
Durham
DH99 1WR

SET(O) Version 04/2007 - page 13 of 13