Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

APPLICANT BIOGRAPHIC DETAILS AND TRAVEL DATE

APPLICATION ID: GWF033860885

GIVEN NAMES: SHALMA HAYETH

FAMILY NAME: URAZAN FIGUEREDO

DATE OF BIRTH: 11 JUN 1998

PLACE OF BIRTH: BOGOTA

SEX: FEMALE

NATIONALITY: COLOMBIA

PASSPORT NUMBER: RN27306396

VISA APPLICATION NUMBER:

GWF033860885
DATE APPLICATION 24 OCT 2014
SUBMITTED ONLINE:

DATE OF PLANNED ARRIVAL 24 DEC 2014

IN THE UK:

VISA APPLICANT CONTACT DETAILS

APPLICANTS EMAIL [email protected]

ADDRESS:

APPLICANTS PRIMARY 00573103246426

NUMBER:

APPLICANTS SECONDARY
NUMBER:
>> OFFICIAL USE ONLY
VISA APPLICATION FEE AND PAYMENT CONFIRMATION

PAYMENT REFERENCE: 3627977392

TOTAL FEE: USD 142.00

PAYMENT MADE: YES - ONLINE

PAYMENT DATE: 24 OCT 2014

VISA APPLICATION SUBMISSION LOCATION

SUBMISSION METHOD: STANDARD

VISA APPLICATION BRITISH EMBASSY BOGOTA - BOGOTA

LOCATION:

>>OFFICE USE ONLY

CATEGORY: GENERAL VISITOR

TYPE: (GENERAL) SINGLE, DOUBLE AND MULTIPLE, VALID UP TO 6

MONTHS

EC NUMBER:

Created: 24/10/2014 Page 1 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

DECLARATION
I declare that the information given on this form whether input by myself, input on my behalf by a third party or automatically pre-populated is complete
and correct to the best of my knowledge and belief. I also declare that the photograph submitted with this form is a true likeness of me. I confirm that if,
before this application is decided, there is a material change in my circumstances or new information relevant to this application becomes available, I
will inform the United Kingdom diplomatic mission handling my application.

I understand that all information provided by me will be processed by the Home Office in accordance with the Data Protection Act 1998. I am aware
that the Home Office is the data controller in relation to the information provided by me in this application form. I am aware that the information I
provide, including biometric data, will be treated in confidence, but it may be disclosed to other government departments, agencies, local authorities,
foreign governments, and other bodies, to enable the Home Office or those bodies to perform their functions. Any disclosures will be in accordance with
the Data Protection Act 1998. I also understand that the information provided by me may also be used for staff training purposes.

I declare that the documents that I have supplied with this application are genuine and the statements I have made with this application are truthful. I
understand that the Home Office (or a trusted third party) may make reasonable checks to confirm the accuracy and authenticity of evidence I have
provided and documents I have submitted with this application. I further understand that the Home Office (or a trusted third party) may also make
reasonable checks on any sponsors to my application to verify statements contained in the application and establish that I will comply or have complied
with the terms of any visa granted.

I understand that UK entry clearance applications may be handled by British Missions in other locations, including outside the country in which I have
applied for entry clearance and that this may involve the transferring of my application and supporting documents to and from another Mission. I
understand that the Home Office will be responsible for transferring my application and supporting documents safely. I understand in these
circumstances my application will still be handled in line with Home Office published customer service standards.

I understand that the fee payable is for an application processing and entry clearance decision-making service, not for the guaranteed delivery of a
visa, therefore I will not be entitled to a refund should my application for entry to the UK or Commonwealth and Overseas Territories be refused or
granted for a shorter time period than I applied for. I also understand that my visa application fee will be refunded only if the application is withdrawn in
writing within 3 months and 7 days of the original date of application and prior to the submission of biometric data or any processing taking place.

I also understand that the information provided by me, or information made available to the Home Office during the processing of my application, may
be shared with my sponsor(s) or any person(s) acting on their behalf or any applicant linked to my application (for example to my spouse / partner if we
apply for visas for a trip together) for the sole purpose of considering my application. I am aware that if there is any information I do not want you to
disclose to them I will tell you by enclosing a letter with my supporting documentation. If such requests prevent you from making legitimate inquiries, my
application may be refused.

I am also aware that my application will be automatically refused and I may be banned from going to the UK for 10 years if I use a false document, lie or
withhold relevant information. I may also be banned if I have breached immigration laws in the UK. I am further aware that should I use a false
document, lie or withhold relevant information my details may be passed to law enforcement agencies.

I understand that I may be required to provide a record of my fingerprints and a photograph of my face (“biometric data”) as part of my application. If I
refuse to do so, my application may be treated as invalid and, if so, will not be considered further. (See Statutory Instrument 2006 No 1743 - The
Immigration (Provision of Physical Data) Regulations 2006, Regulation 7(1)).

I am aware that I may be billed for any NHS medical treatment undertaken in the UK and that I do not have recourse to public funds during my stay in
the UK.
I understand that if I fail to pay NHS debts incurred by me this could adversely affect future entry clearance applications I make.

I understand that my details may, in certain circumstances, be passed to fraud prevention agencies to prevent and detect fraud and money laundering.
I also understand that such agencies may provide the Home Office with information about me. Further details explaining when information may be
passed to or from fraud prevention agencies and how that information may be used can be obtained from the Home Office website.

I am aware that it is an offence under the Immigration Act 1971 (as amended) to make a statement which I know to be false, or not believe to be true, in
order to obtain a visa/entry clearance to the UK.

I hereby apply for a visa/entry clearance to the United Kingdom.

Information for sponsors

Personal information which is provided about a person acting in support of an application, including any documentary evidence provided by or about
them, will be processed in accordance with the Data Protection Act 1998 by the Home Office, which is the data controller in relation to the information
provided.
The Home Office will use this information to make decisions about the application and to prevent and detect fraud. We may share this information with
other government departments or agencies, local and public authorities, foreign governments, companies (including financial and utility companies),
employers or other bodies in order to make reasonable checks to verify the information provided in the application and confirm that sponsors have or
will comply with the terms of any visa which may be or have been granted. Any information received by the Home Office about a sponsor may be used
in reaching a decision on the application. Full details of the way in which the data may be processed can be found on the Home Office website at
http://www.ukba.homeoffice.gov.uk/

I confirm that, where I have a sponsor, I have informed my sponsor of the information set out above and my sponsor has confirmed that they consent to
me providing the information about them which is set out in this application.

APPLICANT'S SIGNATURE:

DATE SIGNED:

FORM COMPLETED BY: SHALMA HAYETH URAZAN FIGUEREDO

GWF033860885

Created: 24/10/2014 Page 2 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

APPLICANT NAME: Shalma Hayeth Urazan Figueredo

APPLICATION NUMBER: GWF033860885
DATE OF APPLICATION: 24/10/2014
TYPE OF VISA: General Visitor
PURPOSE OF APPLICATION: Visit
TYPE OF APPLICATION: (General) Single, double and multiple, valid up to 6 months
TOTAL FEE: USD 142.00
SUBMISSION METHOD: Standard
ISSUING OFFICE: British Embassy Bogota - Bogota
PAYMENT MADE: YES - ONLINE

FORM: (General) Single, double and multiple, valid up to 6 months

PART 1 > PASSPORT AND TRAVEL INFORMATION

PASSPORT / TRAVEL DOCUMENT
1 FAMILY NAME / SURNAME URAZAN FIGUEREDO
(IF YOU ONLY HAVE ONE NAME, PLEASE ENTER IT HERE
AND IN THE GIVEN NAME BOX)
2 GIVEN NAME(S) / FORENAME(S) SHALMA HAYETH
(IF YOU ONLY HAVE ONE NAME, PLEASE ENTER IT HERE
AND IN THE FAMILY NAME BOX)
3 DATE OF BIRTH 11 JUN 1998
4 PLACE OF BIRTH BOGOTA
5 GENDER FEMALE
6 NATIONALITY COLOMBIA
7 DO YOU CURRENTLY HOLD, OR HAVE YOU EVER HELD, NO
ANY OTHER NATIONALITY OR NATIONALITIES?
8 CURRENT PASSPORT OR TRAVEL DOCUMENT NUMBER RN27306396
9 PLACE OF ISSUE BOGOTA
10 ISSUING AUTHORITY BOGOTA CALLE 100
11 DATE OF ISSUE 03 NOV 2010
12 DATE OF EXPIRY 03 NOV 2020
13 CURRENT LOCATION COLOMBIA
14 ARE YOU A NATIONAL OF THE COUNTRY IN WHICH YOU YES
ARE APPLYING?
15 IS THIS YOUR FIRST PASSPORT? YES

TRAVEL INFORMATION
16 ARE YOU TRAVELLING WITH ANYONE? YES
17
NATIONALITY COLOMBIA

FAMILY NAME URAZAN FIGUEREDO

GIVEN NAMES DAVID YESID

DATE OF BIRTH 03 FEB 1994

VISA HELD NO

18 DATE OF PLANNED ARRIVAL IN THE UK 24 DEC 2014

19 HOW LONG DO YOU INTEND TO STAY IN THE UK? 11 DAYS

Created: 24/10/2014 Page 3 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

20 WHAT IS THE MAIN ADDRESS AND CONTACT DETAILS LINE 1: 3 NAIRN CLOSE
OF WHERE YOU WILL BE STAYING WHILST IN THE UK? LINE 2: WASHINGTON
POST CODE: NE37 1PN
PRIMARY CONTACT NUMBER: 0191 4171700
SECONDARY CONTACT NUMBER: 07908119468
EMAIL: [email protected]

PART 2 > PERSONAL DETAILS AND TRAVEL HISTORY

PERSONAL DETAILS
21 WHAT IS YOUR PERMANENT RESIDENTIAL ADDRESS LINE 1: CANTON MILITAR NORTE
AND CONTACT DETAILS? LINE 2: CASAS FISCALES CL106
LINE 3: NO 7A-19CA D628
LINE 4: BOGOTA
COUNTRY: COLOMBIA
PRIMARY CONTACT NUMBER: 00573103246426
EMAIL: [email protected]
22 HOW LONG HAVE YOU LIVED AT THIS ADDRESS? 2 YEARS
23 ARE YOUR PREFERRED CONTACT DETAILS DIFFERENT NO
FROM THE CONTACT DETAILS ALREADY PROVIDED
ABOVE?

TRAVEL HISTORY
24 HAVE YOU BEEN ISSUED ANY VISA FOR THE UK, UK NO
OVERSEAS TERRITORIES OR COMMONWEALTH
COUNTRY IN THE LAST 10 YEARS?
25 HAVE YOU EVER TRAVELLED TO THE UK IN THE LAST 10 NO
YEARS?
26 HAVE YOU MADE AN APPLICATION TO THE HOME NO
OFFICE TO REMAIN IN THE UK IN THE LAST 10 YEARS?
27 HAVE YOU BEEN REFUSED ENTRY TO THE UK IN THE NO
LAST 10 YEARS
(FOR EXAMPLE AT A UK AIRPORT OR SEAPORT)?
28 HAVE YOU BEEN REFUSED A VISA FOR ANY COUNTRY NO
INCLUDING THE UK IN THE LAST 10 YEARS?
29 HAVE YOU BEEN DEPORTED, REMOVED OR OTHERWISE NO
REQUIRED TO LEAVE ANY COUNTRY INCLUDING THE UK
IN THE LAST 10 YEARS?
30 HAVE YOU EVER VOLUNTARILY ELECTED TO DEPART NO
THE UK?
31 ARE YOU, OR HAVE YOU BEEN SUBJECT TO, AN NO
EXCLUSION ORDER FROM THE UK?
32 HAVE YOU EVER TRAVELLED OUTSIDE YOUR COUNTRY YES
OF RESIDENCE, EXCLUDING THE UK, IN THE LAST 10
YEARS?

Created: 24/10/2014 Page 4 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

33
DATE OF TRAVEL 03 JUN 2013

COUNTRY VISITED SPAIN

REASON FOR THE TRIP VISITING FAMILY AND TOURISM

DATE OF TRAVEL 11 JUN 2013

COUNTRY VISITED ITALY

REASON FOR THE TRIP TOURISM

34 DO YOU HAVE A UK NATIONAL INSURANCE NUMBER? NO

35 DO YOU HAVE ANY CRIMINAL CONVICTIONS IN ANY NO
COUNTRY
(INCLUDING SPENT/UNSPENT CONVICTIONS AND
TRAFFIC OFFENCES)?
36 HAVE YOU EVER BEEN CHARGED IN ANY COUNTRY NO
WITH A CRIMINAL OFFENCE FOR WHICH YOU HAVE NOT
YET BEEN TRIED IN THE COURT (INCLUDING TRAFFIC
OFFENCES)?
37 HAVE YOU EVER BEEN INVOLVED IN, SUPPORTED OR NO
ENCOURAGED TERRORIST ACTIVITIES IN ANY
COUNTRY? HAVE YOU EVER BEEN A MEMBER OF, OR
GIVEN SUPPORT TO, AN ORGANISATION THAT HAS
BEEN CONNECTED WITH TERRORISM?
38 HAVE YOU EVER, BY ANY MEANS OR MEDIUM, NO
EXPRESSED VIEWS THAT JUSTIFY OR GLORIFY
TERRORIST VIOLENCE, OR THAT MAY ENCOURAGE
OTHERS TO COMMIT ACTS OF TERRORISM OR OTHER
SERIOUS CRIMINAL ACTS?
39 IN TIMES OF EITHER PEACE OR WAR HAVE YOU EVER NO
BEEN INVOLVED IN, OR SUSPECTED OF INVOLVEMENT
IN, WAR CRIMES, CRIMES AGAINST HUMANITY OR
GENOCIDE?
40 HAVE YOU ENGAGED IN ANY OTHER ACTIVITIES THAT NO
MIGHT INDICATE THAT YOU MAY NOT BE ADMITTED TO
THE UK?
41 IF WE NEED TO INTERVIEW YOU, WHAT LANGUAGE SPANISH
WOULD YOU LIKE TO USE IN THE INTERVIEW?

PART 3 > FAMILY DETAILS

SPOUSE / PARTNER
42 WHAT IS YOUR MARITAL STATUS? SINGLE

FATHER
43 NATIONALITY COLOMBIA
44 FAMILY NAME / SURNAME URAZAN GARCIA
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT
HERE AND IN THE GIVEN NAME BOX)

Created: 24/10/2014 Page 5 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

45 GIVEN NAME(S) / FORENAME(S) SAMIR YESID

(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT
HERE AND IN THE FAMILY NAME BOX)
46 DATE OF BIRTH 28 APR 1971
47 PLACE OF BIRTH CHIQUINQUIRA - BOYACA

MOTHER
48 NATIONALITY COLOMBIA
49 FAMILY NAME / SURNAME FIGUEREDO COLMENARES
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT
HERE AND IN THE GIVEN NAME BOX)
50 GIVEN NAME(S) / FORENAME(S) NIDIA MILENE
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT
HERE AND IN THE FAMILY NAME BOX)
51 DATE OF BIRTH 30 MAY 1974
52 PLACE OF BIRTH VILLAVICENCIO - META

DEPENDENT CHILDREN
53 DO YOU HAVE ANY DEPENDENT CHILDREN? NO

NON DEPENDENT CHILDREN

54 ARE ANY OTHER CHILDREN TRAVELLING WITH YOU? NO

PART 4 > EMPLOYMENT AND INCOME

EMPLOYMENT
55 HAVE YOU EVER WORKED FOR ANY ORGANISATION NO
(STATE OR NON-STATE) LISTED BELOW?
ARMED FORCES (INCLUDING NATIONAL SERVICE)
GOVERNMENT (CENTRAL OR LOCAL)
JUDICIARY
MEDIA
PUBLIC OR CIVIL ADMINISTRATION
SECURITY (INCLUDING POLICE AND PRIVATE SECURITY
COMPANIES)?
56 WHAT IS YOUR CURRENT WORKING STATUS? STUDENT (NON WORKING)
57 NAME OF INSTITUTION YOU ARE STUDYING AT LICEOS DE EJERCITO - BACHILERATO PATRIA
58 NAME OF COURSE YOU ARE STUDYING DECIMO GRADO

INCOME AND EXPENDITURE

59 DO YOU HAVE SAVINGS, PROPERTIES OR OTHER NO
INCOME, FOR EXAMPLE FROM STOCKS AND SHARES?
60 HOW MUCH DO YOU SPEND EACH MONTH ON LIVING 350
COSTS?
61 HOW MUCH OF YOUR TOTAL MONTHLY INCOME IS 350
GIVEN TO YOUR FAMILY MEMBERS AND OTHER
DEPENDANTS?

Created: 24/10/2014 Page 6 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

62 WHAT IS THE COST TO YOU PERSONALLY OF YOUR 0

TRIP IN GBP(£)?
63 THE TOTAL AMOUNT OF MONEY YOU HAVE FOR THIS 1500
TRIP
64 THE COST OF THE AEROPLANE, BOAT OR TRAIN 125
TICKETS
65 THE COST OF YOUR ACCOMMODATION 0
66 THE COST OF YOUR LIVING EXPENSES 0
67 IS SOMEONE OTHER THAN YOU PAYING FOR ALL OR A YES
PART OF YOUR TRIP?
68 WHAT IS THE TOTAL AMOUNT IN GBP(£)? 650

PART 5 > FAMILY AND FRIENDS IN THE UK

FAMILY AND FRIENDS
69 PLEASE ENTER DETAILS OF WHAT YOU PLAN TO DO WHILE IN THE UK I WILL STAY WITH MY UNCLES
WHILST IN THE UK PARTNERS FAMILY. DURING MY STAY I PLAN TO ENJOY
CHRISTMAS AND NEW YEAR WITH THEM IN THEIR
HOME. WHILE I AM IN THE UK WE PLAN ON VISITING
NEWCASTLE, EDINBURGH AND LONDON.
70 DO YOU HAVE ANY FRIENDS OR FAMILY IN THE UK? YES
71
RELATIONSHIP OTHER RELATIVE

FAMILY NAME GALLAGHER

GIVEN NAME JANE

NATIONALITY UNITED KINGDOM

STATUS IN THE UK BRITISH CITIZEN

ADDRESS 1 3 NAIRN CLOSE

ADDRESS 2

ADDRESS 3

ADDRESS 4 WASHINGTON

POSTAL CODE NE37 1PN

PRIMARY CONTACT NUMBER 0191 4171700

SECONDARY CONTACT NUMBER

EMAIL [email protected]

VISIT OR STAY YES

PART 6 > MEDICAL TREATMENT

MEDICAL TREATMENT
72 HAVE YOU EVER RECEIVED MEDICAL TREATMENT IN NO
THE UK?

PART 7 > UNDER 18

UNDER 18

Created: 24/10/2014 Page 7 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

73 PLEASE GIVE DETAILS OF YOUR PARENTS/GUARDIAN(S) GRID

IN YOUR HOME COUNTRY?

RELATIONSHIP MOTHER

NATIONALITY COLOMBIA

FAMILY/LAST NAME FIGUEREDO COLMENARES

GIVEN NAME(S) NIDIA MILENE

DATE OF BIRTH 30 MAY 1974

PLACE OF BIRTH VILLAVICENCIO

ADDRESS 1 CANTON MILITAR NORTE

ADDRESS 2 CASAS FISCALES CL106

ADDRESS 3 NO 7A-19CA D628

ADDRESS 4 BOGOTA

POSTAL CODE

COUNTRY COLOMBIA

CONTACT NUMBER 00573103246426

EMAIL ADDRESS [email protected]

RELATIONSHIP FATHER

NATIONALITY COLOMBIA

FAMILY/LAST NAME URAZAN FIGUEREDO

GIVEN NAME(S) SAMIR YESID

DATE OF BIRTH 28 APR 1971

PLACE OF BIRTH CHIQUINQUIRA - BOYACA

ADDRESS 1 CANTON MILITAR NORTE

ADDRESS 2 CASAS FISCALES CL106

ADDRESS 3 NO 7A-19CA D628

ADDRESS 4 BOGOTA

POSTAL CODE

COUNTRY COLOMBIA

CONTACT NUMBER 00573103246426

EMAIL ADDRESS [email protected]

74 WHO ARE YOU TRAVELLING TO THE UK WITH? OTHER ADULT

Created: 24/10/2014 Page 8 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

75
RELATIONSHIP BROTHER

CURRENT PASSPORT/TRAVEL DOCUMENT NUMBER AO405337

NATIONALITY COLOMBIA

FAMILY/LAST NAME URAZAN FIGUEREDO

GIVEN NAME(S) DAVID YESID

DATE OF BIRTH 03 FEB 1994

PLACE OF BIRTH VILLAVICENCIO

ADDRESS 1 CANTON MILITAR NORTE

ADDRESS 2 CASAS FISCALES CL106

ADDRESS 3 NO 7A-19CA D628

ADDRESS 4 BOGOTA

POSTAL CODE

COUNTRY COLOMBIA

CONTACT NUMBER 00573103246426

EMAIL ADDRESS [email protected]

76 ARE YOU STAYING AT A PRIVATE ADDRESS IN THE UK? YES

77
FAMILY NAME GALLAGHER

GIVEN NAME JANE

DATE OF BIRTH 12 FEB 1959

NATIONALITY UNITED KINGDOM

RELATIONSHIP FRIEND

STATUS BRITISH CITIZEN

ADDRESS 1 3 NAIRN CLOSE

ADDRESS 2

ADDRESS 3

ADDRESS 4 WASHINGTON

POSTAL CODE NE37 1PN

CONTACT NUMBER 0191 4171700

EMAIL ADDRESS [email protected]

LENGTH OF STAY 11 DAYS

PART 8 > ADDITIONAL INFORMATION

ADDITIONAL INFORMATION
78 IS THERE ANY OTHER INFORMATION YOU WISH TO BE I WILL TRAVEL TO SPAIN WITH MY BROTHER ON THE
CONSIDERED AS PART OF YOUR APPLICATION? 10TH OF DECEMBER TO VISIT OUR UNCLE WHO LIVES
IN BARCELONA. WE WISH TO TRAVEL WITH HIM ON THE
24TH OF DECEMBER TO VISIT HIS PARTNERS FAMILY
WHO LIVE IN NEWCASTLE UPON TYNE. WE WISH TO
SPEND CHRISTMAS AND NEW YEAR WITH THEM IN
THEIR HOME AND ALSO VISIT SOME OF THE FAMOUS
PLACES IN THE UK LIKE LONDON AND EDINBURGH.

VISA CONFIRMATION QUESTIONS

79 DO YOU INTEND TO WORK IN THE UK? NO

Created: 24/10/2014 Page 9 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

80 IS THE MAIN PURPOSE OF YOUR TRIP TO VISIT/STAY NO

WITH A CLOSE FAMILY RELATIVE WHO IS SETTLED IN
THE UK?
81 DO YOU INTEND TO STUDY IN THE UK? NO

Created: 24/10/2014 Page 10 CODE

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

DECLARATION
I declare that the information given on this form whether input by myself, input on my behalf by a third party or automatically pre-populated is complete
and correct to the best of my knowledge and belief. I also declare that the photograph submitted with this form is a true likeness of me. I confirm that if,
before this application is decided, there is a material change in my circumstances or new information relevant to this application becomes available, I
will inform the United Kingdom diplomatic mission handling my application.

I understand that all information provided by me will be processed by the Home Office in accordance with the Data Protection Act 1998. I am aware
that the Home Office is the data controller in relation to the information provided by me in this application form. I am aware that the information I
provide, including biometric data, will be treated in confidence, but it may be disclosed to other government departments, agencies, local authorities,
foreign governments, and other bodies, to enable the Home Office or those bodies to perform their functions. Any disclosures will be in accordance with
the Data Protection Act 1998. I also understand that the information provided by me may also be used for staff training purposes.

I declare that the documents that I have supplied with this application are genuine and the statements I have made with this application are truthful. I
understand that the Home Office (or a trusted third party) may make reasonable checks to confirm the accuracy and authenticity of evidence I have
provided and documents I have submitted with this application. I further understand that the Home Office (or a trusted third party) may also make
reasonable checks on any sponsors to my application to verify statements contained in the application and establish that I will comply or have complied
with the terms of any visa granted.

I understand that UK entry clearance applications may be handled by British Missions in other locations, including outside the country in which I have
applied for entry clearance and that this may involve the transferring of my application and supporting documents to and from another Mission. I
understand that the Home Office will be responsible for transferring my application and supporting documents safely. I understand in these
circumstances my application will still be handled in line with Home Office published customer service standards.

I understand that the fee payable is for an application processing and entry clearance decision-making service, not for the guaranteed delivery of a
visa, therefore I will not be entitled to a refund should my application for entry to the UK or Commonwealth and Overseas Territories be refused or
granted for a shorter time period than I applied for. I also understand that my visa application fee will be refunded only if the application is withdrawn in
writing within 3 months and 7 days of the original date of application and prior to the submission of biometric data or any processing taking place.

I also understand that the information provided by me, or information made available to the Home Office during the processing of my application, may
be shared with my sponsor(s) or any person(s) acting on their behalf or any applicant linked to my application (for example to my spouse / partner if we
apply for visas for a trip together) for the sole purpose of considering my application. I am aware that if there is any information I do not want you to
disclose to them I will tell you by enclosing a letter with my supporting documentation. If such requests prevent you from making legitimate inquiries, my
application may be refused.

I am also aware that my application will be automatically refused and I may be banned from going to the UK for 10 years if I use a false document, lie or
withhold relevant information. I may also be banned if I have breached immigration laws in the UK. I am further aware that should I use a false
document, lie or withhold relevant information my details may be passed to law enforcement agencies.

I understand that I may be required to provide a record of my fingerprints and a photograph of my face (“biometric data”) as part of my application. If I
refuse to do so, my application may be treated as invalid and, if so, will not be considered further. (See Statutory Instrument 2006 No 1743 - The
Immigration (Provision of Physical Data) Regulations 2006, Regulation 7(1)).

I am aware that I may be billed for any NHS medical treatment undertaken in the UK and that I do not have recourse to public funds during my stay in
the UK.
I understand that if I fail to pay NHS debts incurred by me this could adversely affect future entry clearance applications I make.

I understand that my details may, in certain circumstances, be passed to fraud prevention agencies to prevent and detect fraud and money laundering.
I also understand that such agencies may provide the Home Office with information about me. Further details explaining when information may be
passed to or from fraud prevention agencies and how that information may be used can be obtained from the Home Office website.

I am aware that it is an offence under the Immigration Act 1971 (as amended) to make a statement which I know to be false, or not believe to be true, in
order to obtain a visa/entry clearance to the UK.

I hereby apply for a visa/entry clearance to the United Kingdom.

Information for sponsors

Personal information which is provided about a person acting in support of an application, including any documentary evidence provided by or about
them, will be processed in accordance with the Data Protection Act 1998 by the Home Office, which is the data controller in relation to the information
provided.
The Home Office will use this information to make decisions about the application and to prevent and detect fraud. We may share this information with
other government departments or agencies, local and public authorities, foreign governments, companies (including financial and utility companies),
employers or other bodies in order to make reasonable checks to verify the information provided in the application and confirm that sponsors have or
will comply with the terms of any visa which may be or have been granted. Any information received by the Home Office about a sponsor may be used
in reaching a decision on the application. Full details of the way in which the data may be processed can be found on the Home Office website at
http://www.ukba.homeoffice.gov.uk/

I confirm that, where I have a sponsor, I have informed my sponsor of the information set out above and my sponsor has confirmed that they consent to
me providing the information about them which is set out in this application.

APPLICANT'S SIGNATURE:

DATE SIGNED:

FORM COMPLETED BY: SHALMA HAYETH URAZAN FIGUEREDO

GWF033860885

Created: 24/10/2014 Page 11 CODE