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APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

PLEASE ATTACH ONE PHOTOGRAPH:
PASSPORT STYLE AND
SIZE (SIZE OF IMAGE
45MM X 35MM)
A RECENT AND TRUE
LIKENESS, SHOWING FULL
FACE, WITH NO HAT,
HELMET OR SUNGLASSES,
ALTHOUGH YOU CAN WEAR
(EVERYDAY)GLASSES
TAKEN AGAINST A PLAIN,
EVENLY LIT AND LIGHT
BACKGROUND

APPLICANT NAME: ALEXEY VINOGRADOV

APPLICATION NUMBER: GWF009701343
DATE OF APPLICATION: 27 DEC 2010
VISA TYPE: VISIT
VISA SUB-TYPE: (GENERAL) LONG TERM VISITOR VISA (5 YEAR)
VISA FEE: EUR 563.00
POSTAGE FEE: EUR 0.00

PHOTOGRAPHS THAT DO
NOT CONFORM TO
THESE STANDARDS WILL
BE REJECTED AND MAY
CAUSE DELAY IN
PROCESSING THE
APPLICATION

SUBMISSION METHOD: IN PERSON

ISSUING OFFICE: VISA APPLICATION CENTRE DUSSELDORF
PAYMENT MADE: YES - ONLINE

FORM: VAF1A
PART 1 > ABOUT YOU
1

GIVEN NAME(S) (AS SHOWN IN YOUR PASSPORT)

ALEXEY

FAMILY NAME (AS SHOWN IN YOUR PASSPORT)

VINOGRADOV

OTHER NAMES (INCLUDING ANY NAMES YOU ARE KNOWN BY AND/OR ANY OTHER NAMES
THAT YOU HAVE BEEN KNOW BY)

SEX

MALE

WHAT IS YOUR MARITAL STATUS?

SINGLE

DATE OF BIRTH

7 MAY 1976

PLACE OF BIRTH

NOVOROSSIYSK

COUNTRY OF BIRTH

RUSSIA

NATIONALITY

RUSSIA

10

DO YOU HOLD, OR HAVE YOU EVER HELD, ANY OTHER NATIONALITIES?

NO

PART 1 > TRAVEL DATES AND PURPOSE OF TRAVEL

11

WHAT IS THE MAIN PURPOSE OF YOUR VISIT TO THE UK?

VISIT MY BROTHER

12

HOW LONG DO YOU INTEND TO STAY IN THE UK?

1-2 WEEKS

13

ON WHICH DATE DO YOU INTEND TO TRAVEL TO THE UK?

30 JAN 2011

14

ON WHICH DATE DO YOU INTEND TO LEAVE THE UK?

10 FEB 2011

PART 2 > PASSPORT INFORMATION

15

PLEASE ENTER THE DETAILS OF THE PASSPORT OR TRAVEL DOCUMENT THAT YOU WILL
USE TO TRAVEL TO THE UK.

4788304

CURRENT PASSPORT OR TRAVEL DOCUMENT NUMBER

16

PLACE OF ISSUE

HAMBURG

17

ISSUING AUTHORITY

RUSSIAN CONSULATE

18

DATE OF ISSUE

18 NOV 2010

19

DATE OF EXPIRY

18 NOV 2015

20

IS THIS YOUR FIRST PASSPORT?

NO

PART 2 > PASSPORT INFORMATION > ADDITIONAL INFORMATION

21

YOU ANSWERED 'NO' TO THE QUESTION 'IS THIS YOUR FIRST PASSPORT?' WHERE THE
INFORMATION IS AVAILABLE, PLEASE PROVIDE FULL DETAILS OF ALL PASSPORTS HELD
OVER THE LAST 10 YEARS, INCLUDING WHERE THEY ARE NOW.

NO. 3102902 - NOT VALID, BUT AVAILABLE, NO. 1182703 - NOT VALID, BUT AVAILABLE

PART 3 > CONTACT DETAILS

22

PLEASE PROVIDE DETAILS OF YOUR FULL ADDRESS AND POSTAL CODE. THIS MUST BE
THE ADDRESS AT WHICH YOU LIVE RATHER THAN YOUR FAMILY HOME.

GRIESSTRASSE 14

APT/FLOOR/SUITE/ROOM/STREET
23

CITY/TOWN/VILLAGE/SUBURB/STATE/PROVINCE(WHERE APPLICABLE)

HAMBURG

24

SELECT THE COUNTRY IN WHICH YOU LIVE

GERMANY

25

POSTAL CODE/ZIP CODE

20535

26

HOW LONG HAVE YOU LIVED AT THIS ADDRESS?

2 YEARS

27

HOME (LANDLINE) TELEPHONE NUMBER

49 178 135 68 27

28

YOUR MOBILE/CELLULAR NUMBER

49 178 135 68 27

29

WILL THESE BE YOUR CONTACT DETAILS DURING THE APPLICATION PROCESS?

YES

PART 4 > YOUR FAMILY > MOTHER AND FATHER

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IF KNOWN, PLEASE ENTER THE DETAILS OF YOUR MOTHER AND FATHER, EVEN IF
DECEASED. IF YOU DO NOT KNOW THE ANSWERS TO ANY OF THE QUESTIONS PLEASE
STATE 'NOT KNOWN'. IF THE DATE OF BIRTH IS NOT KNOWN, PLEASE ENTER A DATE OF
'01 JAN 1900'.

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TAMARA

MOTHER'S GIVEN NAME(S)

31

MOTHER'S FAMILY NAME

VINOGRADOVA

32

MOTHER'S DATE OF BIRTH

21 NOV 1942

33

MOTHER'S PLACE AND COUNTRY OF BIRTH

TOROPETS, RUSSIA, FORMER USSR

34

MOTHER'S NATIONALITY/NATIONALITIES

RUSSIAN

35

FATHER'S GIVEN NAME(S)

VLADIMIR

36

FATHER'S FAMILY NAME

VINOGRADOV

37

FATHER'S DATE OF BIRTH

19 JAN 1947

38

FATHER'S PLACE AND COUNTRY OF BIRTH

TARUTINO, UKRAINE, FORMER USSR

39

FATHER'S NATIONALITY/NATIONALITIES

RUSSIAN

PART 4 > YOUR FAMILY > CHILDREN

40

DO YOU HAVE ANY DEPENDANT CHILDREN?

NO

41

PLEASE NOTE: IF A CHILD IS TRAVELLING WITHOUT THEIR PARENTS, YOU SHOULD

PRESENT WRITTEN NOTIFICATION FROM THE CHILD'S PARENT OR LEGAL GUARDIAN
THAT THEY CONSENT TO THE CHILD'S VISIT.

NO

WILL ANY OTHER CHILDREN BE TRAVELLING WITH YOU?

PART 5 > EMPLOYMENT AND FINANCES

42

PLEASE NOTE: CHILDREN UNDER THE AGE OF 18 SHOULD ENTER THEIR PARENTS
DETAILS.

EMPLOYMENT FULL TIME

WHAT ARE YOUR CURRENT PERSONAL CIRCUMSTANCES?

PART 5 > EMPLOYMENT AND FINANCES > EMPLOYMENT

43

WHAT IS YOUR PRESENT OCCUPATION?

ENGINEER

44

WHAT IS THE NAME OF THE COMPANY OR ORGANISATION YOU WORK FOR?

GERMANISCHER LLOYD INDUSTRIAL SERVICES GMBH

45

WHEN DID YOU START THIS JOB?

1 OCT 2010

46

WHAT IS YOUR WORK ADDRESS?

BROOKTORKAI 18, 20457 HAMBURG, GERMANY

47

WHAT IS YOUR EMPLOYER'S TELEPHONE NUMBER?

49 40 36149 5256

48

WHAT IS YOUR EMPLOYER'S E-MAIL ADDRESS?

HOLGER.BERNDT@GL-GROUP.COM

49

PLEASE GIVE DETAILS OF ANY ADDITIONAL JOBS OR OCCUPATIONS.

FORMER EMPLOYER FROM 2006 TILL OCTOBER 2010 - SGS GERMANY GMBH, RABOISEN
28, 20095 HAMBURG

50

HAVE YOU EVER WORKED FOR ANY ORGANISATION OF A TYPE (STATE OR NON-STATE)
LISTED BELOW?

NO

ARMED FORCES (INCLUDING NATIONAL SERVICE)

51

GOVERNMENT (CENTRAL OR LOCAL)

NO

52

JUDICIARY

NO

53

MEDIA

NO

54

PUBLIC OR CIVIL ADMINISTRATION

NO

55

SECURITY (INCLUDING POLICE AND PRIVATE SECURITY COMPANIES)

NO

PART 5 > EMPLOYMENT AND FINANCES > INCOME AND EXPENDITURE

56

WHAT IS YOUR TOTAL MONTHLY INCOME FROM ALL SOURCES OF EMPLOYMENT OR

OCCUPATION, AFTER TAX?

2379 EURO

57

DO YOU RECEIVE INCOME FROM ANY OTHER SOURCES INCLUDING FRIENDS OR FAMILY?

NO

58

DO YOU HAVE SAVINGS PROPERTIES OR OTHER INCOME FOR EXAMPLE FROM STOCKS
AND SHARES?

YES

59

HOW MUCH OF YOUR MONTHLY INCOME IS USED TO SUPPORT YOUR FAMILY MEMBER'S
AND OTHER DEPENDANTS?

CURRENTLY 0

60

HOW MUCH DO YOU SPEND EACH MONTH ON LIVING COSTS?

825 EURO

61

HOW MUCH MONEY IS AVAILABLE FOR YOUR VISIT?

6000 EURO

62

WHO WILL PAY FOR YOUR TRAVEL TO THE UNITED KINGDOM?

63

WHO WILL PAY FOR YOUR EXPENSES SUCH AS ACCOMMODATION AND FOOD?

MY BROTHER OR I

64

IF SOMEONE OTHER THAN YOURSELF IS PAYING FOR ALL OR ANY PART OF THIS VISIT,
HOW MUCH MONEY WILL THEY GIVE YOU?

65

WHAT IS THE COST TO YOU PERSONALLY OF YOUR STAY IN THE UNITED KINGDOM?

MAX. 400 EURO PER WEEK, FROM EXPERIENCE

YOU STATED THAT YOU HAVE SAVINGS PROPERTY OR INCOME.

ABT 6000 EURO

66

PLEASE GIVE DETAILS AND STATE WHICH CURRENCY E.G. US DOLLARS OR UK POUNDS
STERLING.

PART 6 > PREVIOUS APPLICATIONS AND TRAVEL HISTORY

67

HAVE YOU EVER TRAVELLED TO THE UK IN THE LAST 10 YEARS?

YES

68

HAVE YOU EVER TRAVELLED OUTSIDE YOUR COUNTRY OR RESIDENCE EXCLUDING THE
UK IN THE LAST 10 YEARS?

YES

69

HAVE YOU EVER BEEN REFUSED A VISA FOR ANY COUNTRY INCLUDING THE UK?

NO

70

HAVE YOU BEEN GRANTED A UK VISA IN THE LAST 10 YEARS?

YES

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71

HAVE YOU BEEN REFUSED ENTRY ON ARRIVAL TO THE UK IN THE LAST 10 YEARS?

NO

72

HAVE YOU EVER BEEN DEPORTED REMOVED OR OTHERWISE REQUIRED TO LEAVE ANY
COUNTRY INCLUDING THE UK?

NO

73

HAVE YOU MADE AN APPLICATION TO THE HOME OFFICE TO REMAIN IN THE UK IN THE
LAST 10 YEARS?

NO

74

DO YOU HAVE A UK NATIONAL INSURANCE NUMBER?

NO

75

DO YOU HAVE ANY CRIMINAL CONVICTIONS IN ANY COUNTRY (INCLUDING TRAFFIC

OFFENCES)?

NO

76

HAVE YOU EVER BEEN CHARGED IN ANY COUNTRY WITH A CRIMINAL OFFENCE FOR
NO
WHICH YOU HAVE NOT YET BEEN TRIED IN THE COURT (INCLUDING TRAFFIC OFFENCES)?

77

IN TIMES OF EITHER PEACE OR WAR HAVE YOU EVER BEEN INVOLVED IN OR SUSPECTED
OF INVOLVEMENT IN WAR CRIMES CRIMES AGAINST HUMANITY OR GENOCIDE?

NO

78

HAVE YOU EVER BEEN INVOLVED IN SUPPORTED OR ENCOURAGED TERRORIST

ACTIVITIES IN ANY COUNTRY? HAVE YOU EVER BEEN A MEMBER OF OR GIVEN SUPPORT
TO AN ORGANISATION THAT HAS BEEN CONCERNED IN TERRORISM?

NO

79

HAVE YOU EVER BY ANY MEANS OR MEDIUM EXPRESSED VIEWS THAT JUSTIFY OR
GLORIFY TERRORIST VIOLENCE OR THAT MAY ENCOURAGE OTHERS TO TERRORIST ACTS
OR OTHER SERIOUS CRIMINAL ACTS?

NO

80

HAVE YOU ENGAGED IN ANY OTHER ACTIVITIES THAT MIGHT INDICATE THAT YOU MAY
NOT BE CONSIDERED A PERSON OF GOOD CHARACTER?

NO

PART 6 > PREVIOUS APPLICATIONS AND TRAVEL HISTORY > ADDITIONAL INFORMATION
81

YOU STATED THAT YOU HAD TRAVELLED TO THE UK IN THE LAST 10 YEARS.

21. DECEMBER 2008 - 4. JANUAR 2009, VISIT OF MY BROTHER, 9. APRIL 2010 - 22. APRIL
2010, VISIT OF MY BROTHER

PLEASE PROVIDE DETAILS OF ALL YOUR TRIPS TO THE UK OVER THE LAST 10 YEARS.
82

YOU STATED THAT YOU HAD TRAVELLED OUTSIDE YOUR COUNTRY OF RESIDENCE,
EXCLUDING THE UK, IN THE LAST 10 YEARS.

BULGARIA 18.07.2007 - 28.07.2007, 04.09.2010 - 13.09.2010, CZECH REPUBLIC

10.04.2008 - 14.04.2008, TURKEY - ROUGHLY EVERY TWO YEARS FOR ABOUT A WEEK AS
VACATION

PLEASE PROVIDE DETAILS OF ALL YOUR TRIPS ABROAD IN THE LAST 10 YEARS.
83

YOU STATED THAT YOU HAD BEEN GRANTED A UK VISA IN THE LAST 10 YEARS.

UK328976L

PLEASE ENTER THE REFERENCE NUMBER(S) IF KNOWN. THIS CAN BE FOUND ON THE
PREVIOUS VISA(S) IN YOUR PASSPORT. YOU SHOULD ENTER DETAILS EVEN IF YOU DID
NOT USE THE VISA(S).

PART 7 > YOUR VISIT

84

ARE YOU A NATIONAL OF THE COUNTRY IN WHICH YOU ARE APPLYING?

NO

85

APART FROM THOSE LISTED AS FAMILY EARLIER IN THE APPLICATION WILL YOU BE
TRAVELLING WITH ANYONE ELSE?

NO

PART 7 > YOUR VISIT > ADDITIONAL INFORMATION

86

YOU STATED THAT YOU ARE NOT A NATIONAL OF THE COUNTRY YOU ARE APPLYING IN.
PLEASE PROVIDE DETAILS OF YOUR IMMIGRATION STATUS E.G. A RESIDENCE PERMIT,
VISA OR GREEN CARD.

RESIDENCE PERMIT

PART 7 > YOUR VISIT > GENERAL VISITOR

87

WHAT WILL YOU DO IN THE UK?

VISIT MY BROTHER

88

DO YOU INTEND TO WORK IN THE UK?

NO

89

DO YOU INTEND TO STUDY IN THE UK?

NO

PART 7 > YOUR VISIT > YOUR STAY IN THE UK

90

PLEASE NOTE: IF YOU ARE STAYING ANYWHERE ELSE WHILE IN THE UK PLEASE ENTER
ADDITIONAL CONTACT DETAILS IN PART 8> ADDITIONAL DETAILS.

WITH IMMEDIATE FAMILY

WHERE WILL YOU STAY IN THE UK?

91

GIVEN NAME(S) (IF APPLICABLE)

DMITRI

92

FAMILY NAME OR HOTEL/B&B NAME

VINOGRADOV

93

APT/ FLOOR/ SUITE/ ROOM/ STREET

207, BLACKSTOCK ROAD

94

CITY/ TOWN/ VILLAGE/ SUBURB/ STATE/ PROVINCE (WHERE APPLICABLE)

LONDON

95

POSTAL/ ZIP CODE

N5 2LL

96

LANDLINE TELEPHONE NUMBER

44 794 223 44 05

97

EMAIL ADDRESS OR WEBSITE ADDRESS (IF APPLICABLE)

DVINOG@ESSEX.AC.UK

PART 7 > YOUR VISIT > FRIENDS AND FAMILY

98

DO YOU HAVE ANY FRIENDS OR FAMILY IN THE UK?

YES

99

HOW MANY FRIENDS AND/ OR FAMILY DO YOU HAVE IN THE UK?

PART 7 > YOUR VISIT > FRIENDS AND FAMILY (1)

100

PLEASE PROVIDE DETAILS OF YOUR FRIENDS AND / OR FAMILY.

DMITRI VINOGRADOV

FULL NAME
101

NATIONALITY

RUSSIA

102

THEIR ADDRESS

207, BLACKSTOCK ROAD, LONDON, N5 2LL

103

THEIR HOME (LANDLINE) TELEPHONE NUMBER

44 794 223 44 05

104

THEIR PERMISSION TO STAY IN THE UK (IF APPLICABLE)

WORK PERMIT F363486

105

WHAT IS THEIR RELATIONSHIP TO YOU?

BROTHER

106

DO YOU INTEND TO VISIT THIS PERSON WHILE YOU ARE IN THE UK?

YES

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PART 8 > ADDITIONAL INFORMATION

107

IS THERE ANY OTHER INFORMATION YOU WISH TO BE CONSIDERED AS PART OF YOUR

APPLICATION?

NO

108

HAVE YOU USED AN AGENT OR REPRESENTATIVE TO COMPLETE THIS APPLICATION?

NO

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DECLARATION
I HEREBY APPLY FOR AN ENTRY CLEARANCE TO THE UNITED KINGDOM. THE INFORMATION I HAVE GIVEN IS COMPLETE AND TRUE TO THE BEST OF MY KNOWLEDGE. 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 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 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 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 UK BORDER AGENCY (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 UK BORDER AGENCY (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 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 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 UK BORDER AGENCY 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 UK BORDER AGENCY PUBLISHED CUSTOMER SERVICE STANDARDS.
I AM AWARE THAT I MAY BE BILLED FOR ANY 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 ALL INFORMATION PROVIDED BY ME WILL BE PROCESSED BY THE UK BORDER AGENCY IN ACCORDANCE WITH THE DATA PROTECTION ACT 1998. I AM
AWARE THAT THE UK BORDER AGENCY 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 UK BORDER AGENCY 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 ALSO UNDERSTAND THAT THE INFORMATION PROVIDED BY ME, OR INFORMATION MADE AVAILABLE TO UK BORDER AGENCY 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 DECLARE THAT THE INFORMATION GIVEN ON THIS FORM IS CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I ALSO CONSENT TO THE PROCESSING OF INFORMATION
PROVIDED BY ME BY THE UK BORDER AGENCY.
APPLICANT'S SIGNATURE:

DATE SIGNED:

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FOR OFFICE USE ONLY

APPLICATION NUMBER: GWF009701343
APPLICANT'S EMAIL ADDRESS: ALEXVINO@GMAIL.COM

ONLINE PAYMENT DETAILS

ISSUE / REFUSE :

AMOUNT PAID

EUR 563.00

AUTH CODE

427329510

DATE PAID

27 DEC 2010

CATEGORY

VISIT

TYPE

(GENERAL) LONG TERM VISITOR VISA (5

YEAR)

CODE

CHECK 1

CHECK 2

DATE EFFECTIVE

DATE OF EXPIRY

POLICE REGISTRATION YES / NO

TIER

ECO TIME TAKEN

AUTHORISING ECO

EC NUMBER

ISSUED DATE

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