THIS FORM IS SUPPLIED FREE OF CHARGE IM2A (Revised 12/01)

Application for United Kingdom entry clearance Reference:

Please read the information on page 3 before completing this form

Type of entry clearance required (please tick appropriate boxes) Two recent
photographs to be
Transit attached here
Visitor six months one year Two years five years
Student Please also complete form IM2S
Settlement As spouse/fiancé(e)/other relative/partner. Please also complete form IM2B
Long Stay: Returning resident
Dependant of any applicant in long stay categories
Permit free employment/Retired Person of Independent
Means/Investor Please also complete form
Working Holidaymaker/Work permit holder/Innovator or to IM2C (except HSMP)
establish a business/Highly Skilled Migrant Programme (HSMP)
Certificate of entitlement, UK ancestry Please also complete form IM2D
Are you applying as a non-EEA dependant of an EEA national? Yes No

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 4. Sex M F 5. Place of birth

6. Father’s full name

7. Mother’s full name

8. Current Nationality 9. Country of residence

10. Home Address

Telephone number

11. Are you? Married Single Divorced Widowed Separated

If married, full name of spouse

Date of birth of Spouse Where is your spouse now?

12. Passport or travel document number Place of issue

Date of issue Date of expiry

If not travelling on own passport please give the following details:

Name of passport
Your relationship to passport holder
holder
Complete here if dependants included on your passport are travelling with you

Name Place Of Birth Date Of Birth Relationship To You Nationality

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13. Is this your first passport? Yes No If no, provide details of previous passport(s)

Number Place of issue Number Place of issue

14. Have you ever applied for UK entry clearance? Yes No

If yes, please give dates and places of application

15. Have you visited the UK before? Yes No

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 Yes No If yes, complete IM2E
cancelled?
17. Have you ever been deported, removed or otherwise
Yes No
required to leave the UK?
18. Have you ever been refused an Entry Clearance or been
Yes No
deported from another country?

If yes, please give country and date

19. Do you have any criminal convictions? Yes No

20. Have you ever been a charge on public funds in the UK? Yes No

21. Type of visit: (1) Private (2) Business (3) Family (4) Other

If (3): family member’s name and relationship to you

If (4): specify reason

22. Have you any other reason for travelling to the UK? Yes No Please specify

23. How long do you intend to stay in the UK? 24. Date of arrival

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 Telephone number

If yes, please give details to include a
28. Do you have any friends or relatives in the UK? Yes No
contact number

29. What is your present job?

30. What date did you start this job? 31. What is your annual income?

32. Where do you work (name, address and telephone number)?

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’s Signature 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’s Passport.

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

Authorising
Issue Refuse Tier ECO Time Taken Date
ECO

Category Type Code Police Y/N?

Date Effective Date Of Expiry Vignette Number 3

Check 1 Check 2

ECM Issue Check (Name & Date)

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