Form S1

Application for registration as -

• aBritishcitizen,• aBritishOverseasTerritoriescitizen,or• aBritishOverseascitizen

byoronbehalfofastatelesspersonbornbefore 1 January 1983

IMPORTANT:BeforecompletingthisformpleasereadtheaccompanyingguideS1.Fillinthepartsoftheformwhichapplytoyourapplicationandcrossouttheotherparts.Ifthereisnotenoughspaceforyouranswer,pleaseuseaseparatesheetofpaper.PleasewriteclearlyinBLOCKLETTERSanduseblackorblue-blackink.

August 2015

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Section 1 - Personal Information

1.1 PleasegiveheredateandHomeOfficereferencenumberofanypreviousapplicationorcorrespondence.

1.2 DetailsofApplicant(i.e.thestatelessperson).Title-pleasetick:

Mr Mrs Miss Ms Other

1.3 Surname/Familyname

1.4 Allothernames

1.5 Nameatbirthifdifferentfromabove

1.6 Dateofbirth: D D M M Y Y Y Y

1.7 Placeandcountryofbirth:

1.8 Ifnameatbirthisdifferentfromyourpresentname,pleasegive:

Dateofchangetopresentname D D M M Y Y Y Y

1.9 Reasonforchange(e.g.marriage,adoption,deedpoll)

1.10 Presentaddress

Postcode:

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1.11 Daytimetelephonenumber:

Mobiletelephonenumber:

Emailaddress:

Forvalidationpurposes,pleasere-writeyouremailaddressintheboxbelow:

1.12 Currentmaritalstatus(Pleasetickoneboxonly)

Single/nevermarried Divorcedorcivilpartnershipdissolved

Marriedoracivilpartner Legallyseparated

Unmarriedpartner Widowedorasurvivingcivilpartner

1.13 Ifmarried,pleasegive:

1.14 Spouse’sfullnamebeforemarriage:

1.15 Spouse’sdateofbirth: D D M M Y Y Y Y

1.16 Spouse’splaceofbirth

1.17 Spouse’scountryofbirth

1.18 Spouse’snationality

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1.19 Pleaseexplainthereasonwhytheapplicanthasbeenstatelessfrombirth

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Section 2 - Residence Requirements

Thissectiondoesnotapplyiftheapplicationisbasedontheapplicant’sbirthintheUnitedKingdomoranoverseasterritory(seesectionBoftheguide)

2.1 Pleasegivebelowdetailsoftheparentonwhomtheapplicant’squalificationdepends(seesectionsAandCtoOintheguide)

2.2 Parent’sfullname

2.3 Parent’sdateofbirth D D M M Y Y Y Y

2.4 Parent’splacecountryofbirth

2.5 Ifparentconcernedisdead,pleasegivedateofdeath

D D M M Y Y Y Y

2.6 Pleasegivenationalityattimeofdeath

2.7 Pleaseshowthenationalityoftheparentconcernedimmediatelybefore1January1983bytickingtheappropriatebox

2.8 AcitizenoftheUnitedKingdomandColonies(seesectionsA,D,E,HandJintheguide)

Ifbynaturalisationorregistration,pleasegivecertificatenumber,dateandplaceofnaturalisationor registration

2.9 ABritishsubjectwithoutcitizenship(seesectionsF,I,K,MandNintheguide)

2.10 ABritishsubjectundersection2oftheBritishNationalityAct1948(seesectionsGandOintheguide)

2.11 ABritishsubjectbyregistrationundersection1oftheBritishNationalityAct1965(seesectionCintheguide)

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2.12 Other(pleasespecify)

2.13 Ifbynaturalisationorregistration,pleasegivecertificatenumber,dateandplaceofnaturalisation or registration

2.14 RegistrationorNaturalisationnumber

2.15 Date of registration or naturalisation

D D M M Y Y Y Y

2.16 Place of registration or naturalisation

2.17 Ifyourparentsweremarriedpleasegivethedateofmarriage

D D M M Y Y Y Y

2.18 Iftheapplicant’squalificationalsodependsonordinaryresidence(seesectionsC,F,GandK-Ointheguide)pleasegivebelowallofhisorheraddressesintheUnitedKingdom,oroverseasterritoryforthelast3years.

Address Address

From: From:To: To:

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Address Address

From: From:To: To:

Address Address

From: From:To: To:

Address Address

From: From:To: To:

Address Address

From: From:To: To:

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Section 3 Referees and Identity

Affixpassportsizephoto.SeeGuideANforinformation

Thispartoftheformistobefilledinbyyourrefereesonceyourphotographhasbeenaffixedasideasexplainedabove.Yourrefereesshouldreadpage12oftheguidetoconfirmthattheyareeligible.Checkswillbecarriedouttoensurethatrefereesmeettherequirementsbelowandtheirsignaturesaregenuine,andwemaycontactthemaspartofourenquiries.

Nameofapplicant:

3.1 Onerefereeshouldbeapersonofanynationalitywhohasprofessionalstanding,e.g.Ministerofreligion,civilservant,oramemberofaprofessionalbodye.g.accountantorsolicitor(whoisnotrepresentingyouwiththisapplication).TheotherrefereemustnormallybetheholderofaBritishcitizenpassportandeitheraprofessionalpersonorovertheageof25.

Bothshoulddeclarethat:

•theyarenotarelative,solicitororagentoftheapplicant;

•theyarenotemployedbytheHomeOffice;

•theyhavenotbeenconvictedofanimprisonableoffence(unlessthatconvictioncanbedisregardedinlinewiththetableshownonpage17oftheBookletAN);

•theyhaveknowntheapplicantpersonallyformorethan3years;

•theyarewillingtogivefulldetailsoftheirknowledgeoftheapplicant;

•theywilladvisetheHomeOfficeofanyreasonwhytheapplicantshouldnotbenaturalised.

1st Referee declarationIdeclarethatIamqualifiedtoactasareferee.Thephotographaboveisatruelikenessoftheapplicant.Iconfirmeachofthepointsin3.1above.Iconfirmthattothebestofmyknowledgethedetailsgivenonpage3ofthisformarecorrect.

3.2 Sayhowyouknowtheapplicant,andstateyourageandprofession:

3.3 1strefereefullname:

3.4 Sex: Male Female

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3.5 Address:

Postcode:

Ifyouhavebeenatthisaddressforlessthan3yearspleaselistpreviousaddressesonaseparatepieceofpaper.

3.6 Daytimetelephonenumber:

3.7 Emailaddress:

3.8 CurrentBritishcitizenpassportnumber(ifany):

IunderstandthatImaybeliableforprosecutionresultinginapenaltyofupto3monthsimprisonmentorafinenotexceeding£5000orboth,ifIknowinglyorrecklesslymakeafalsedeclaration.

Signatureof1streferee: Date:

D D M M Y Y Y Y

2nd Referee declaration

IdeclarethatIamqualifiedtoactasareferee.Thephotographonpage20isatruelikenessoftheapplicant.Iconfirmeachofthepointsin3.1above.Iconfirmthattothebestofmyknowledgethedetailsgiveninthisformarecorrect.

3.9 Sayhowyouknowtheapplicant,andstateyourageandprofession:

3.10 2ndrefereefullname:

3.11 Sex: Male Female

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3.12 Address:

Postcode:

Ifyouhavebeenatthisaddressforlessthan3yearspleaselistpreviousaddressesonpage23.

3.13 Daytimetelephonenumber:

3.14 Emailaddress:

3.15 CurrentBritishcitizenpassportnumber(ifany):

IunderstandthatImaybeliableforprosecutionresultinginapenaltyofupto3monthsimprisonmentorafinenotexceeding£5000orboth,ifIknowinglyorrecklesslymakeafalsedeclaration.

Signatureof2ndreferee: Date:

D D M M Y Y Y Y

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Section 4 Biometric enrolment (british citizenship applications only)

InaccordancewithBritishNationality(General)(Amendment)Regulations2015anyoneapplyingfornaturalisationorregistrationasaBritishcitizenmustregistertheirbiometricinformation.Formoreinformationaboutregisteringyourbiometricinformation,pleaseseetheaccompanyingguidancenotes,whichyoumustreadbeforecompletingthisform.

Ifyouhaveacurrentgrantofleaveonabiometricresidencepermit(BRP),youmustprovideyourBRPfortheapplicationtobevalidandcomplete.

4.1 HaveyoubeenissuedwithaBRPwithapreviousapplicationforleave?

Yes gotoquestion4.2 No gotoquestion4.12

PleasegivedetailsofyourBRP.Pleasenotefortheapplicationtobevalidandcomplete,yourcurrentBRPmustbeprovided,unlessitisnotavailableforoneofthereasonsspecifiedontheapplicationform.

4.2 BRPnumber

4.3 Issuedate 4.4 ExpirydateD D M M Y Y Y Y D D M M Y Y Y Y

4.5 Place of issue

4.6 Nationality

4.7 BRPenclosed? Yes No

Ifnotenclosedthenpleasestatethelocationofbiometricresidencepermit:

ReturnedtoHomeOffice gotoquestion4.8

Lost gotoquestion4.9 Stolen gotoquestion4.10

Other gotoquestion4.11

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4.8 IftherequiredBRPhasbeenreturnedtotheHomeOffice,pleasegivedetailsofthereasonitwassenttous

Dateitwassenttous D D M M Y Y Y Y

4.9 IftheBRPwaslostpleasegivethedatethiswasreportedtotheHomeOfficecardmanagementservice

D D M M Y Y Y Y

4.10 Ifthebiometricresidentpermitwasstolen,pleasegivethepolicereportnumber,crimereferencenumber,thepolicestationandthedatereportedtothepolice.

Policereportnumber

Crimereferencenumber

Police station

DatereportedtothePolice: D D M M Y Y Y Y

4.11 IftherequiredBRPisnotenclosedpleasegivedetailswhyyouareunabletoprovideit:

4.12 HaveyouhadyourfingerprintstakenaspartofapreviousUKimmigrationapplicationmadeintheUKorabroad?

Yes gotoquestion4.13 No gotoquestion4.16

4.13 Dateyourfingerprintsweretaken: D D M M Y Y Y Y

4.14 Givedetailswhereyourfingerprintsweretaken,includingthetownorcityandcountry:

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4.15 GivedetailsoftheBritishdiplomaticpost(s)involvediftheapplication(s)wasorweremadeabroad:

4.16 Doyouhaveamedicalorphysicalconditionwhichmayrequirespecialarrangementsforyourbiometricfeaturestoberecorded?

Yes pleaseprovideuswithaletterfromadoctorregisteredwiththeGeneralMedicalCouncil(GMC)givingdetailsoftheconditionand/orspecialneedsandexplaininganyarrangementsthatmaybenecessary.

No

Applicantsundertheageof16

Pleasecompletequestions4.17,4.18and4.19

(Applicantsundertheageof16mustbeaccompaniedbyaparentorlegalguardian)

4.17 Istheapplicant

16yearsoldormore completequestions4.1to4.16,thengoto4.21

Lessthan16yearsold gotoquestion4.18

4.18 Givedetailsofthepersonwhowillbeaccompanyingtheapplicantwhenheorsheattendstheirbiometricinformationenrolmentappointment.

Nameofresponsibleadult

Dateofbirth D D M M Y Y Y Y

Nationality

Relationshiptochild

4.19 isthispersontheapplican’tsparentorlegalguarian?

Yes gotoquestion4.21 gotoquestion4.20

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4.20 Pleaseexplainwhyapersonotherthantheapplicant’sparentorlegalguardianwillbeaccompanyingtheapplicant

4.21 DeclarationAsrequiredbyBritishNationality(General)(Amendment)(2)Regulations2014,IconfirmthatIwishtoregistermybiometricinformation.

IunderstandthattheHomeOfficemaymakeenquiriesaboutanyresponsibleadultnominatedtobepresentwhenmychild’sfingerprintsand/oraphotographaretaken.

SignatureDateD D M M Y Y Y Y

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Section 5 Declaration

Warning:togivefalseinformationonthisformknowinglyorrecklesslyisacriminaloffencepunishablewithupto3months’imprisonmentorbyafinenotexceeding£5000orboth.

(Section46(1)oftheBritishNationalityAct1981,asamended).

5.1 I(fullnameinblockletters)

declarethat,tothebestofmyknowledgeandbelief,theinformationgiveninthisapplicationiscorrect.IknowofnoreasonwhyIshouldnotbegrantedBritishcitizenship.IpromisetoinformtheHomeSecretaryinwritingofanychangeincircumstanceswhichmayaffecttheaccuracyoftheinformationgivenwhilstthisapplicationisbeingconsideredbytheHomeOffice.Iunderstandthatinformationgivenbymewillbetreatedinconfidence,butmaybesubmittedforcheckingagainstrecordsheldbyotherGovernmentdepartments,theSecurityServiceandotheragencies,localauthoritiesandthepolice,whereitisnecessaryforimmigrationornationalitypurposes,ortoenablethesebodiestocarryouttheirfunctions.

IunderstandthatImaybeliableforprosecutionifIhaveknowinglyorrecklesslyprovidedfalseorincompleteinformation.

IauthorisetheHMRevenue&CustomstoprovidetheUKVisasandImmigrationwithanyinformationrelevanttothisapplication,andwithanyinformationneededtochecktheinformationIhaveprovided.IunderstandthatanyinformationprovidedtotheHMRevenue&Customsinconnectionwiththisapplicationmaybeusedbythemforthepurposeoftheirstatutoryfunctions.

5.2 IconfirmthatIhavereadandunderstoodtheguideS2-statelesspersonsregistration

5.3 IconfirmthatIhaveenclosedtheappropriateregistrationfeeandpaymentslip

5.4 IconfirmthatIhaveenclosedtheappropriatedocuments

5.5 Iunderstandthatacertificateofcitizenshipmaybewithdrawnifitisfoundtohavebeenobtainedbyfraud,falserepresentationorconcealmentofanymaterialfact,orifonthebasisofmyconducttheHomeSecretaryconsidersittobeconducivetothepublicgood.

5.6 *Ideclarethat,althoughIdonotmeetallofthestatutoryrequirementsforregistration,Ibelievethat,inviewofthefollowingspecialcircumstances,theHomeSecretaryshouldtreatmeasfulfillingthoserequirementsorwaivetheneedinmycasetofulfilthem.

*Delete if not applicable

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5.7 Specialcircumstances-whichrequirementsdoyouthinkyoufailtomeetandwhatarethespecialcircumstances?(continueonaseparatesheetofpaper).

5.8 Pleasesignbelowonceyouaresatisfiedyouhavecompletedtheformcorrectly.Feesarenotfullyrefundableforapplicationsthatfail.Youarerecommendedtoreadtheguide,particularlythosesectionsonhowtoqualifyandtheresidencerequirements.

Signature Date

D D M M Y Y Y Y