Declaration of Renunciation of British Citizenship, British Overseas

Form RN 04 2019 Official Copy

Declaration of Renunciation of British Citizenship, British Overseas Citizenship, British Overseas Territories Citizenship, British National (Overseas) or British Subject Status To be used by people in the Channel Islands, Isle of Man and British overseas territories, and by people who live elsewhere and want to apply by post. The Home Office will use the personal information you provide to consider your application.e W 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.

IMPORTANT: Please read the guide RN before you fill this form in. Both parts of the form should be completed, signed and submitted. Please write in BLOCK LETTERS. If your declaration of renunciation is registered the Applicant’s Copy of this form will be signed, stamped and returned to you, and will be formal evidence of the renunciation. 1. I (full name):

of (full address):

Postcode:

Telephone number:

Email address:

was born on (date of birth): at (place and country of birth):

Form RN Application form (version 04/19) Page 1 of 6 2. I am a: (please tick)

British citizen British overseas citizen

British overseas territories citizen British national (overseas)

British subject

I hold that status by:

Birth

Descent (through a parent or grandparent)

Registration

Naturalisation

If you acquired that status by registration or naturalisation, please give the:

Date of registration or naturalisation:

Certificate number:

Home Office reference number:

I wish to renounce: (please tick)

British citizenship British overseas citizenship

British overseas territories citizen British national (overseas) status

British subject status

See section 1 of the Guide and enclose evidence of your citizenship(s) or status – see section 3

You must complete either section 3 or section 4. If both apply, please complete both. You should send evidence of any other citizenship held or about to be acquired.

3. I hold the following citizenship or nationality other than the citizenship or status I wish to renounce:

Form RN Application form (version 04/19) Page 2 of 6 4. I am about to acquire the following citizenship or nationality after making this declaration:

5. If you are under 18 please state your date of marriage or civil partnership:

6. Declaration:

Warning: To give false information on this form knowingly or recklessly is a criminal offence punishable with up to 3 months’ imprisonment or a fine not exceeding £5000 or both (Section 46(1) of the British Nationality Act 1981 as amended).

I, (full name in BLOCK LETTERS) ______declare that to the best of my knowledge and belief the details given on this form are true.

Signature Date

7. Declaration by countersignatory

Name:

Address:

Postcode:

Daytime telephone number:

Either: I confirm that I am aged 18 or over, that I know the person who is making this declaration of renunciation, and that he/she is of full capacity. I am willing to give full details of my knowledge of this person. (See sections 1 and 3 in the guide.)

Form RN Application form (version 04/19) Page 3 of 6 Or:

I confirm that the person who is making this declaration is not of full capacity, but that renunciation would be in his or her best interests for the following reasons. I enclose documentation to show that he or she is in my care.

I understand that I may be liable for prosecution resulting in a penalty of up to 3 months imprisonment or a fine not exceeding £5,000 or both if I knowingly or recklessly make a false declaration.

Signature Date

Form RN Application form (version 04/19) Page 4 of 6 Form RN 04 2019 Applicant’s Copy

1. I (full name)

of (full address)

Postcode: was born on (date of birth) at (place and country of birth)

2. I am a: (please tick)

British citizen British overseas citizen

British overseas territories citizen British national (overseas)

British subject

I wish to renounce: (please tick)

British citizenship British overseas citizenship

British overseas territories citizen British national (overseas) status

British subject status

Form RN Application form (version 04/19) Page 5 of 6 3. I hold the following citizenship or nationality other than the citizenship or status I wish to renounce:

4. I am about to acquire the following citizenship or nationality after making this declaration:

5. I, (full name in BLOCK LETTERS) ______declare that to the best of my knowledge and belief the details given on this form are true.

Signature: Date:

Official confirmation of renunciation:

Signature:

Home Office

Form RN Application form (version 04/19) Page 6 of 6