Beruflich Dokumente
Kultur Dokumente
(G)
version 04/13
APPLICATION FOR A GRANT OF LEAVE AND BIOMETRIC IMMIGRATION DOCUMENT UNDER TIER 4 (GENERAL) STUDENT MAIN APPLICANT This form is for students who are already in the United Kingdom to apply to study under Tier 4 (General).
In accordance with paragraph 34 of the Immigration Rules, this form is specified for applications made on or after 6 April 2013. Please check on the website at www.ukba.homeoffice.gov.uk that this is the current form for use on the date that you apply. You are advised to read the help text and separate guidance notes that are available to help with this form. Please read them before making your application. If you do not already have them, you can download them from our website. Applications made on this form may be made by post, courier or in person. To apply in person you must make an appointment. Details of where you can make an application in person can be found on our website:www.ukba.homeoffice.gov.uk/contact/applyinginperson/ Postal address: UK Border Agency Tier 4 PO Box 500 Durham DH99 1WJ Courier address: UK Border Agency Tier 4 Millburngate House Millburngate Durham DH97 1PA Postal address (Student Batch): UK Border Agency PBS Dependants PO Box 505 Durham DH99 1WD
Intentionally Blank
If you do not select a fee then we cannot take a payment and your application will be rejected as invalid.
A1. Is your sponsor a Highly Trusted Sponsor? A2. Tick the applicable fee (ht): The student is making a standard postal application as a Tier 4 (General) student YES NO
The student is making a Tier 4 (General) student application in person For applications made in person at a public enquiry office, the total fee includes a 100 apopintment fee, which may be retained should the applicant fail to attend their appointment without good reason. A3. Address for correspondence in the UK (ht) House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Postcode A4. If you are using a solicitor or other authorised immigration advisor to help you with this application form, you should enter the name of that person here (ht) A5. Your full Name (ht):
- 406 - 781
A17. Amount - please tick appropriate box (ht) A18. Cardholders signature: A19. Date D D
Y Y
If you are producing a double-sided copy of this application form, please include this page and make sure it falls on the reverse of the payment details page in the two-sided copy. For administrative reasons, it is important that the rest of the form begins with Section B Your Personal Details facing upwards
Date of birth
Date of birth
Date of birth
Date of birth
Date of birth
Date of birth
Last name
Date of birth
Date of birth
Date of birth
Date of birth
Tier 4 (General) Application Form You must complete all of the sections and questions in this form that apply to you. The form will not be valid if it is not fully completed and your application will be rejected and returned to you. There is a separate help text leaflet available with this form. Where a question in this form has information available in the help text leaflet it will be marked with (ht)
In this section you will be asked to provide information about your personal situation, for example your name, date of birth and nationality as well as information about any other names you have used, or other nationalities you have held. Photographs For your application to be valid, you must provide two recent identical passport-size photographs of yourself with your full name written on the back of each one. The photographs must be in the format specified in the separate photograph guidance, including the mandatory requirements, which can be found on our website at http://www.ukba.homeoffice.gov.uk. Please ensure that you place the photographs in a small sealed envelope attached to this part of the form - and without allowing any staples, clips, pins or anything else to mark or damage the photographs. The photographs will be checked against the images taken when your biometric features are recorded. I have enclosed the required photographs as outlined in the box above. I am a low risk student and I am applying under the differentiation arrangements (please see paragraph 10 and 11 of the Tier 4 guidance for more information about this arrangement) B1. What is your name, as given in your passport or travel document? (ht) Title - please select from the following list: Mr Mrs Miss Ms Dr
B3. What is your date of birth? D Married Civil Partner Single Divorced Widow/Widower D M M Y Y Y Y Dissolved Civil Partnership Surviving Civil Partner Unmarried Partner Separated Separation Order B4. What is your relationship status? (ht):
Tier 4 (General) Application Form B5. What village, town or city were you born in?
B8. If you currently hold or have ever held any other Nationality, please provide details in the box below: (ht) What Nationality did you or do you hold? Date held from: Date held to:
Please tick to confirm that you are submitting the required evidence relating to this other Nationality with this application. B9. If you are currently known by or have ever been known by any other name, please provided details in the box below: (ht) What name are you or were you known by? Date of Birth when using this name: Dates that you used Dates that you used this name from: this name to:
Please tick to confirm that you are submitting the required evidence relating to this other name with this application. Now go to Section C
D4. Is your representative based in the UK? Yes - go to D5 No - go to D6 D5. What is their UK address? House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Postcode: Now go to D7 D6. What is their overseas address? House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Country Postcode: D7. Please provide your representatives contact details: Work telephone number Mobile telephone number E-mail address line 1 E-mail address line 2 Fax number Tier 4 (G) Application Form (version 04/13) - page 10
Tier 4 (General) Application Form D8. Is your representative regulated by the Office of the Immigration Services Commissioner? (ht) Yes - go to D9 No - go to D10
Now go to D11 D10. What is the reason that they are not OISC registered? They are authorised by designated professional body or regulator They are registered or authorised in an EEA State They are supervised They are exempt or employed or supervised by exempt person They are specified by an order I dont know
D11. Is your representative listed with one of the UK Border Agencys Public Enquiry Office (PEO) services? Yes Now go to Section E No
E1. Have you ever had a Home Office or UK Border Agency reference number assigned to you? (ht) Yes - go to E2 No - go to E3
E2. What is/are your Home Office or UK Border Agency reference number? You may enter up to 3 reference numbers below: Reference number 1 Reference number 2 Reference number 3 E3. Do you currently have a National Insurance number? (ht) Yes - go to E4 No - go to E5
E5. Have you previously had a National Insurance number? (ht) Yes - go to E6 No - go to Section F
Now go to section F
Lost - go to F2
F3; Please provide the following details: What was the Police report number? What was the crime reference number? Which police station What date was this was this reported at? reported to the Police on?
Tier 4 (General) Application Form F4: Have you had a previous Passport or Travel Document? (ht) Yes go to F5 No go to Section G
F5; Please provide the following details: Previous Passport or Travel Document What is the passport or travel document number? What is What is the the issue nationality date? on the passport? What is What is Is the the expiry the place passport date? of issue? or travel document enclosed? Yes go to Section G If the passport or travel document is not enclosed, please indicate why: Lost - go to F6 Stolen - go to F7 No go to next column Expired and returned to national authorities go to Section G Already with UKBA
F7; Please provide the following details: What was the Police report number? What was the crime reference number? Which police station What date was this was this reported at? reported to the Police on?
Now go section G
No - go to next column
G4; Please provide the following details: What was the Police report number? What was the crime reference number? Which police station What date was this was this reported at? reported to the Police on?
G5; Have you reported this to the UKBA card management service? Yes go to G6 No go to Section H
H2; What was your address? House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Country Postcode H3; What date did you move to this address? D D M M Y Y Y Y
H4; What date did you move from this address? D D M M Y Y Y Y If you have lived at more than one address in Northern Ireland, please continue on a seperate sheet. H5; Have you lived at any other addresses in the UK within the last 5 years? (ht) Yes go to H6 No go to Section I
H6; What was your address? House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Postcode
Tier 4 (General) Application Form H7; What date did you move to this address? D D M M Y Y Y Y
If you have lived at more than one address in the last five years, please continue on a seperate sheet. Now go to Section I
I4; If you were sentenced to a period of imprisonment, what was the length of the prison sentence in months?
I7; Have you ever had any civil judgements issued against you or received a civil penalty under the UK Immigration Acts? (ht) Yes go to I8 No go to I11
Tier 4 (General) Application Form I9; Date of the judgement or civil penalty D D M M Y Y Y Y
I11; Have you ever been charged or indicted in any country with a criminal offence for which you have not yet been tried in court? (ht) Yes go to I12 No go to I13
I13; In either peace or war time, have you ever been involved in, or suspected of involvement in, war crimes, crimes against humanity or genocide? (ht) Yes go to I14 No go to I15
I15; Have you ever been involved in, supported or encouraged terrorist activities in any country? (ht) Yes go to I16 No go to I17
Tier 4 (General) Application Form I17; Have you ever been a member of, or given support to an organisation which has been concerned with or involved in terrorism? (ht) Yes go to I18 No go to I19
I19; Have you, by any means or medium, expressed views that justify or glorify terrorist violence or that may encourage othes to commit terrorists acts or activities or other serious criminal activites? (ht) Yes go to I20 No to to Section J
Now go to Section J
J3; I am submitting evidence of exceptional circumstances which prevented me from submitting my application within 28 days of overstaying. Tick to confirm J4; Were you required to register with the Police as a condition of your previous leave? Yes No
J5; Did you have a visa or entry clearance when you came to the UK? (ht) Yes go to J6 No go to J10
J6; In which country did you obtain your visa or entry clearance?
J8; What date was your visa or entry clearance valid from? D D M M Y Y Y Y
J9; What date was your visa or entry clearance valid to? D D M M Y Y Y Y
Tier 4 (General) Application Form J10. How did you enter the UK? By air By sea By the Channel Tunnel Travelling overland via the Republic of Ireland J11. At which Port did you enter the UK?
J14. Have you ever stayed in the United Kingdom beyond your period of leave? (ht) Yes - go to J15 No - go to J16 J15. Please provide details:
J16. Have you ever knowingly used deception when seeking leave to enter or remain, entered the United Kingdom illegally or worked in the united Kingdom without immigration permission to do so (contrary to your conditions of stay)? (ht) - go to J17 Yes No - go to J18 J17. Please provide details:
J18. Have you ever been refused entry clearance, leave to enter or leave to remain in the UK? Yes - go to J19 No - go to J20 J19. Please give details:
Tier 4 (General) Application Form J20. Have you ever been removed, required to leave or deported from the UK? (ht) Yes - go to J21 No - go to J22
J22. Do you currently have any other applications with the UK Border Agency on which you are awaiting a decision? (ht) Yes - go to J23 No - go to J24
J24. Do you currently have an immigration appeal before the Tribunal which has not yet been finally determined? (ht) Yes - go to J25 No - go to Section K
Now go to Section K.
K2; Have you claimed Attendance Allowance? Yes K3; Have you claimed Carers Allowance? Yes K4; Have you claimed Child Benefit? Yes K5; Have you claimed Child Tax Credit? Yes K6; Have you claimed Council Tax Benefit? Yes No No No No No
K9. What is the name of the local housing authority or housing association that provided this?
Tier 4 (General) Application Form K10. Have you claimed Housing Benefit? Yes No
K11. Have you claimed Income-based Jobseekers Allowance? Yes K12. Have you claimed Income Support? Yes No No
K15. Have you claimed State Pension Credit? Yes K16. Have you claimed Working Tax Credit? Yes No No
K17. Have you claimed Income-related Employment and Support Allowance? Yes No
K18. Is your housing provided by a local authority or housing authority as part of an agreement between your employer and a housing authority? (ht) Yes No K19. Have you claimed Council Tax Reduction? Yes No
K20. Have you claimed Personal Independence Payment? Yes K21. Have you claimed Universal Credit? Yes Now go to Section L Tier 4 (G) Application Form (version 04/13) - page 25 No No
L3. Please provide your Tier 4 sponsors address: (ht) House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Country Postcode: L4. Do you have a CAS? (ht) Yes - go to L5 No - go to L6
Tier 4 (General) Application Form L9. What date does your course end? (ht) D D M M Y Y Y Y L10. Is the address of your primary site of study the same as your Tier 4 sponsors address (as given above)? (ht) Yes - go to L12 No - go to L11 L11. Please provide the address of your main site of study: House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Country Postcode: L12. What is the study level of your course? Below NQF Level 6 - go to L14 At NQF Level 6 or NQF Level 7 - go to L15 At NQF Level 8 - go to L13 L13. Are you applying for the Doctorate Extension Scheme? (ht) Yes Now go to L15 L14. How can you demonstrate your English Language ability? I am a national of a listed country. I am providing a degree-level qualification from a listed country. I have previously studied in the UK as a Tier 4 (Child) Student. I am providing an English Language test certificate at level B1 of the CEFR which is from an approved and registered provider. Now go to L16 L15. How can you demonstrate your English Language ability? I am a national of a listed country. I am providing a degree-level qualification from a listed country. I have previously studied in the UK as a Tier 4 (Child) Student. I am providing an English Language test certificate at level B2 of the CEFR which is from an approved and registered provider. I am studying at a Sponsor who is an HEI or Recognised Body and who have tested my ability and has confirmed on my CAS that I can speak English to the required standard. I am studying at a Sponsor who is an HEI or Recognised Body and who has confirmed on my CAS that I am a gifted student. Tier 4 (G) Application Form (version 04/13) - page 27 No
Tier 4 (General) Application Form L16. Can you speak English to the required standard? Yes No Now go to Section M
M2. If you have paid anything towards your course fees, please provide this amount below: Amount paid .
M3. If you have paid something towards your course fees, what are you submitting as evidence of this? (ht) Receipts for payments It is stated on my CAS I am a low risk National M4. Do you have an established presence in the UK? (ht) Yes M5. Where are you intending to study? (ht) Inside the Inner London area Outside the Inner London area M6. If you have paid anything to your sponsor for your accommodation, please provide the amount below: (ht) Accommodation . M7. If you have paid something to your sponsor towards your accommodation, what are you submitting as evidence of this? (ht) Receipts for payments It is stated on my CAS I am a low risk National No
Tier 4 (General) Application Form M8. Are you receiving money from an Official Financial Sponsor? (ht) Yes go to M9 No go to M11
M9. If they are not covering the full amounts, please state how much your Official Financial Sponsor is paying towards: Maintenance . Course fees .
M10. Please tick one of the following: I am enclosing a letter from my Official Financial Sponsor with this application My Official Financial Sponsorship is shown on my CAS. I am a low risk National M11. Will you receive any other financial sponsorship, such as a scholarship or bursary, from your Tier 4 educational sponsor? Yes go to M12 No go to M14 M12. If they are not covering the full amounts, please state how much your Tier 4 Educational sponsor is paying towards: Maintenance . Course fees .
M13. Your Tier 4 educational sponsor must show this on your CAS record: My Tier 4 sponsor has agreed to show this on my CAS record. M14. Please provide a summary of how much money you are still required to show for your outstanding fees and maintenance: Maintenance . Course fees Total . .
M15. Are all of the funds you are using to demonstrate your ability to maintain yourself and any dependants in your own name or in the name of your parent(s) or legal guardian(s)? The funds are in my own name - go to M18 The funds are in the name of my parent(s) or legal guardian(s) - go to M16 M16. Please tick to confirm the following: I am providing a letter from my parent(s) or legal guardian(s) I am a low risk national and am not required to provide this evidence. M17. I am also providing one of the following: My full Birth Certificate naming both me and my parents. A Certificate of Adoption naming me and my adoptive parent(s). Tier 4 (G) Application Form (version 04/13) - page 29
Tier 4 (General) Application Form A formal Court document naming me and my legal guardian(s). I am a low risk national and am not required to provide this evidence. M18. Please tick to confirm that you are providing one of the following documents: Personal bank or building society statements. A building Society pass-book. A letter from a bank or building society confirming funds A letter from a regulated financial institution confirming the agreement of a loan. No evidence is required as I do not owe any money for fees or maintenance. I am a low risk national and am not required to provide this evidence. Now go to Section N
Please also tick to confirm that you are enclosing your ATAS certificate with your application:
N3. Have you previously been given leave for a course as a Postgraduate Doctor or Dentist? Yes No
N4. Have you previously had leave as a Tier 4 (General) student or Student? Yes go to N5 No go to N6
N6. Are you currently being sponsored by or have you ever been sponsored by a Government or an International Scholarship Agency? (ht) Yes go to N7 No go to N9 N7. Are there any restriction imposed on the length of stay in the United Kingdom as a result of this sponsorship? Yes go to N8 No go to N9 N8. Please provide details of the restrictions:
Please tick to confirm that you are enclosing written confirmation from your sponsor stating that they consent to your application.
Tier 4 (General) Application Form N9. I am: Studying English as a Foreign Language course only - go to N10 Studying any other type of course - go to N11 A Student Union Sabbatical Officer - we will use the information provided on your CAS as evidence. Undertaking a Foundation course as a Post-graduate Doctor or Dentist - go to N12
N10. If you have been assessed by means of an academic or professional reference, you must send us each original reference used by your sponsor as the basis for their offer to you. Please tick one of the following boxes: I am enclosing the original reference(s) with my application. I am enclosing copies of my reference(s) along with a letter from my sponsor confirming the content of the reference copies. n/a I am a low risk national and am not required to include this document with my application. Now go to Section O
N11. You must send us the evidence that your Tier 4 sponsor used as the basis for assigning a CAS to you, unless you are exempt from doing so. Please tick one of the following boxes: I am enclosing all of the qualification certificates and transcripts of results used as the basis of my course offer. I was assessed by my sponsor by other means. I am a low risk national and am not required to include this document with my application. Now go to Section O
N12. You must send us your original certificate of qualification and/or your original transcript of results of your UK qualification in Medicine or Dentistry, as listed by your Tier 4 sponsor on your CAS: I am enclosing the required evidence. I am a low risk national an am not required to include this document with my application. Now go to Section O
O2. What is the name of your Parent or Legal Guardian? Title - please select from the following list: Mr Mrs Miss Ms Dr
O5. Please provide their address: House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Country Postcode: O6. How are you related to your Parent or Legal Guardian?
O7. What is the name of your Parent or Legal Guardian? Title - please select from the following list: Mr Mrs Miss Ms Dr
10. Please provide their address: House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Country Postcode: 11. How are you related to your Parent or Legal Guardian?
12. Please tick the following box: I am enclosing a letter from my Parent(s) or legal guardian(s) confirming they consent to this application.
The information given in my application is complete and is true to the best of my knowledge and belief. The photographs I have submitted with my application are a true likeness of me. The documents I have submitted in support of my application are complete and correct to the best of my knowledge and belief. I agree to co-operate with UK Border Agency officials, or any other person charged by the Secretary of State for the Home Office with conducting pre-issue and post-issue checks in relation to this application. If there is a material change in my circumstances or any new information relevant to this application becomes available before it is decided, I will inform the UK Border Agency. I am aware that the rules and requirements for applications may change in the future and that I should not assume the current rules and requirements will continue to apply. I agree to the UK Border Agency using the data provided in this application in accordance with its Information Charter. I understand that my details may in certain circumstances be passed to other people, including fraud prevention agencies, to prevent and detect fraud, money laundering and other crimes. I also understand that the UK Border Agency may receive information about me.
Name
Signature
Date D D M M Y Y Y Y
Name
Signature
Date D D M M Y Y Y Y
Tier 4 (General) Application Form Summary Sheet Fill in this part of the form to help us to make sure that we have received the students documents and to keep a record of them while they are with us. At A, tell us how many of each of the listed documents the student has sent with this application. This is a standard list, students should only send in the documents from this list that are required for their application. At B, list any other documents and state how many in each case. Continue on a separate sheet if necessary. Part A - Type of document Passports Biometric Residence Permits and/ or travel documents Police registration certificates Marriage or civil partnership certificates Birth certificates Driving Licences Fill in the summary sheet below listing the supporting evidence (documents) sent. You must send the required evidence as specified in this application form and the Tier 4 of the points based system Policy Guidance. Failure to submit required evidence is likely to lead to refusal of your application. Area Possession of a Confirmation of Acceptance for Studies (CAS) Maintenance (Funds) Documents provided (please list) How many? Part B - Listed Items 2 photographs How many?
Finally please ensure that your application is addressed correctly, as given on the front of this form.