UK Visas & Immigration

APPLICANT NAME: Diana Burlaka

UNIQUE APPLICATION NUMBER: 3434-6186-6834-5966

PASSPORT NUMBER: GC990496

COUNTRY OF NATIONALITY: Ukraine

DATE OF APPLICATION: 28 July 2022 12:42 British Summer Time (BST)

TYPE OF VISA/APPLICATION: Ukraine Scheme

REGISTRATION EMAIL: barberkh25@gmail.com

CONTACT EMAIL: barberkh25@gmail.com

Immigration adviser details

Are you using an immigration adviser based in the No

UK?

Contact preferences
Which email address can we use to contact you? barberkh25@gmail.com

Which phone number can we use to contact you? 07502223883

Other names and nationalities

In addition to the names already provided, are you Yes

now or have you ever been known by another name?

Given name(s) Diana

Family name Bulbina

In addition to the names already provided, are you No

now or have you ever been known by another name?

Do you currently hold, or have you ever held, any No

other nationality or citizenship?

Your location
Enter the country in which DIANA BURLAKA is Ukraine

making their application

Eligibility
What are you applying for? Ukraine Sponsorship Scheme visa (Homes for

Ukraine)

Were you living in Ukraine on 31 December 2021? Yes

What type of sponsor do you have? an individual

Does your sponsor have the right to live in the UK for Yes

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the next 6 months?

Given names Clare Louise

Family name Iley

Has Clare Louise Iley ever been known by another Yes

name?

Given name(s) Clare Louise

Family name Sardeson

Country of nationality United Kingdom

Date of birth 1967-04-14

Does Clare Louise Iley have any other nationalities? No

Does Clare Louise Iley have any of these identity Passport

documents?

Passport number 53877632

What evidence can you provide of Clare Louise Iley's British passport

identity?

Telephone number 07502 223883

Confirm your telephone number 07502 223883

Email address clareiley@aol.com

Confirm email address clareiley@aol.com

Address FOUR WINDS

MILTON ROAD

Town/City CHIPPING NORTON

Postcode OX7 6BD

Is this the address you will be staying at in the UK? Yes

Will there be any other people living at this address? Yes

Given name(s) John Alastair

Family name Iley

Country of nationality United Kingdom

Date of birth 1967-09-29

Does John Alastair Iley have any of these identity Passport

documents?

Passport number 560370575

Given name(s) Charlotte Alice

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Family name Iley

Country of nationality United Kingdom

Date of birth 2000-10-04

Does Charlotte Alice Iley have any of these identity Passport

documents?

Passport number 557636256

Given name(s) George Samuel

Family name Iley

Country of nationality United Kingdom

Date of birth 2002-12-26

Does George Samuel Iley have any of these identity Passport

documents?

Passport number 557054982

Personal details
Select the sex that is on your passport or travel Female

document

Address Ukrain

Kharkiv

Poltava way 133

Town/City City

Province/Region/State Kharkiv

Postal code (if applicable) 61064

Travel history
When do you plan to arrive in the UK? 2022-08-04

Criminality
For either the UK or any other country, have you ever No

been:

• refused a visa

• refused entry at the border

• refused permission to stay or remain

• refused asylum

• deported

• removed

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• required to leave

• excluded or banned from entry

Have you ever: No

• entered the UK illegally

• remained in the UK beyond the validity of your visa

or permission to stay

• breached the conditions of your leave, for example,

worked without permission or received public

funds when you did not have permission

• given false information when applying for a visa,

leave to enter, or leave to remain

• breached UK immigration law in any other way

At any time, have you ever had any of the following, No

in the UK or in another country?

• criminal convictions

• outstanding criminal proceedings

• cautions or fixed penalty notices

• court judgements

• civil penalties for breaking UK immigration law

Have you ever conducted any activities which would No

indicate that your presence would be harmful to the

UK or its people, or mean that you are not

considered a person of good character?

Employment history No

People applying with you

Is anyone applying with you, that you have not Yes

already mentioned?

Given names Kostiantyn

Surname Burlaka

What is Kostiantyn Burlaka's relationship to you? My husband

Date of birth 1993-09-13

Passport number Gc990769

Do you have anyone else applying with you that you No

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haven't mentioned?

Declaration
I understand and accept this

Collecting your biometric residence permit Headington, 152 London Road, Oxford, OX3 9ED

I confirm that I understand and accept these

conditions

By sending this application, you confirm that to the best of your knowledge and belief the following is

correct:

• the information relating to the application

• the supporting evidence

I understand that the data I have given can be used as set out in the privacy policy

I consent to organisations, including financial institutions, providing information to the Home Office when

requested in relation to this application.

I have discussed with any applicants that I am applying on behalf of, and confirmed that the contents of the

application are correct and complete.

I agree to the terms and conditions.

I understand that if false information is given, the application can be refused and I may be prosecuted, and,

if I am the applicant, I may be banned from the UK.

I am the applicant aged 18 or over

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