THIS FORM IS SUPPLIED FREE OF CHARGE

IM2A (Revised 12/01)
Reference:

Application for United Kingdom entry clearance
Type of entry clearance required (please tick appropriate boxes) Transit Visitor Student Settlement Long Stay: six months one year Two years

Please read the information on page 3 before completing this form
Two recent photographs to be attached here five years

Please also complete form IM2S As spouse/fiancé(e)/other relative/partner. Please also complete form IM2B Returning resident Dependant of any applicant in long stay categories Permit free employment/Retired Person of Independent Means/Investor Working Holidaymaker/Work permit holder/Innovator or to establish a business/Highly Skilled Migrant Programme (HSMP) Certificate of entitlement, UK ancestry Please also complete form IM2C (except HSMP) Please also complete form IM2D Yes No

Are you applying as a non-EEA dependant of an EEA national? Please answer all questions 1. Full name (as shown in your passport) 2. Any other names you have been known by 3. Date of Birth 6. Father’ full name s 7. Mother’ full name s 8. Current Nationality 10. Home Address 4. Sex M F

5. Place of birth

9. Country of residence

Telephone number 11. Are you? Married Single Divorced Widowed Separated

If married, full name of spouse Date of birth of Spouse 12. Passport or travel document number Date of issue Date of expiry Where is your spouse now? Place of issue

If not travelling on own passport please give the following details: Name of passport holder Your relationship to passport holder

Complete here if dependants included on your passport are travelling with you Name Place Of Birth Date Of Birth Relationship To You Nationality

Page 1

13. Is this your first passport? Number

Yes

No

If no, provide details of previous passport(s) Number Yes No Place of issue

Place of issue

14. Have you ever applied for UK entry clearance? If yes, please give dates and places of application 15. Have you visited the UK before? If yes, please give dates and length of each stay 16. Have you ever been refused UK entry clearance, refused leave to enter the UK or had your leave to enter or remain cancelled? 17. Have you ever been deported, removed or otherwise required to leave the UK? 18. Have you ever been refused an Entry Clearance or been deported from another country? If yes, please give country and date 19. Do you have any criminal convictions? 20. Have you ever been a charge on public funds in the UK? 21. Type of visit: (1) Private (2) Business

Yes

No

Yes

No

If yes, complete IM2E

Yes Yes

No No

Yes Yes (3) Family

No No (4) Other and relationship to you

If (3): family member’ name s If (4): specify reason 22. Have you any other reason for travelling to the UK? 23. How long do you intend to stay in the UK? 25. How much money is available to you for your stay? 26. Who is paying for your ticket? 27. Intended address in the UK Postcode 28. Do you have any friends or relatives in the UK? Yes No Yes No

Please specify 24. Date of arrival

Telephone number If yes, please give details to include a contact number

29. What is your present job? 30. What date did you start this job? 32. Where do you work (name, address and telephone number)? 31. What is your annual income?

Declaration – to be completed by all applicants Please tick to confirm that you have read and understood the information on page 3 I declare that the information given on pages 1 and 2 of this application is correct to the best of my knowledge and belief. Information given will be treated in confidence. I understand that the information on this form may be disclosed to the Department of Work and Pensions in the UK for the purpose of determining benefit claims and to the Department of Health in the UK for the purpose of investigating payment for any NHS treatment. I agree to the information on this form being used for these purposes. Applicant’ Signature s Date

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Application for United Kingdom entry clearance INFORMATION
Please read these instructions before completing the application form. You are asked to sign the form to confirm that you have taken note of the contents (if you have downloaded this form from the internet, please also sign each page where indicated). Completing the form Your application form should be accompanied by: • • • • • The correct fee (entry clearance fees will not be refunded) Two recent passport-sized photographs (not more than six months old) Your current passport Other documents as required. Please refer to the information leaflets. The appropriate fee plus postage if required

Please complete the form in black ink and tick the boxes that apply. Applicants must complete all the questions on the form, any additional forms stated and the declaration. Applicants should put ‘ N/A’where a question is not applicable to them. A separate form should be completed by every person intending to travel unless you are a dependant under 16 included on your parent’ Passport. s Your entry clearance An entry clearance can be a Visa or an Entry Certificate Your visa or entry certificate will have effect as leave to enter when you arrive in the UK. Visit entry clearances will be valid for unlimited journeys within the validity period. The duration of each visit will be limited to a maximum period of six months. The expiry date reflects the date on which both the entry clearance and any leave to enter conferred by the entry clearance are no longer effective. Therefore, you will be required to leave the UK by the expiry date. Even if you hold a valid entry clearance you may still be examined by an Immigration Officer on arrival in the United Kingdom. You can still be refused entry to the UK by an Immigration Officer if they are satisfied that: (a) your entry clearance was obtained by false representations or by failure to disclose material, whether or not you knew of these actions; or (b) there is a change in circumstances between the date of your application and your arrival in the UK; or refusal is justified on medical grounds, because you are subject to a deportation order, or because your exclusion would be conducive to the public good. An Immigration Officer may also vary or suspend your leave to enter on arrival in the UK. An Immigration Officer can ask anyone to be medically examined on arrival in the UK, if they consider it necessary. You may be required to have a medical examination before your entry clearance is issued. Non-EEA Dependant of an EEA national This category is for non-EEA (European Economic Area) national family members of EEA nationals who are applying for a family permit to go to the UK to install themselves with the EEA national. See also the EEA nationals information leaflet.

Drugs Warning The UK has severe penalties against drug smuggling. Drug traffickers may try to bribe travellers. If you are travelling to the UK avoid any involvement with drugs.

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FOR OFFICE USE ONLY
CASH REGISTER DETAILS

Issue Category

Refuse

Tier

ECO Time Taken Type Date Of Expiry

Authorising ECO Code

Date Police Y/N? Vignette Number 3

Date Effective Check 1 Check 2

ECM Issue Check (Name & Date)

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