Declaration for spouses, civil partners, proposed civil partners, fiancé(e)s, and

unmarried partners
Applicant’s name:

Partner’s name:

This declaration must be signed by the applicant’s partner and not by a

representative or other person acting on their behalf. It must be sent to the Home
Office with the applicant’s documents. If you fail to do so, the application may be
refused.

I confirm that (tick relevant box)

 I am a British citizen
 I am settled in the UK (I have indefinite leave)
 I have leave to remain in the UK as a refugee / or as a person requiring
humanitarian protection

Tick the following to confirm which applies to you

 Spouse/civil partner
I confirm that I am the spouse or civil partner of the applicant. I declare that we are
still married/in civil partnership and that we are living together as partners and intend
to live together permanently in UK.

 Fiancé(e)/proposed civil partner/unmarried partner

I confirm that I am the proposed civil partner/ fiancé(e)/ unmarried partner of the
applicant. I declare that we are living together in a relationship akin to marriage and
that we intend to live together permanently in the UK.

I understand that the information relating to me that is contained in this application

and any supporting documentation will be handled according to the privacy policy at
www.visas-immigration.service.gov.uk/privacyPolicy.

I am aware that it is a criminal offence, to make a statement or representation which

I know to be false or do not believe to be true, or otherwise to help someone to
obtain leave to remain in the United Kingdom by means which include deception

Signature

Date