Application for a Certificate of Entitlement to the Right of Abode (To Be Completed Only by People Currently in the UK)

Form ROA Application for a certificate of entitlement to the right of abode (To be completed only by people currently in the UK) Important: please read the guide supplied with this form before you fill it in. Please write in BLOCK CAPITALS using black ink. Before making your application, you may wish to check whether you are eligible to apply under the Windrush Scheme. If you are covered by the scheme you should not apply for a Certificate of Entitlement to the Right of Abode on this form. For more information, and to access the Windrush Scheme application form, see www.gov.uk/government/publications/undocumented- commonwealth-citizens-resident-in-the-uk Warning: It is an offence under section 26(1)(c) of the Immigration Act 1971 to give information which you know to be false or do not believe to be true. The offence is punishable with imprisonment or a fine or both. The Home Office will use the personal information you provide to consider your application. We may also share your information with other public and private sector organisations in the UK and overseas. For more detail please see the Privacy Notice for the Border, Immigration and Citizenship system at www.gov.uk/government/publications/personal-information-use-in- borders-immigration-and-citizenship. This also sets out your rights under the Data Protection Act 2018 and explains how you can access your personal information and complain if you have concerns about how we are using it. June 2020 Section 1 - Personal information 1.1 Please give previous Home Office reference numbers: 1.2 If you have had a certificate of entitlement to right of abode before, please give the passport number(s), date and place of issue: 1.3 On what grounds do you have a claim to right of abode? (see section 3 of the guide): British citizen or a Commonwealth citizen 1.4 Title - please select: Mr Mrs Miss Ms Other (please state) 1.5 Surname/family name (note: the name you give here will be the name shown on your certificate so please ensure it is spelt correctly and you have written it in the correct order): Other names: 1.6 Name at birth if different from above: 1.7 Please state any other names by which you have been known, and state the dates when these names were used: Please provide official documents to confirm any name changes, for example, marriage certificate, change of name deed. 1.8 Your present nationality: ROA application form (version 06/20) Page 2 of 9 1.9 Date of birth: 1.10 Village or town or city of birth: 1.11 Country of birth: 1.12 Present address (you must give us any change of address in writing while we are considering this application): Postcode: Daytime/Mobile telephone number: Evening telephone number: Email address: For validation purposes, please write your email address again in the box below: If someone is representing you, for example an agent or solicitor, or you are making an application through a consulate, please tell us their: 1.13 Name: 1.14 Address: Postcode: 1.15 Telephone number: Email address: ROA application form (version 06/20) Page 3 of 9 Details of your parents 1.16 Your father’s name: 1.17 Your father’s town and country of birth: 1.18 Your father’s nationality when you were born or adopted: 1.19 Your father’s date of birth: 1.20 If deceased, date of death: 1.21 Your mother’s name: 1.22 Your mother’s town and country of birth: 1.23 Your mother’s nationality when you were born or adopted: 1.24 Your mother’s date of birth: 1.25 If deceased, date of death: 1.26 Date of your parents’ marriage: 1.27 Please provide a current address and telephone number for your parents: Father: Telephone number: ROA application form (version 06/20) Page 4 of 9 Mother: Telephone number If you are claiming right of abode through your husband or former husband, please give details here. 1.28 Husband’s full name: 1.29 Any other names by which he is or has previously been known: 1.30 Husband’s date of birth: 1.31 Husband’s town and country of birth: 1.32 Husband’s address: 1.33 Contact telephone: 1.34 Date of marriage: Place of marriage: 1.35 If he holds a British passport, please give the number, date and place of issue: ROA application form (version 06/20) Page 5 of 9 If you are claiming right of abode through a grandparent, please give details here. 1.36 Your grandfather’s full name: 1.37 Your grandfather’s town and country of birth: 1.38 Your grandfather’s nationality at the time of your parent’s birth/adoption: 1.39 Your grandfather’s date of birth: 1.40 Your grandmother’s full name and maiden name: 1.41 Your grandmother’s town and country of birth: 1.42 Your grandmother’s nationality at the time of your parent’s birth/adoption: 1.43 Your grandmother’s date of birth: 1.44 Your grandparents’ date of marriage: ROA application form (version 06/20) Page 6 of 9 Section 2 - Your residence in the United Kingdom 2.1 Please state when and where you entered the United Kingdom: Place: 2.2 Please provide all UK addresses for the last 5 years (continue on a separate piece of paper if necessary. Address: From: To: Address: From: To: Address: From: To: Address: From: To: Address: From: To: ROA application form (version 06/20) Page 7 of 9 Section 3 - Other information 3.1 Is there any other information you would like to be considered as part of your application? You will need to provide evidence. For example, if you or a family member have been issued with a certificate of entitlement. Yes No If you have selected yes, give details: ROA application form (version 06/20) Page 8 of 9 Section 4 - Declaration 4.1 I (full name in BLOCK LETTERS): declare that, to the best of my knowledge and belief, the information given in this application is correct. I promise to notify the Home Secretary, in writing, of any change of circumstances which may affect the accuracy of the information given whilst this application is being considered by the Home Office. I understand that the information given by me will be treated in confidence but may be submitted for checking against records held by other government departments, local authorities and the police where it is necessary for immigration and nationality purposes, or to enable these bodies to carry out their functions. I understand that I may be liable for prosecution if I have knowingly or recklessly provided false information. I understand that a certificate of right of abode may be revoked if it is discovered that I am no longer eligible to hold it. 4.2 I confirm that I have read and understand the Guide ROA 4.3 I confirm that I have enclosed the appropriate fee and payment slip 4.4 I confirm that I have enclosed the documents specified in Guide ROA 4.5 I have enclosed 2 photographs taken within the last 6 months 4.6 I do not have a UK passport describing me as a British citizen or a British subject with a right of abode 4.7 I am present in the country in which I am submitting my application 4.8 Sign below once you are satisfied you have completed the form correctly Signature: Date: ROA application form (version 06/20) Page 9 of 9.

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