20180515-Form NSV002 v1.1

NSV002 (Revised 08/201)
OFFICIAL SENSITIVE PERSONAL (when completed)
Developed Vetting (DV) Questionnaire

Important: Please read the notes on Pages 3 and 4 before completing the form.
1. How to complete this form

Please ensure you only write inside the fields provided. Do not mark or strike through any other areas of the form. If
completing by hand please write in BLACK INK using BLOCK LETTERS. If an answer will not fit in the space provided,
please enter your answer on the continuation sheets (pages 105 to 107). If you make a mistake, please do not correct it
but delete it by striking it through. Please do not use correcting fluid.
Ensure you answer ALL the questions. You can use the abbreviation NA (Not Applicable)if a question does not
apply to you. Not Known - If you do not know the answer, or you cannot provide the information needed, write NOT KNOWN
in the first line only of the relevant question. Please provide an explanation why the information is unknown to you
in the appropriate boxes or on the continuation sheets (pages 105 to 107). Unanswered questions or Not Known
replies may cause delay to the processing of this questionnaire.
YOU MUST READ THE PRIVACY NOTICE ON PAGE 114 BEFORE COMPLETING THE FORM
2. Security Clearance Required - To be completed by all Sponsors

Sponsors must also complete pages 109 to 113.
Type of Security Clearance required:
(EDV may only be requested if the post for which the applicant is seeking
DV DV – review EDV clearance has been designated as attracting Enhanced DV.)
Precedence (how urgent is the requirement for clearance?) Routine Priority Immediate
If you have requested Priority or Immediate clearance, please provide justification below :
I certify that this Priority/Immediate application is supported by a letter of justification, signed at the appropriate level
Date by which clearance is required:
dd mm yyyy
If the employee requires this clearance to access classified information from NATO/EU/Other countries or international
organisations, please tick appropriate box. NATO EU Other (please specify)
(NATO, EU, and Other countries/international organisations clearances are only required if the employee has a specific
need to access classified information or sites belonging to these bodies.)
3. Your Details
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx) b. Gender: Male: Female: Other:
If you have answered 'Other', please provide your gender identity:
c. Full Forenames:
Failure to declare all forenames will result in your application for security clearance being delayed or cancelled. Please tick the
box to confirm that you have declared all forenames, including any middle names.
d. Surname (now):
e.Date of Birth: Country of Birth:
dd mm yyyy
f. Town of Birth: g. County / Region of Birth:
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h. Has your surname changed at any time since birth? Yes No
i. If you have answered 'Yes', please provide your surname at birth:
j. Reason for surname change:
k. Apart from the surname(s) you have already declared, have you ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames you have had and the reason for change.
Previous surname Reason for change of surname
l. Have your forenames changed at any time since birth? Yes No
If you have answered 'Yes', please provide your forename(s) at birth:
Reason for forename change:
m. Apart from the forename(s) you have already declared, have you ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames you have had and the reason for change.
Previous forename Reason for change of forename
4. Your Additional Details

a. Current rank/grade: b. Job title:
c. Staff or Service Number (if you do not currently have one, please leave this field blank)
(For example, Civil Service staff number, HM Forces service number, Police collar/employee number)
d. Do you have a UK National Insurance Number? Yes No
If ‘yes’, please enter your National Insurance Number.

(Please enter this in the correct format AB112233C, with capital letters and no spaces.)
Is this a temporary NI number? Yes No
If you do not have a UK NI number (either temporary or permanent) please provide a brief explanation:
Page 2
Statement of HM Government Personnel Security and National Security

Vetting Policy
MINIMUM PERSONNEL SECURITY CONTROLS
1. It is HM Government’s policy that all areas of government and the national infrastructure should include in their recruitment
processes certain basic checks. These checks include verification of the applicant’s identity, employment history, their right to work
in the UK and, if appropriate, checks of any unspent criminal records. Within government these controls are described in the
Baseline Personnel Security Standard. In addition, the Centre for the Protection of National Infrastructure (CPNI) produces a range
of relevant guidance on personnel security and makes similar advice available to the wider national infrastructure.
NATIONAL SECURITY VETTING
2. National security vetting comprises a range of additional checks and may be applied where a risk assessment indicates it is
proportionate to do so. The risk assessment process takes account of the access an individual may have to sensitive assets
(physical, personnel or information) at risk from a wide range of threats. These threats include: terrorism, espionage, or other
actions that could threaten the United Kingdom. The requirements of international agreements concerning the protection of allies’
information may also inform such assessments.
3. It is government policy that individuals should not be expected to hold an existing security clearance in order to apply for posts
that require vetting, except where such posts are short term and need to be filled urgently.
4. There are three different types of national security vetting clearance: Counter Terrorist Check (CTC), Security Check (SC) and
Developed Vetting (DV). Before any such clearance is undertaken the requirements of the Baseline Personnel Security Standard
must be met. Whilst the information required and the range and depth of checks undertaken at each level may vary, they are all
intended to allow Government departments and agencies, the Armed Forces and police forces to assess whether individuals who
are to be employed in sensitive posts or critical functions might represent a security risk either directly or indirectly.
CHECKS
5. Individuals subject to national security vetting (including UK nationals taking up sensitive posts in international organisations) will
be asked to provide via questionnaire personal information about themselves, partners, family members and other associates. It
may be checked, and retained for future checks, against:
• Relevant personnel records held by the employing department or company

• Criminal records (both spent and unspent as defined by the Rehabilitation of Offenders Act 1974)
• Information held by the Security Service.
• Credit reference agency records"
6. The process may also take account of:
• Financial circumstances generally

• Third party character references
• Any medical considerations that could give rise to security concerns"
7. Interviews with the vetting subject and referees may be carried out to establish good character and to verify information that has
been provided.
DECISION MAKING
8. National security vetting decisions may only be taken by Government departments, agencies, the Armed Forces or police forces.
All the available information is taken into account to reach a reasoned decision on an individual’s suitability to hold a security
clearance.
9. Security clearances may be refused or withdrawn where:
• There are security concerns related to an individual’s involvement or connection with activities, organisations or individuals
associated with the threats described in this Statement (or any similar new threats that emerge);
• Personal circumstances, current or past conduct indicate that an individual may be susceptible to pressure or improper influence;
• Instances of dishonesty or lack of integrity cast doubt upon an individual’s reliability;
• Other behaviours or circumstances indicate unreliability."
10. Wherever possible existing employees will have an opportunity to discuss, comment on and challenge any adverse information
that arises. However in certain circumstances it may not be possible to share such information as this could compromise national
security, the public interest or third party confidentiality.
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AVENUES OF APPEAL
11. Existing employees who are subject to national security vetting and either refused a security clearance or whose clearance is
withdrawn may appeal against such decisions. All departments and agencies that carry out national security vetting must provide
for an internal appeal process. Where individuals remain dissatisfied they may appeal to the Security Vetting Appeals Panel, an
independent body.
12. The Panel will consider the case, review the information and invite the appellant and the organisation to make representations.
The Panel will make recommendations to the Head of Department or organisation in the light of its findings as to whether the
decision should stand or be reviewed. The Panel may also comment on the security vetting procedures and adequacy of the
internal appeal arrangements.
13. There are no national security vetting appeal routes for applicants for employment who are refused a security clearance.
Separate arrangements exist for applicants, employees and contractors of the security and intelligence agencies, who may
complain to the Investigatory Powers Tribunal. Any individual may apply to an Employment Tribunal if they feel that they have been
discriminated against in any part of the recruitment process.
ONGOING PERSONNEL SECURITY MANAGEMENT
14. The national security vetting process provides an assessment of the vetting subject at the time the process is carried out but
active ongoing personnel security management is required to ensure that a security clearance maintains its currency. As a
minimum this will involve active consideration of the vetting subject’s continuing conduct in respect of security matters; it will also
require checks to be repeated at regular intervals.
Please note that any information provided will be treated in strict confidence. In cases where a potential risk is identified, and a
decision taken to 'manage the situation' rather than refuse security clearance, those tasked with managing that risk will need the
appropriate information in order to do this effectively.
FAILURE TO DISCLOSE RELEVANT CIRCUMSTANCES OR INFORMATION IS LIKELY IN ITSELF TO BE REGARDED AS

EVIDENCE OF UNRELIABILITY AND WILL BE TAKEN INTO ACCOUNT WHEN ASSESSING YOUR SUITABILITY FOR
SECURITY CLEARANCE. IT IS THEREFORE IN YOUR OWN INTERESTS TO BE HONEST AND OPEN IN THE INFORMATION
YOU PROVIDE IN THIS QUESTIONNAIRE.
Fair Processing Statement
You will now be asked to supply “personal” and “sensitive personal” data as defined byFXUUHQW'DWD3URWHFWLRQOHJLVODWLRQ
You will be supplying this data to the appropriate Vetting Authority (VA) where it will be processed exclusively for
the purpose of security vetting, in accordance with HM Government's vetting policy, save that, in the highly
unlikely event that data supplied by you discloses or suggests that:
· a criminal offence has occurred or is likely to occur.

· staff may be at risk, e.g. if you have been diagnosed with a serious mental condition as potentially
endangering yourself or others.
then the vetting authority may pass on that information alone to the appropriate person(s). Subject to this, the
vetting authority will protect the information you provide and will ensure that it is not passed to anyone who is not
authorised to see it.
We handle all personal information that we have gathered during the vetting process in confidence. In a very
small number of cases, if we think we have found a serious risk to national security, we may discuss the case with
the relevant security authorities. In an even smaller number of risky cases, and only with your agreement, relevant
information may be shared with the personnel management authority of the organisation which will employ you/is
employing you, where this will help your employer to manage a particular risk that we have identified. If you are
worried about confidentiality, please contact your sponsor for advice.
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5. Your Nationality
In this section you are required to provide details of your current and any former Nationality.
If applicable you must provide full details of the date of naturalisation or when you took up residency in the UK. If
naturalised, please ensure that you provide details of your current and previous nationality.
a. Is your present nationality:
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you have answered 'other', please enter your nationality:
b. Have you held this nationality since birth? Yes No
If you answered ‘no’, from what date have you held this nationality? Since
mm yyyy
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do you currently hold, or have you ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that you currently hold or have previously held.
Nationality 1: Is/was Current or Date from: Date to:

this: previous?
Nationality Current
Citizenship Previous mm yyyy mm yyyy

this: previous?
Nationality Current
6. Your Citizenship
British Naturalisation
a. Are you British naturalised? Yes No
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not your birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If you are not a British Citizen, and you are currently living in the UK, please enter the date of taking up permanent
residence in the UK. (This is not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
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7. Your Addresses
In this section you are asked to provide address details to cover the past 10 years. This should include:
• Periods of no fixed abode

• Periods abroad
• Student accommodation
• Flat/property that you may have rented while working away from home
• Any other addresses at which you live or have lived while away from your permanent home address
You do not need to provide details of hotels etc. at which you may have spent a short period on holiday.
Please provide your current permanent home address first and work backwards.
Address 1:
Type of address: Current or previous? Date from: Date to:
UK Current
Overseas Previous mm yyyy mm yyyy
BFPO
No fixed abode
Please fill in the fields which are applicable:
Flat number: House number: House name:
(BFPO addresses only) Name/Rank/Number: BFPO Code:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
County (or Region/Area/State for overseas addresses):
Postcode (or equivalent, where applicable, for overseas addresses):
Country (if not UK or a BFPO address):
Address 2:
UK Current
BFPO
No fixed abode
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Address Line 1:
Address Line 2:
Address Line 3:
Town:
Address 3:
UK Current
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
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Address 4:
UK Current
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
8. Your Contact Details

In this section you are asked to provide your contact details. It is possible you will be contacted during the vetting
process so it is important your contact details are correct.
a. If we need to contact you, would you prefer to be contacted at: Home Work
We will try to meet your contact preference where possible but this cannot always be guaranteed.
b. Please provide your contact telephone numbers (in order of preference). If you are not providing a contact email
address, you must enter at least TWO separate telephone numbers.
Preferred contact number:
Country code (+): Number: Extension

(if applicable) (if applicable)
Alternative contact number 1:

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Alternative contact number 2:

c. Contact email address:
9. Your Work Address

Please provide details of your current work address
Type of address: UK Overseas BFPO
Building number: Building name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
10. Interview Details

a. Would you prefer to be interviewed at Work Home
(We will try to meet your preference but this cannot always be guaranteed)
b. Do you wish to be interviewed at a work address other than the one you have provided in Section 9? Yes No
If you have answered ‘yes’, please give the address:
Type of address: UK Overseas BFPO
Building number: Building name:
Address Line 1:
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Address Line 2:
Address Line 3:
Town:
11. Your Marital Status

a. What is your current marital status?
Single Married In a Civil Partnership

Go to Section 12 Go to 11b Go to 11b
Divorced/Civil Partnership dissolved Annulled Separated

Go to 11c Go to 11c Go to 11d
Engaged Widowed Cohabiting

Now please go to Section 12 Go to 11e Go to 11f
11b. Marriage / Civil Partnership Details

Date of marriage or partnership ceremony:
dd mm yyyy
Where did it take place?
Town:
County/region:
Country: Now please go to Section 12
11c. Divorce, Dissolution or Annulment Details

If this is 3 years ago or
Date of divorce/dissolution or annulment less, please go to
Section 12. Otherwise,
dd mm yyyy
please go to Section 13.
Court at which Decree Nisi and Decree Absolute / Conditional Order and Final Order granted:
11d. Separation Details

Date of separation: less, please go to
dd mm yyyy please go to Section 13.
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11e. Widowed Details

Please provide the date of your Spouse/Partner's death: less, please go to
please go to Section 13.
dd mm yyyy
11f. Cohabitation Details
Date on which you began cohabiting: Now please go to

Section 12
dd mm yyyy
12. Details of this Partner

Please note: we require details of a spouse or civil partner, even if you are not living with them.
If your spouse or partner is deceased, where the form asks for current information please provide details as at the time of
their death.
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
b. Full Forenames: c. Surname (now):
d. Gender: Male: Female: Other:
If you have answered 'Other', please provide their gender identity:
e. Has their surname changed at any time since birth? Yes No
f. If you have answered 'Yes', please provide their surname at birth:
g. Reason for surname change:
h. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
i. Have their forenames changed at any time since birth? Yes No
If you have answered 'Yes', please provide their forename(s) at birth:
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j. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
k. Date of Birth: l. Country of Birth:
dd mm yyyy
m. Town of Birth: n. County / Region of Birth:
o. As a child, was this partner adopted? Yes No
If you have answered 'Yes', please give the date of adoption (if
the full date is not known, please give the year)
dd mm yyyy
p. Occupation:
q. Do you have any other information about this person that you feel may be relevant? Yes No
(for example, if they hold/held security clearance or are/were in Government employment)
If you have answered ‘yes’, please give the information below.
Your Partner’s Nationality
In this section you are required to provide details of your partner’s nationality and any former nationality.
If applicable you must provide full details of the date of naturalisation or when they took up residency in the UK. If British
naturalised, please ensure that you provide details of all their nationalities including previous nationality.
a. Is their present nationality:
If you have answered 'other', please enter their nationality:
b. Have they held this nationality since birth? Yes No
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
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If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held.

this: previous?
Nationality Current

this: previous?
Nationality Current
Your Partner’s Citizenship 0
a. Are they British naturalised? Yes No
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If they are not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not necessarily
the same as the date of the permission to stay in the UK)
dd mm yyyy
Your Partner’s Addresses0
Please provide address details for this partner to cover the past 5 years. This should include:

• Periods abroad
• Flat/property that they may have rented while working away from home
• Any other addresses at which they live or have lived while away from their permanent home address
You do not need to provide details of hotels etc. at which they may have spent a short period on holiday. Please provide
their current permanent home address first and work backwards.
Address 1:
UK Current
BFPO
No fixed abode
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Flat number: House number: House

name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Address 2:
UK Current
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:

Page 14
Address 3:
UK Current
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
13. Relationships within the last 3 years

Have you had any other marriages, civil partnerships or cohabiting relationships WITHIN THE LAST 3 YEARS? You need
not enter details of anyone you have already included on this form. Yes No
If you have answered ‘No’, please go to Section 14.
If you have answered ‘Yes’, please provide details below. If this includes more than one partner during the last 3 years
please tick here and enter additional details on the continuation sheets in the same format.
If you do not know full details of this individual, and you are unable to obtain them, please tick here and give an
explanation:
a. Was the relationship a marriage or civil partnership? Yes No
If you answered ‘No’, please go to 13b. If you answered ‘Yes’, please answer the following questions:
dd mm yyyy
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Town:
County/region:
Country:
Was the marriage / partnership ended by:
Spouse/Partner’s death? Yes No If ‘yes’, please give date:

dd mm yyyy
Divorce/dissolution? Yes No If ‘yes’, please give date:
dd mm yyyy
Court at which Decree Nisi
and Decree Absolute /
Conditional Order and Final
Order granted:
Other? Yes No If ‘yes’, please give an explanation:
Now please go to ‘Details of this Partner’
b. Date on which you began cohabiting:
dd mm yyyy
Until what date were you cohabiting?
dd mm yyyy
Was the relationship ended by:
Partner’s death? Yes No If ‘yes’, please give date:

dd mm yyyy
Now please complete ‘Details of this Partner’, below.
Details of this Partner

If this spouse or partner is deceased, where the form asks for current information please provide details as at the time of
their death.
Page 16
e. Has their surname changed at any time since birth? Yes No
f. If you have answered 'Yes', please provide their surname at birth:
g. Reason for surname change:
h. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
i. Have their forenames changed at any time since birth? Yes No
j. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
k. Date of Birth: l. Country of Birth:
dd mm yyyy
m. Town of Birth: n. County / Region of Birth:
o. As a child, was this partner adopted? Yes No
If you have answered 'Yes', please give the date of adoption (if
the full date is not known, please give the year)
dd mm yyyy
p. Occupation:
q. Do you have any other information about this person that you feel may be relevant? Yes No
(for example, if they hold/held security clearance or are/were in Government employment)
If you have answered ‘yes’, please give the information below.
Page 17
Your Partner’s Nationality
In this section you are required to provide details of this partner’s nationality and any former nationality.
If applicable you must provide full details of the date of naturalisation or when they took up residency in the UK. If British
mm yyyy

this: previous?
Nationality Current

this: previous?
Nationality Current
Your Partner’s Citizenship
a. Are they British naturalised? Yes No
Number: Date:
dd mm yyyy
British Residency
b. If they are not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not necessarily
the same as the date of the permission to stay in the UK)
dd mm yyyy
Page 18
Your Partner’s Addresses
Please provide address details for this partner to cover the past 5 years. This should include:

• Periods abroad
• Flat/property that they may have rented while working away from home
• Any other addresses at which they live or have lived while away from their permanent home address
You do not need to provide details of hotels etc. at which they may have spent a short period on holiday. Please provide
their current permanent home address first and work backwards.
Address 1:
UK Current
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Address 2:
UK Current
BFPO
No fixed abode
Page 19

name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Address 3:
UK Current
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
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14. Marriages/civil partnerships more than 3 years ago
Have you had any other marriages or civil partnerships that ended MORE THAN 3 YEARS AGO? You need not enter details
of anyone you have already included on this form. Yes No
If you have answered ‘No’, please go to Section. If you have answered ‘Yes’, please answer the following questions. If you
had more than one spouse or partner prior to the last 3 years, please tick here and enter additional details on the
continuation sheets in the same format.
dd mm yyyy
Town:
County/region:
Country:
Was the marriage / partnership ended by:
Spouse/Partner’s death? Yes No If ‘yes’, please give date:

dd mm yyyy
Divorce/dissolution? Yes No If ‘yes’, please give date:
dd mm yyyy
Court at which Decree Nisi
and Decree Absolute /
Conditional Order and Final
Order granted:
15. Your Parents

Please provide details of ALL your parents and your parents’ current and/or former partners in the last 3 years. If your
parents are separated and either of them is living with a new partner (or has done so within the last 3 years), details of
their partner are required.
Details of any other step parents, foster parents, adoptive parents, legal guardians, etc. are also required. Details of
natural father and natural mother must be provided, even if full details are not known.
If a parent is deceased, where the form asks for current information please provide details as at the time of their death.
Details about your Natural Father

If you do not know full details of your natural father, please tick here and give an explanation:
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx):
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e. Date of Birth: f. Country of Birth:
dd mm yyyy
g. Town of Birth: h. County / Region of Birth:
i. Has their surname changed at any time since birth? Yes No
j. If you have answered 'Yes', please provide their surname at birth:
k. Reason for surname change:
l. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
m. Have their forenames changed at any time since birth? Yes No
n. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
o. Occupation: p. Date of death (if applicable):
dd mm yyyy
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Your natural father’s nationality
In this section you are required to provide details of this parent’s nationality and any former nationality. If applicable you
must provide full details of the date of naturalisation or when they took up residency in the UK. If British naturalised,
please ensure that you provide details of all their nationalities including previous nationality.
mm yyyy

this: previous?
Nationality Current

this: previous?
Nationality Current
Your father’s citizenship
a. Is your father British naturalised? Yes No
Number: Date:
dd mm yyyy
British Residency
b. If your father is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not
necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
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Your father’s address
Please provide your father’s current permanent address below.
Type of address: Date from:
UK
Overseas mm yyyy
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Details about your Natural Mother

If you do not know full details of your natural mother, please tick here and give an explanation:
b. Full Forenames c. Surname (now)
dd mm yyyy
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Yes No
Yes No
dd mm yyyy
Your natural mother’s nationality

mm yyyy
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this: previous?
Nationality Current

this: previous?
Nationality Current
Your mother’s citizenship
a. Is your mother British naturalised? Yes No
Number: Date:
dd mm yyyy
British Residency
b. If your mother is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not
dd mm yyyy
Your mother’s address

Please provide your mother’s current permanent address below.
UK
Overseas mm yyyy
BFPO
No fixed abode

name:
Page 26
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Details of other Parents, Adoptive Parents, Foster Parents, Step-Parents or Legal

Guardians
Do you have any other parents, adoptive parents, step-parents or legal guardians? Yes No
If you have answered ‘No’, please go to Section 16. If you have answered ‘Yes’, please answer the following questions.
First Individual
a. Type of relationship:
Step Father Step Mother Foster Father Foster Mother
Adoptive Father Adoptive Mother Father’s Partner Mother’s Partner
Legal Guardian Legal Guardian’s Father’s Former Mother’s Former

Partner Partner Partner
If you do not know full details of this individual, please tick here and give an explanation:
b. If you were adopted, please give the date of adoption.
dd mm yyyy
c. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
d. Full Forenames e. Surname (now)
f. Gender: Male: Female: Other:
g. Date of Birth: h. Country of Birth:
dd mm yyyy
Page 27
i. Town of Birth: j. County / Region of Birth:
k. Has their surname changed at any time since birth? Yes No
l. If you have answered 'Yes', please provide their surname at birth:
m. Reason for surname change:
n. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
o. Have their forenames changed at any time since birth? Yes No
p. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
q. Occupation: r. Date of death (if applicable):
dd mm yyyy
Their nationality
Page 28
Is this: Nationality or citizenship mm yyyy
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held:

this: previous?
Nationality Current

this: previous?
Nationality Current
Their citizenship
a. Is this parent British naturalised? Yes No
Number: Date:
dd mm yyyy
British Residency
b. If this parent is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not
dd mm yyyy
Their address
Please provide this parent’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode

name:
Page 29
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Second Individual

b. If you were adopted, please give the date of adoption.

dd mm yyyy
dd mm yyyy
i. Town of Birth: j. County / Region of Birth:
k. Has their surname changed at any time since birth? Yes No
l. If you have answered 'Yes', please provide their surname at birth:
m. Reason for surname change:
Page 30
n. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
o. Have their forenames changed at any time since birth? Yes No
Yes No
dd mm yyyy
Their nationality
mm yyyy
Page 31

this: previous?
Nationality Current

this: previous?
Nationality Current
Their citizenship
Number: Date:
dd mm yyyy
British Residency
dd mm yyyy
Their Address
UK mm yyyy
Overseas
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Page 32
Town: County (or Region/Area/State for overseas addresses):
16. Your Partner’s Parents

Please provide details of ALL your partner's parents, and their current and/or former partners in the last 3 years. If this
section is inapplicable, please go to Section 17.
Details of their natural father and natural mother must be provided, even if full details are not known. If their parents are
separated, and either parent is living with a new partner (or has done so within the last 3 years), details of their parent's
partners are required. Details of any other step parents, foster parents, adoptive parents, legal guardians, etc. are also
required.
Details About Your Partner’s Natural Father

If you do not know full details of your partner’s natural father, please tick here and give an explanation:
dd mm yyyy
Yes No
Page 33
Yes No
dd mm yyyy
Your partner’s natural father’s nationality

mm yyyy

this: previous?
Nationality Current

this: previous?
Nationality Current
Page 34
Your partner’s father’s citizenship
a. Is your partner’s father British naturalised? Yes No
Number: Date:
dd mm yyyy
British Residency
b. If your partner’s father is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is
not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
Your partner’s father’s address

Please provide your partner’s father’s current permanent address below.
UK
Overseas mm yyyy
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Page 35
Details About Your Partner’s Natural Mother
If you do not know full details of your partner’s natural mother, please tick here and give an explanation:
dd mm yyyy
Yes No
Yes No
dd mm yyyy
Page 36
Your partner’s natural mother’s nationality
mm yyyy

this: previous?
Nationality Current

this: previous?
Nationality Current
Your Partner’s Mother’s Citizenship
a. Is your partner’s mother British naturalised? Yes No
Number: Date:
dd mm yyyy
British Residency
b. If your partner’s mother is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This
is not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
Page 37
Your Partner’s Mother’s Address
Please provide your partner’s mother’s current permanent address below.
UK
Overseas mm yyyy
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Details of other Parents, Adoptive Parents, Foster Parents, Step-Parents or Legal

Guardians
Does your partner you have any other parents, adoptive parents, step-parents or legal guardians? Yes No
First Individual

b. If your partner was adopted, please give the date of adoption

dd mm yyyy
Page 38
dd mm yyyy
i. Town of Birth: g. County / Region of Birth:
j. Has their surname changed at any time since birth? Yes No
k. If you have answered 'Yes', please provide their surname at birth:
l. Reason for surname change:
m. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
n. Have their forenames changed at any time since birth? Yes No
o. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
p. Occupation: q. Date of death (if applicable):
dd mm yyyy
Page 39
Their nationality
mm yyyy

this: previous?
Nationality Current

this: previous?
Nationality Current
Their citizenship
Number: Date:
dd mm yyyy
British Residency
dd mm yyyy
Page 40
Their Address
UK mm yyyy
Overseas
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Second Individual

b. If your partner was adopted, please give the date of adoption.

dd mm yyyy
Page 41
dd mm yyyy
i. Town of Birth: g. County / Region of Birth:
j. Has their surname changed at any time since birth? Yes No
k. If you have answered 'Yes', please provide their surname at birth:
l. Reason for surname change:
m. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
n. Have their forenames changed at any time since birth? Yes No
Yes No
dd mm yyyy
Page 42
Their nationality
mm yyyy

this: previous?
Nationality Current

this: previous?
Nationality Current
Their citizenship
Number: Date:
dd mm yyyy
British Residency
dd mm yyyy
Page 43
Their Address
UK mm yyyy
Overseas
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
17. Your Siblings

Do you have any brothers or sisters aged 16 or over? Yes No
If you answered ‘No’, please go to Section 18. If you answered ‘Yes’, please provide full details of ALL brothers and
sisters aged 16 or over, including those who have died in the last 5 years. If you have more than 4 brothers and sisters,
please use the continuation sheet.
In addition to full brothers and sisters, please include:
▪ Half brothers and sisters,
▪ Step brothers and sisters,
▪ Adopted brothers and sisters.
First Brother or Sister

Relationship:
Brother Sister Half Brother Half Sister
Step Brother Step Sister Adopted Brother Adopted Sister
Page 44
a. Full Forenames b. Surname (now)
c. Gender: Male: Female: Other:
d. Date of Birth: e. Country of

Birth:
dd mm yyyy
h. Has their surname changed at any time since birth? Yes No
i. If you have answered 'Yes', please provide their surname at birth:
k. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
l. Have their forenames changed at any time since birth? Yes No

m. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
n. Occupation: o. Date of death (if applicable):
dd mm yyyy
Page 45
Their nationality
In this section you are required to provide details of this brother/sister’s nationality and any former nationality. If
applicable you must provide full details of the date of naturalisation or when they took up residency in the UK. If British
mm yyyy

Nationality: Is/was Current or Date from: Date to:
this: previous?
Nationality Current

this: previous?
Nationality Current
Their citizenship
a. Is this brother/sister British naturalised? Yes No
Number: Date:
dd mm yyyy
British Residency
b. If this brother/sister is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is
dd mm yyyy
Page 46
Their address
Please provide this brother/sister’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Second Brother or Sister

Relationship:
d. Date of Birth: e. Country of Birth:
dd mm yyyy
Page 47
Yes No

Yes No
dd mm yyyy
Their nationality
mm yyyy
Page 48
this: previous?
Nationality Current

this: previous?
Nationality Current
Their citizenship
Number: Date:
dd mm yyyy
British Residency
dd mm yyyy
Their address
UK mm yyyy
Overseas
BFPO
No fixed abode

name:
Address Line 1:
Page 49
Address Line 2:
Address Line 3:
Third Brother or Sister

Relationship:
dd mm yyyy
Yes No
Page 50
Yes No
dd mm yyyy
Their nationality

mm yyyy

this: previous?
Nationality Current

this: previous?
Nationality Current
Page 51
Their citizenship
Number: Date:
dd mm yyyy
British Residency
dd mm yyyy
Their address
UK mm yyyy
Overseas
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
Fourth Brother or Sister

Relationship:
Page 52
dd mm yyyy
Yes No
Yes No
dd mm yyyy
Page 53
Their nationality
mm yyyy

this: previous?
Nationality Current

this: previous?
Nationality Current
Their citizenship
Number: Date:
dd mm yyyy
British Residency
dd mm yyyy
Page 54
Their address
UK mm yyyy
Overseas
BFPO
No fixed abode

name:
Address Line 1:
Address Line 2:
Address Line 3:
18. Your Co-residents

Other than the persons you have already declared on this form, please give details of anyone aged 18 or over who lives
with you in your household. (For example lodgers, au-pairs, flat-mates, your own or your partner's adult children etc.) For
this purpose 'Household' means a group of people (not necessarily related) living at the same address who share cooking
facilities and share a living room, sitting room or dining area.
You do not need to enter details of:
▪ Your partner,
▪ Anyone else who you have already included on this form,
▪ People who live in the same hostel,
▪ People with whom you live in shared Service accommodation.
Do you live with any co-residents? Yes No
If you have answered ‘No’, please go to Section 19. If you have answered ‘Yes’, please answer the following questions. If
you have more than 4 co-residents, please use the continuation pages.
First Co-resident
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b. Full Forenames: c. Surname:
c. Please provide either their age or date of birth (you only need to provide one).
:
Date of Birth: Age
dd mm yyyy
Present nationality: Occupation:
Second Co-resident
Date of Birth: Age:
dd mm yyyy
Third Co-resident
Date of Birth: Age:
dd mm yyyy
Fourth Co-resident
Date of Birth: Age:
dd mm yyyy
Page 56
19. Current Employment/Current Service
What is your current employment status? You may select more than one employment. For example, if you have a civilian job
but are also a reservist.
Select all that apply.
Employed in HM Government Service, the Civil Nuclear Industry, Police Forces and the devolved administrations
Please complete Section 19/1
Serving in HM Forces – Regular Please complete Section 19/2
Serving in HM Forces – Reserves Please complete Section 19/2
In other full or part-time employment (excepting self-employment) Please complete Section 19/3
Self-employed Please complete Section 19/4
Unemployed Please complete Section 19/5
19/1: Employment in HMG

Organisation: Date of joining:
mm yyyy
Your grade:
Please provide details (including current contact information where known) of all the immediate supervisors, both current
and previous, that you have had with this employer since you joined them or within the last 5 years, whichever is shorter.
Give your present supervisor first and work backwards. If you have had more than 4 supervisors, please use the
continuation pages
Current Supervisor
Forename(s) Surname: Date from:
mm yyyy
Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx):
Rank/grade (if any): Job title:
Current contact email address (if known): Telephone:
Section, Unit, Branch or Establishment (if applicable):
Address Line 1:
Address Line 2:
Address Line 3:
Town: County (or Region/Area/State)
Country:
Previous Supervisor
Forename(s) Surname: Tick here if details not fully known
Date from: Date to:

mm yyyy mm yyyy
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Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Date from: Date to:

mm yyyy mm yyyy
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Address Line 1:
Address Line 2:
Address Line 3:
Country:
19/2: Serving in HM Forces (Regular or Reserve)

When did your current military service begin?
Your rank: mm yyyy
Service: Service number:
and previous, that you have had in each posting with HM Forces (Regular or Reserve) since you began serving with them
or within the last 5 years, whichever is shorter. This should be the person who directly supervises you and sees you most
frequently. It must be someone of Petty Officer/SNCO rank (or equivalent grade) or above.Give your present supervisor
first and work backwards. If you have had more than 4 supervisors, please use the continuation pages.
Current Supervisor
mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 59
Previous Supervisor
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 60
Previous Supervisor
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
19/3 Other Employment (excepting Self-Employment)

Name of employer: Date of joining:
Your employer’s address: mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
and previous, that you have had with this employer within the last 12 months. This should be the person who directly
supervises you and sees you most frequently. Give your present supervisor first and work backwards. If you have had
more than 4 supervisors, please use the continuation pages.
Page 61
Current Supervisor
mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 62
Previous Supervisor
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
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19/4 Self-Employment
Date on which you established/
Name of company: joined the company: mm yyyy
Your company’s address:
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Is your business a registered charity, of which you are a trustee? Yes No
If ‘yes’, please give the registered charity number:

Please provide details of someone in a position of authority who knows you well through your work. This could be a
senior business partner in your company, or a senior representative of a customer by whom you have been contracted to
carry out work (for example, a Government official).
Forename(s) Surname:
Please explain briefly how you know this individual:
Their rank/grade (if any): Their job title:
How long have you worked with/for this individual? years months
Please provide current contact details for this individual.

Contact email address (if known): Telephone:
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 64
19/5 Unemployment
Date from which this period of unemployment started
mm yyyy
Are you claiming unemployment benefit? Yes No

If ‘Yes’, please provide the address of the relevant Benefit Office:
Building Number:
Building Name:
Street:
District/Area:
Town:
County/Region: Postcode:
Country:
20. Details of Previous Employment

Within the last 10 years, have you had any previous full or part-time employment, including previous periods of military
service, or any periods of unemployment lasting for 3 months or more? Yes No
Please give details of all previous employment / Service / unemployment in excess of 3 months during this period,
starting with the most recent first. Please use the continuation sheets if necessary.
Previous HM Government employment: Section 20/1
Previous military service: Section 20/2
Other previous employment (excepting self-employment) Section 20/3
Previous self-employment Section 20/4
Previous unemployment Section 20/5
20/1: Previous HMG Employment

Date from: Date to:
mm yyyy mm yyyy
Organisation: Grade on leaving:
Please provide details (including current contact information where known) of each supervisor that you had within the
last 5 years of employment in this organisation. This should be the person who directly supervised you and saw you most
frequently. Details of anyone who supervised you more than 5 years ago are not required.
Page 65
Supervisor 1
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Supervisor 2
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
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Supervisor 3
Date from: Date to:
mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
20/2: Previous Service in HM Forces (Regular or Reserve)

Date from: Date to:
mm yyyy mm yyyy
Was this Reserve Service? Yes No
Your rank on discharge:
Service: Service number:
Please provide details (including current contact information where known) of each supervisor that you had within the
last 5 years of this period of service. This should be the person who directly supervised you and saw you most frequently.
It must be someone of Petty Officer/SNCO rank (or equivalent grade) or above. Details of anyone who supervised you
more than 5 years ago are not required.
Supervisor 1
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
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Address Line 2:
Address Line 3:
Country:
Supervisor 2
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Supervisor 3
Date from: Date to:
mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Page 68
Country:
20/3 Other previous employment (excepting self-employment)

Date from: Date to:
mm yyyy mm yyyy
Name of employer:
Your employer’s address:

Address Line 1:
Address Line 2:
Address Line 3:
Country:
Please provide details (including current contact information where known) of each supervisor you had during
employment in this organisation. This should be the person who directly supervised you and saw you most frequently.
Details of anyone who supervised you more than 5 years ago are not required.
Supervisor 1
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 69
Supervisor 2
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Supervisor 3
Date from: Date to:

mm yyyy mm yyyy
Address Line 1:
Address Line 2:
Address Line 3:
Country:
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20/4 Previous self-employment

Date from: Date to:
mm yyyy mm yyyy
Name of company:
Your company’s address:

Address Line 1:
Address Line 2:
Address Line 3:
Country:
Please provide details of someone in a position of authority who knew you well through your work while you were self-
employed. This could be a senior business partner in your company, or a senior representative of a customer by whom
you have been contracted to carry out work (for example, a Government official). Please enter the current information and
contact details for this individual.
Forename(s) Surname:
Please explain briefly how you knew this individual:
Their rank/grade (if any): Their job title:
How long did you work with/for this individual? years months
Please provide current contact details for this individual.
Contact email address (if known): Telephone:
Address Line 1:
Address Line 2:
Address Line 3:
Country:
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20/5 Previous Unemployment

Date from: Date to:
mm yyyy mm yyyy
Were you claiming unemployment benefit? Yes No

If ‘Yes’, please provide the address of the relevant Benefit Office:
Building Number:
Building Name:
Street:
District/Area:
Town:
Country:
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Deliberately blank
Page 73
21. Full Time Education
Have you received full time education during the last 5 years ? Yes No
If you answered ‘No’, please go to Section 22. If you answered ‘Yes’, please answer the following questions:
Name of School/College/University:
Dates attended: From: To:
mm yyyy
mm yyyy
Faculty/Department (for Higher Education):
Please provide details for the Head, Principal or Tutor who knew you best:
Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
Full Forenames: Surname:
Official address:
Address Line 1:
Address Line 2:
Address Line 3:
Country
Consent Statement
I acknowledge that the vetting authority may ask schools/colleges/universities that I have attended full time in the last 5
years to provide them with my personal data. I understand that they will approach the Head/Principal/member of staff
whom I have identified as having known me best and request them to give an assessment of my character and behaviour
while I was under their supervision. This information will be used solely for the purpose of national security vetting and
will not be disclosed by the vetting authority to anyone who is not authorised to see it. I consent to the academic
institution producing such an assessment for the vetting authority and providing my personal data to them.
Signature Date:
dd mm yyyy
Your full name:
Your date of birth:
dd mm yyyy
Page 74
22. Internet Use
Most people use the internet and social media regularly and routinely for all sorts of reasons, including: recreation, shopping,
education, professional and personal development, and communicating with family, friends and sometimes much wider
communities of interest. The vetting process therefore needs to take proper and appropriate account of online activities to be
assured that:
• There are no implications for an individual’s personal security, i.e. they are not putting themselves or HMG at risk.
• Individuals comply with HMG’s acceptable use policies in respect of social media and online activity generally.
• Individuals are not markedly different in terms of their online personas from how they and their vetting referees would otherwise
describe themselves.
This section seeks some information about your use of the internet and social media for discussion with your Vetting Officer. As
part of your vetting a Vetting Officer may contact you to request a record of your social media activity or other social media usage
and will potentially conduct a search of open source information and images of you on the internet.
Internet Experience and Usage

Apart from for the completion of this application, do you ever access the internet, or have you ever accessed it?
Yes No
If you have responded ‘No’, please go to Section 23. You are reminded that, by submitting this application for security clearance,
you will be giving permission for Vetting Officers to conduct open source checks of the internet.
If you have responded ‘Yes’, please answer the following questions:
a. Do you use the internet every day? Yes No
b. How many hours do you spend online in an average day? Hours
c. How many hours do you spend online in an average week or month? (Please only answer one. Choose whichever
period will give a more meaningful answer.)
Per week Hours or Per Month Hours
d. Where do you most commonly access the internet? Select all that apply.
At home At work While out, using Wi-Fi While out, using mobile data
While travelling Other Please specify:
e. Thinking about the sites you access/activities you undertake, which 3 or 4 websites or apps would you say you spend
the greatest time on?
f. Which Internet Service Providers (ISP's) do you use? Please include home and mobile providers. We are aware that you will
not know details of all public Wi-Fi but please provide your standard default providers as used at home and by your phone.
g. Do you use any email services? Yes No

If you have answered ‘Yes’:
What email service(s) do you use? (Please provide all the email services you use.)
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Please provide details of ALL your email addresses.
h. Have you set up any web pages (work or personal)? Yes No

If you have answered ‘Yes’, please provide details.
i. Do you administer any work or personal web pages? Yes No

j. Noting that most websites require you to provide some personal details to access their site/services, do you ever
choose not to access a site because of this requirement? Yes No
If you have answered ‘Yes’, what makes this decision for you?
k. When you do enter personal details on a website, do you enter full and accurate personal details and/or contact
information? (For example,when logging into public Wi-Fi or registering on a social networking account.This does not apply to
online shopping or banking, where accurate details must be supplied by default.) Yes No
If you have answered ‘No’, please explain your reasoning.
l. What devices do you use to access the internet? Select all that apply.
PC (Personal Computer) Tablet Phone Other Please specify:
m. Have you created fake profiles, used aliases, handles or monikers associated with your on-line activity, including for
social media and gaming accounts/profiles? Yes No
n. Do you access, or have you accessed the Deep Web (parts of the web that are not accessible via normal search
engines) or utilised The Onion Router (TOR)? Yes No
If you have answered ‘Yes’, for what purposes?
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Types of Internet Activity/Services
Please include those accessed through an App on Mobile or Tablet or any other device.
a. Gambling sites:
Daily Frequently (once a week or more) Occasionally (less than once a week)
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
b. National Lottery or other Lottery sites:

used:
c. Chat rooms:
used:
d. Online dating:
used:
e. Blogs (personal):
used:
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f. On-line gaming, particularly Role Playing Games (RPG) or multi-player online games:
used:
g. Pornography:
used:
h. Private Wikis or bulletin boards:

used:
i. Pirate/illegal streaming sites

used:
j. Do you have a separate games console? Yes No
If ‘Yes’:
• How regularly do you game online?
Rarely (less than Historically (More than 2 years ago) Never

once a month)
• Do you use the chat functionality within games? Yes No
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If ‘Yes’, please provide an explanation. Is this exclusively to speak to others about the game or do you use these for wider
conversations/socialising?
k. Do you conduct any online transactions using Digital or virtual currencies (for example Bitcoin)? Yes No
If ‘Yes’, why do you use this payment method?
Online Social Media

a. Do you use any social networking sites? (For example Facebook, Twitter etc). Yes No
If ‘Yes’, please provide details of all the social networking sites you use.
Networking site Name displayed Unique ID or identifier Associated email address
b. Do you have any detailed or specific personal information associated with any social media accounts? For example,
address, contact details, bank details etc. Yes No
If ‘Yes’, do you regularly review your security and privacy settings? Yes No
c. Have you ever disclosed the nature of your work or your security clearance via social media, instant messaging or
other internet chat functions? Yes No
If ‘Yes’, please provide details.
d. Do you use any business networking sites or are you registered with any recruitment agencies? (For example, LinkedIn,
Monster etc.) Yes No
If ‘Yes’:
• Please provide details of your profiles/usernames.
• Does either your professional profile or on-line CV contain any references to Government departments or
working for Government? Yes No
• Does your profile(s) include details of your security clearance? Yes No
e. Has your opinion on a political or work issue ever been influenced or altered by someone you have met online?
Yes No
Page 79
f. Have you ever misrepresented personal details about yourself when communicating with an individual or group online?
For example, your name, age, gender, interests, beliefs etc. Yes No
If ‘yes’, please can you explain why this is.
g. Have you ever been barred from a site or forum, had access to a site removed or been asked by administrators to
withdraw comments or posts? Yes No
If ‘yes’, please provide details.
h. Have you ever knowingly 'liked', tweeted or in other ways linked with an individual or organisation that could be
considered extremist? For example, terrorist groups, violent political activists or movements etc. Yes No
i. Have you ever posted, been identified in or shared any imagery that could be considered obscene or that indicates
involvement in an illegal activity or with any extremist group or individuals, or have you used a webcam to create such
imagery? Yes No
j. Do you use internet-telecommunications services such as SKYPE or FaceTime? Yes No
If ‘yes’, do you contact individuals outside the UK? Yes No

If you do, please provide details.
k. Have you ever discussed work or work-related topics online (other than in an official capacity)? (Including over
Skype/Facetime etc., blog posts, comments pages on news websites, etc). Yes No
l. Have you ever shared (including through file sharing sites) information that is illegal or has been obtained illegally?
Yes No If ‘yes’, have you ever done so for profit? Yes No
Security Awareness
a. Do you use public Wi-Fi or Wi-Fi hotspots to access the internet? Yes No
If ‘Yes’, have you exchanged or used bank details or personal information while connected to unsecured Wi-Fi?
Yes No
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b. For each personal device that you use to access the internet, please state:
Type of Device What security measures do you use? Is anti-virus Please specify what software you use
(e.g. phone, (For example, pin lock or passwords on software installed?
tablet, PC) mobile devices)
Yes No
Yes No
Yes No
Yes No
c. Do you have unique passwords for each account or website you access? Yes No
d. What is your approach to using passwords?
Use a different password every time Use a variation of the same data or information each time
Alternate between a selection of the same passwords Use the same password every time Other
If you have answered ‘Other’, please provide details.
e. How often do you update your passwords/pin locks?
f. Have you concealed your IP address when online or taken steps to reduce the traceability of your IP address and/or
location? Yes No
g. Is there any other information that you wish to provide that will allow us better to understand your internet profile and
activities? Yes No
23. Your Character Referees

Please provide details of a minimum of three referees who, collectively, must have known you well over the past 10 years.
These SHOULD NOT BE relatives or partners and preferably not supervisors or employers. At least one of the referees
should be someone in your own age group whom you regularly communicate with at least once per month and
socialise with outside the workplace. They should preferably be British citizens (but this is not obligatory) and, since it
may be necessary for them to be interviewed, they must be able to make themselves available for that purpose in the UK
or in a major military base or diplomatic mission overseas.
Between them, referees should cover each specific area in which you have lived during this period. Therefore additional
referees should be named if you have moved frequently during the last 10 years. It is not sufficient to nominate someone
you know officially or professionally, such as a doctor, unless you know them socially as well. Similarly, staff members of
a school, college or university should not be chosen unless they are close personal friends. Referees should include a
person (not a partner), who knows you well in your home environment and ideally someone (other than a supervisor or
employer) who knows you well in the work environment.
YOU SHOULD TELL YOUR REFEREES THAT YOU WISH TO PUT THEIR NAMES FORWARD.
Please ensure that the contact details you provide for your referees are up to date.
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First Character Referee
a. Title b. Forename(s) c. Surname
d. Enter either a date of birth, or approximate age if this is not known.
Date of birth: Age:

dd mm yyyy
e. Occupation: f. Email address:
g. Please provide at least one contact telephone number for this referee:
Preferred contact number: Alternative contact number:
h. Address:
Address Line 1:
Address Line 2:
Address Line 3:
i. Alternative address for interview (if applicable):
Address Line 1:
Address Line 2:
Address Line 3:
j. How long have you known the Referee (years)? k. When did you last see the Referee?
Month Year
l. Please specify contact methods. Select all that apply.
Once a week Once a month Once a year
Face to face:
Email/letter:
Telephone:
Social networking:
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Second Character Referee

Date of birth: Age:

dd mm yyyy
g Please provide at least one contact telephone number for this referee:
h. Address:
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 1:
Address Line 2:
Address Line 3:
Month Year
Face to face:
Email/letter:
Telephone:
Social networking:
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Third Character Referee

Date of birth: Age:
dd mm yyyy
f. Please provide at least one contact telephone number for this referee:
h. Address:
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 1:
Address Line 2:
Address Line 3:
Month Year
Face to face:
Email/letter:
Telephone:
Social networking:
Page 84
24. Health Declaration
Please read the following BEFORE answering the questions below and overleaf about your health.
In some cases it may be necessary to consult your doctor and you may be asked to attend a medical examination. Any
enquiries will be conducted by the vetting authority's medical adviser, an approved Occupational Health Organisation
(OHO) or Medical Officer (MO), such as BMI Health Services, or approved Medical officer (MO). Where appropriate, referral
may also be made to a psychologist or psychiatrist. We have used the term "medical adviser" to denote all of these. In all
but the most exceptional circumstances, these reports will not be made available to Departmental Security Officers,
Personnel Officers or to line management. Exceptionally, a medical report may need to be seen by an appropriate senior
person in your vetting authority in order to help reach a proper assessment of your suitability to hold a security
clearance. This may or may not include access to your full medical records. In such cases, you will be asked to give your
consent for this to be done.
By signing the declaration, you will be giving your consent, under the terms of the Access to Medical Reports Act 1988,
for the medical adviser to obtain a medical report from your doctor or other specialist, if this is considered necessary.
Under the terms of the Act, you have the right to withhold your consent at any stage in the process but you should be
aware that this could mean it is not possible to grant or renew your security clearance.
Once you have given your consent, you have the right to see the medical report before it is supplied to the medical
adviser. The medical adviser will provide you with a copy of the letter that they send to your doctor or specialist asking
them to provide a report. You will have 21 days from the date of that letter in which to ask your doctor/specialist to let you
see the report before they send it to the medical adviser. Your doctor or other specialist will tell you if you cannot see any
part of the report for professional medical reasons. If you are given access to your report, it will not be forwarded to the
medical adviser until you give your consent.
If you think any information in the medical report is incorrect or misleading, you can ask in writing for it to be amended.
You should note that if your doctor or other specialist does not accept the information as incorrect or misleading, they do
not have to make any amendment. They will however invite you to prepare a written statement on the disputed
information, which will be attached to the medical report when it is sent to the medical adviser. Subject to the provisions
of the Act, you have a right to see the medical report for up to six months after it has been sent to the medical adviser. If
your doctor or other specialist gives you a copy of the medical report at your request, they may charge you a reasonable
fee to cover the cost of supplying it.
I have read and XQGHUVWRRG the Health Declaration

Details about your health
Please answer the following questions about your health. Although it may be taken into account, information provided will
not necessarily prevent you having a security clearance.
Please note, certain psychological and medical conditions may have security implications but will be assessed on a case-
by-case basis.
a. Are you currently taking any medication? Yes No
b. Have you suffered at any time from clinical depression, mental illness, nervous breakdown / nervous debility, serious
medical or psychological problems? Yes No
c. Do you suffer, or have you ever suffered from any condition that may cause occasional and momentary loss of
consciousness? Yes No
d. Are you currently or have you ever been a habitual user of addictive substances? For example, drugs or alcohol.
Yes No
e. Are you aware of any health matters not already covered by your previous answers which might affect your suitability
for access to sensitive information or assets? Yes No
• If you have answered 'No' to all the above questions, go to Section 25. You need not sign the next page.
• If you have answered 'Yes' to Question 24a only, please give details of your medication below, then go to
Question 25. You need not sign the next page.
• If you have answered 'Yes' to Question 24b, c, d or e, please give full details on the next page of your GP and, if
appropriate, any other medical professionals involved in your treatment. Please sign and date the next page
where indicated.
Details:
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GP Details
f. Your Surname:
g. Your Forename(s):
h. Surname of Your Current General i. Title (Dr/Prof etc):

Practitioner/Medical Officer:
j. Surgery Name:
Address Line 1:
Address Line 2:
Town:
Country:
Medical Professionals
If you have a hospital specialist or any other medical professional (e.g. occupational health) who is treating/assisting you
to manage the health matter that you have declared, please give their details below. If necessary, please use the
continuation pages to enter details of further specialists/professionals.
Surname of Medical i. Title (Dr/Prof etc):

Professional:
Hospital Name (if appropriate):
Address Line 1:
Address Line 2:
Town:
Country:
m. Hospital Registration Number:

(if appropriate)
PLEASE READ THIS BEFORE SIGNING.

You are only required to sign here IF you have answered 'Yes' to any question from 24b to 24e, inclusive. By signing this
page, you will be giving your consent, under the terms of the Access to Medical Reports Act 1988, for the VMA/OHO/MO to
obtain a medical report from your doctor or other specialist, if this is considered necessary. Under the terms of the Act,
you have the right to withhold your consent at any stage in the process, but you should be aware that this may mean it is
not possible to grant or renew your security clearance.
Signed: Date:
Day Month Year
I wish to exercise my right to see the medical report before it is sent to the vetting authority's medical adviser.
Yes No
Page 86
25. Criminal Convictions & Related Matters
In line with HM Government's policy on vetting, you must declare any matter which may be relevant. This includes any
criminal convictions which you may have, including those which are 'spent'. You must declare convictions issued by a Scottish
court even if you know that they have been weeded from the Criminal History System in accordance with Police Scotland’s rules on
the retention of information.
You must reveal all convictions, whether or not spent, under the legislation.
In line with the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975, the Rehabilitation of Offenders (Exclusions and
Exceptions)(Scotland) Order 2003 and the Rehabilitation of Offenders (Exceptions) Order (Northern Ireland) 1979, spent
convictions may also be taken into account where protecting public safety or public order is involved.
The relevant department or agency will decide if a criminal conviction affects your security clearance. Although it may be taken into
account, this information will not necessarily prevent you from being awarded a security clearance.
Please answer the three questions on the next page and sign and date the section. You have the option to detach the Criminal
Declaration (Pages 8 and 8) should you wish the Vetting Authorities alone to see your response on these matters. You should
remove the section and place in an envelope, then seal the envelope, sign your name across the flap and attach it to the front of
the questionnaire before sending to your sponsor.
Failure to disclose relevant circumstances or information is likely in itself to be regarded as evidence of unreliability and
will be taken into account when assessing your suitability for security clearance.
Tick here if you have read and understand these instructions.
I confirm that I understand I must declare all spent convictions.
Page 87
You are reminded that your answers will be checked against national criminal records.
a. Have you ever been convicted or found guilty by a Court (including juvenile courts) of ANY offence in ANY country,
excluding parking and speeding convictions but including all other motoring offences even where a spot fine has been
administered by the police? Yes No
If you have answered ‘Yes’, please give full details (including dates):
b. Have you ever been on probation, or received any type of police caution, or been absolutely/conditionally discharged,
or had a fixed penalty notice or penalty notice for disorder issued to you, or accepted a fiscal fine from the Procurator
Fiscal in Scotland, or been bound over after being charged with any offence, or is there any action pending against you?
Yes No
c. Have you ever been convicted by a Court Martial, or sentenced to detention or dismissal or fined while serving in the
armed forces of the UK or any Commonwealth or foreign country?
Yes No
Please take the time to review all the answers you have given for the criminal convictions & related matters section before
you continue.
I confirm that I have reviewed all the answers I have given for the criminal convictions & related matters section and they
are correct
Please enter your full name and sign and date below.
Surname:
Full forenames:
Signed: Date:
Day Month Year
Page 88
26. Security Information
You are reminded that your answers will be checked against national security records. Failure to make a full declaration
may result in your being denied clearance.
a. Have you ever been involved in Espionage? Yes No
b. Have you ever been involved in terrorism? Yes No
c. Have you ever been involved in sabotage? Yes No
d. Have you ever been involved in actions intended Yes No

to overthrow or undermine Parliamentary democracy by
political, industrial or violent means?
e. Have you ever been a member of, or supported, a group Yes No

or groups involved in any of the above activities?
f. Have you ever had a close association with anyone, Yes No

including any member of your family, who, to your knowledge,
has been a member of or given active support to any such group
or activities?
If you have answered ‘Yes’ to any of the above questions, please provide full details (including dates).
27. Other Information

You are required to state if there are any other matters which might be relevant to the granting of a security clearance.
a. Do you currently have, or have you ever had, significant financial difficulties? Yes No
If you have answered ‘Yes’, please provide full details, including dates.
b. Are you now, or have you ever been, involved in conduct liable to lead to susceptibility Yes No
to pressure or improper influence?
c. Are you aware of any other circumstances or characteristics not covered by your previous Yes No
answers which might affect your suitability for access to sensitive information or assets?
d. Is there any other information that you wish to provide in support of your clearance Yes No
application?
Please provide full details, including dates (if applicable).
Page 89
28. Previous Security Clearances
a. Have you completed any previous government security questionnaires, Yes No
or held a security clearance before?
If you have answered ‘Yes’, please provide details of the most recent government security questionnaire completed or
most recent security clearance held:
b. What level of clearance was it? DV SC CTC Not known
c. Department, Agency or Firm:
d. Vetting Provider (if known - for example, DBS NSV, FCOS etc. ):
e. Date completed:
Month Year
f. Have you ever had a security clearance withdrawn, suspended or refused? Yes No
If you successfully appealed your case then you do not need to answer Yes to this question.
If you have answered ‘Yes’:
g. What level of clearance was it? DV SC CTC Not known
h. Department, Agency or Firm:
i. Date of withdrawal, suspension or refusal:
Month Year
Please provide the reason for this.
Financial Information
29. General Circumstances
In the following questions you are being asked to provide a clear, complete and accurate picture of your current and
recent financial situation. This must reflect the situation of anyone who shares financial responsibility with you.
Independent Credit Reference Checks and investigations into your financial circumstances will be carried out.
a. Are you living with someone? Yes No
b. If you have answered ‘Yes’, Does the person you live with share financial Yes No
responsibility with you or make a contribution to your financial situation?
If you have answered ‘Yes’, it will be necessary to explore the impact of this person's contribution on your financial
situation. Please include the requested information in the relevant sections of this form.
c. For whom do you have a financial responsibility, other than yourself? (For example, partner, children, parent etc).
d. What major financial changes to your budget do you anticipate in the next 12 months?
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e. Have you been the victim of 'identity theft' or credit card fraud? Yes No
30. Financial Circumstances - Household Monthly Income

To enable an accurate assessment of household income, please provide a clear picture of ALL sources of earned and
unearned income (unearned income being income derived from private means rather than from work, for example interest
from bank accounts and dividends on shares etc.)
If you live with more than one person who contributes to your financial situation, please add up their contributions and
give them as a single figure against each of the categories under "Other Person(s)".
Do not leave fields blank. If they are not applicable, please enter zero.
You Other Person(s)
Total annual salary £ £
(gross)
Usual annual bonus £ £

(gross)
Annual car allowance £ £

(gross)
Monthly net salary (including £ £

average bonus and any
allowances)
Monthly income from state £ £

benefits
Monthly income from £ £

pensions and annuities
Monthly net income from £ £

savings and investments
(averaged)
Monthly net income from £ £

rented properties
Monthly maintenance £ £
received
Total Monthly income £ £
Total Household Income £ £
Has all income been declared for tax purposes? (For example, rental income etc.) Yes No
If a fuller explanation of your income would be helpful to us, please provide details here:
Page 91
31. Financial Circumstances - Household Monthly Outgoings

Please provide details of your monthly household outgoings for yourself and your partner (if applicable).
Mortgage / Rent / Board & lodging £
Service charge / Ground rent / Management fees £
Council tax £
Housekeeping £
For example, food and household necessities
Motoring costs (including tax, insurance, petrol & £
maintenance) / commuting and travel costs
Utility bills (gas, electricity, oil, water bills, telephones and £

mobile phones)
Credit card repayments £
Loan repayments £
Satellite / Cable / TV licence / Internet access £
Maintenance payment for children £
Nursery fees / school fees /parental contribution to student £

costs
Pensions / insurance (all insurance - excluding car £

insurance)
Holidays (average per month of annual costs) £
Entertainment (including sports and gym club £

memberships, trips out etc.)
Other regular commitments (For example, lottery tickets, mail £

order catalogue, hire purchase agreements (please detail
below)
Please provide details:
Page 92
32. Financial Circumstances – Properties Owned
a. How many properties do you own, or partly own, in the UK and/or overseas?
This includes those with mortgages outstanding, buy-to-let properties and timeshares.
b. Please provide details of all the properties you own, or partly own. Use the continuation page to add extra properties.
First Property
Address:
name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Country:
Date of purchase: Purchase price (£):
Month Year
Current market valuation (£): Is this property mortgaged? Yes No

If the property is mortgaged:
How many mortgages do you have on it?
For each mortgage, please state:

Mortgage 1
Type of mortgage Mortgage lender Date taken out Term Initial Balance
(months) amount (£) outstanding (£)
Repayment
Interest only
Flexible Month Year
Buy to let
Other
Mortgage 2
Repayment
Interest only
Flexible Month Year
Buy to let
Other
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Mortgage 3
Repayment
Interest only
Flexible
Month Year
Buy to let
Other
Does this property have any secured loans (other than mortgages) on it? Yes No
If there are any loans secured on the property, please provide details of each loan:
Lender Date taken out Initial amount (£) Balance

outstanding (£)
First loan:
Month Year
Second loan:
Month Year
Third loan:
Month Year
Second Property
Address:
name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Country:
Month Year
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Mortgage 1
Repayment
Interest only
Flexible
Month Year
Buy to let
Other
Mortgage 2
Repayment
Interest only
Flexible Month Year

Buy to let
Other
Mortgage 3
Repayment
Interest only
Flexible
Month Year
Buy to let
Other

outstanding (£)
First loan:
Month Year
Second loan:
Month Year
Third loan:
Month Year
Page 95
Third Property
Address:
name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Country:
Month Year


Mortgage 1
Repayment
Interest only
Flexible Month Year

Buy to let
Other
Mortgage 2
Repayment
Interest only
Flexible Month Year
Buy to let
Other
Page 96
Mortgage 3
Repayment
Interest only
Flexible Month Year

Buy to let
Other

outstanding (£)
First loan:
Month Year
Second loan:
Month Year
Third loan:
Month Year
c. Total market valuation of all properties owned: £
d. Total number of mortgages and secured loans:
e. Total of mortgage / secured loan balances outstanding: £
f. Number of properties owned on which there is a mortgage or a secured loan:
g. Have you ever taken a further mortgage advance(s) for any purpose? Yes No
If ‘Yes’, please provide details:
h. Have you ever adjusted the payment terms of your mortgages? Yes No
(For example, payment holiday)
i. Have you ever remortgaged to consolidate your personal debts? Yes No

Page 9
33. Financial Circumstances – Savings and Other Assets
a. Do you (and your partner) have finances in savings accounts, ISAs, bonds, premium bonds, invested in shares, funds
etc? Yes No
If ‘Yes’, how much? £
If ‘No’, please provide a brief explanation as to why you do not have any savings or investments:
b. How often do you save? Regularly Occasionally Hardly ever
c. What is the valuation of your (and your partner’s) vehicles? £
d. What is the valuation of your (and your partner's) other assets? £

(For example, jewellery, antiques, collector’s memorabilia, artwork etc.)
e. Have you ever received a lump sum worth more than £5,000? Yes No
TOTAL OF ALL ASSETS

Please add up:
• Total market valuation of all properties owned - Section 32c
• The value of your/your partner’s savings accounts, ISAs, etc. – Section 33a
• The value of your/your partner’s vehicles - Section 33c
• The value of your/your partner’s other assets – Section 33d
Total Assets (£):
34. Financial Circumstances – Loans

a. How many loan agreements (including student loans) do you have outstanding?
This figure should not include mortgages or loans secured on your properties.
b. Please provide details of each loan.
First loan:
Lender: Purpose: Amount: £
Date taken out: Expiry date (end date of the loan):
dd mm yyyy dd mm yyyy
Monthly repayment: £ Balance outstanding: £
Second loan:
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Third loan:
c. Total of loan balances outstanding: £
35. Financial Circumstances – Credit Cards

a. How many credit, store and charge card accounts do you (and your partner) have?
Please provide details of each card. If necessary, please use the continuation page.
Name of Issuer Type Credit limit Average monthly Balance
(£) payment (£) outstanding (£)
1. Credit card
Store card
Charge card
2. Credit card
Store card
Charge card
3. Credit card
Store card
Charge card
4. Credit card
Store card
Charge card
b. Do you transfer balances between credit cards? (For example, 0% interest deals) Yes No
c. Total of Average Monthly Payments (including any listed on the continuation page): £
d. Total of card balances outstanding (including any listed on the continuation page): £
Page 99
36. Financial Circumstances – Current Accounts: Overdrafts
a. In the last 5 years, how many times have you exceeded your overdraft limit(s)?
b. How many current accounts do you have which were overdrawn in the previous month?
Where applicable, please provide details of all overdrawn current accounts in the previous month. If necessary, please
use the continuation page.
Name of bank Name of branch Overdraft limit £ Maximum overdrawn

in previous month £
1.
2.
3.
c. Total of overdrawn balances: £
TOTAL OF LIABILITIES
Please add up:
• Total of mortgage/secured loan balances outstanding (£) – Section 32e

• Total of loan balances outstanding (£) – Section 34c
• Total of card balances outstanding (£) – Section 35d
• Total of overdrawn account balances (£) – Section 36c
Total of All Liabilities (£):
37. Financial Circumstances – Accommodation Charges

a. Do you pay rent for any property? Yes No
If you have answered ‘No’, please go to Section 38. If you have answered ‘Yes’:
b. How much do you pay per month? £
c. What other costs are you liable for (e.g. service charge, agent's fees, etc.)?
d. Do you share rent and utility costs with other tenants? Yes No
e. Do you receive accommodation free of charge? Yes No
If you have answered ‘Yes’, please provide details:
Page 100
38. Financial Circumstances – Financial Obligations
a. Do you have any form of financial obligation in excess of Yes No
£1,000 that has not been disclosed elsewhere on this form?
b. Have you ever lent or given anyone (including family members) more than £1,000? Yes No
c. If you stated at Section 29b that you share financial responsibility with another Yes No
person, do they (to your knowledge) have debts in their sole name in excess of £5,000?
39. Financial Circumstances – Financial History/Arrangements

a. In the last 10 years have you and/or your partner…..
i. Had a credit or store card application declined? Yes No
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
ii. Had a personal loan application declined? Yes No
iii. Sought a reduction in monthly repayments with a lender? Yes No
iv. Ever consolidated debt onto a new financial arrangement? Yes No
v. Had a default or termination notice issued to you by a bank or creditor? Yes No
vi. Had a credit or store card withdrawn? Yes No
Page 101
vii. Consulted a debt management company or advisory service? Yes No
viii. Arranged a debt management plan (either formal or informal)? Yes No
ix. Been subject to a county court judgement? Yes No
x. Been subject to an attachment of earnings order? Yes No
b. Have you and/or your partner ever:
i. Had repossession proceedings commenced against you? Yes No
ii. Been investigated by HMRC or DWP? Yes No

iii. Applied for an Individual Voluntary Arrangement (IVA), a Debt Yes No

Relief Order (DRO) or (in Scotland only) a Protected Trust Deed or
Minimal Asset Process (MAP) Bankruptcy or Low Income Low Asset
(LILA) Bankruptcy?
iv. Been declared bankrupt? Yes No
v. Do you have any financial interests that may conflict with your duties as a Civil Servant, member of HM Forces, or as a
Government contractor? (For example, your partner runs a company which tenders for contracts that you are
responsible for placing etc.) Yes No
vi. Are there any details or explanations that would help us to understand Yes No
your financial position better?
Page 102
40. Financial Circumstances – Self-Employed Contractors: Additional
Information
a. Are you a self-employed contractor? Yes No
If you have answered ‘No’, please go to the final declaration. If you have answered ‘Yes’, please answer the following
questions:
b. Are you being employed through an agency for the contracted work? Yes No
c. Are you self-employed and submit invoices in your personal/trading name? Yes No
d. Are your invoices submitted by a company, of which you are the Yes No
primary director or shareholder?
If you have answered ‘No’, please go to the final declaration. If you have answered ‘Yes’, please answer the remaining
questions in Section 40.
Company name: Company number:
Accounting date:
Month Year
e. Are your annual returns to Companies House up to date? Yes No

If you have answered ‘No’, please provide details:
f. Are your annual accounts registered at Companies House up to date? Yes No

g. Are payments of VAT, tax and social security paid up to date, by their due date? Yes No
h. Has a late filing penalty been imposed on the company at any time? Yes No
i. Have the directors been fined for non-filing of documents at any time? Yes No
Page 103
j. Has the company been subject to a county court judgement? Yes No
k. Have you ever been involved with a company that has undertaken Yes No
a voluntary liquidation or creditors' winding up?
l. Have you ever been disqualified from being a company director? Yes No
m. Has the company been investigated by HMRC or the DWP? Yes No

n. Please provide details of your personal (& partner's) income from the company, including the amount of any dividends
received and frequency of payments, for the previous and current accounting periods.
Page 104
Continuation of Answers
IMPORTANT: When providing additional information please write the Question Number against each answer and provide
all the information requested in the original question.
Page 105
Page 106
Page 107
Declaration
I declare that I have read and understood the statement of HM Government's vetting policy accompanying this
questionnaire.
I understand that in accordance with this policy the personal information I have provided on this form about myself, my
partner (if applicable) and my family will be submitted for checking against national criminal and security records.
I understand a check against credit reference agency records and investigations into my financial circumstances will also
be carried out. I understand, too, that the information provided may be subject to ongoing checks where they are
necessary and proportionate.
I declare that the information I have given is true and complete to the best of my knowledge and belief, and I understand
that any false statement or deliberate omission in the information I have given in this questionnaire may disqualify me
from employment (including employment in connection with Crown contracts if applicable) or make me liable to
disciplinary action, which may include dismissal.
I undertake to notify any material changes in the information I have given (e.g. change of partner, address or financial
circumstances), including any future criminal convictions, to the Personnel or Security branch concerned.
Important: Data Protection legislation. This questionnaire asks you to supply "personal" and "sensitive personal" data as
defined by current Data Protection legislation. You will be supplying this data to the appropriate vetting authority where it
will be processed exclusively for the purpose of security vetting, in accordance with HM Government's vetting policy, save that,
in the highly unlikely event that data supplied by you discloses or suggests that:
i. a criminal offence has occurred or is likely to occur.

ii. staff may be at risk, e.g. if you have been diagnosed with a serious mental condition as potentially endangering
yourself or others.
then the vetting authority may pass on that information alone to the appropriate person(s). Subject to this, the vetting
authority will protect the information you provide and will ensure that it is not passed to anyone who is not authorised to
see it.
By signing the declaration on this page, you are agreeing that you understand that the data you provide in
this questionnaire will be processed in the manner described above.
If you have any concerns about any of the questions we ask, or what we will do with the information you provide, which
are not answered by the guidance notes please contact the person who issued this form for further information.
Note: Please review the form BEFORE SIGNING to ensure that all questions have been fully answered. Please check that
you have signed the Criminal Convictions Declaration on page 88 and (if you answered 'yes' to any question from 24b to
24e inclusive) the Health Declaration on page 86.
When completed, this application form must be returned to your Sponsor. Contractors, please note at page 87/88 that you
may detach and place in a sealed envelope the Criminal Convictions & Related Matters page before returning the form to
the Sponsor.
You are not compelled to undergo national security vetting and you can withdraw from the process at any
time. However, this is likely to mean that you can no longer be employed in the post for which you needed to
be cleared. If you do decide to withdraw, after submitting this form, you must inform your Sponsor
immediately.
Signed: Date:
Day Month Year
Page 108
Developed Vetting (DV) Questionnaire – Sponsor’s Section
To be completed by all Sponsors (Including HM Forces, Government Agencies and Firms)
Please ensure you have completed Section 2 (Security Clearance Required) on page 1, before submitting this request.
Please ensure you only write inside the fields provided. Do not mark or strike through any other areas of the form. If
completing by hand please write in BLACK INK using BLOCK LETTERS. If an answer will not fit in the space provided,
please enter your answer on the continuation sheets (pages 105 to 107). If you make a mistake, please do not correct it
but delete it by striking it through. Please do not use correcting fluid.
Ensure you answer ALL the questions. You can use the abbreviation NA (Not Applicable). NA - If a question does not
apply to you,write NA in the first two boxes only of the relevant question. Not Known - If you do not know the answer, or
you cannot provide the information needed, write NOT KNOWN in the first line only of the relevant question. Please
provide an explanation why the information is unknown to you in the appropriate boxes or on the continuation sheets
(pages 105 to 107). Unanswered questions or Not Known replies may cause delay to the processing of this questionnaire.
Please specify the following employment details for the post which DV clearance is required:
Employment Type: (If the applicant has more than one employment type (for example if they are a civil servant but also a military
reservist), please select the employment type for which you are applying for clearance.)
Royal Navy Army RAF MOD Civilian Other Civil Servant
Police Officer/civilian staff Civil Nuclear Employee Civil Nuclear Contractor
Contractor Other
Please provide the job title and establishment/location of the post for which the applicant requires this clearance.
Applicant's job title: Establishment location:
Is the applicant an existing employee who has been employed for more than three years? Yes No
Is this clearance being requested on initial recruitment? Yes No
Is the post for which clearance is required Reserved or Non-Reserved? Reserved Non-Reserved
Is the vetting subject (a) an employee of, (b) applying for employment with or (c) closely associated with the vetting
service provider? (For example, closely associated may mean they have a relative who works in the organisation that will be
carrying out the vetting etc.) Yes No
Does the vetting subject (a) make security clearance decisions on behalf of your organisation or (b) provide direct
support to the decision maker? Yes No
Checks Completed
I certify that the following checks have been completed:
• Full Baseline Personnel Security Standard (BPSS), comprising verification of the applicant’s (i) Identity, (ii)
Employment/academic history for (as a minimum) the past 12 months, (iii) Nationality/immigration status
(including right to work in the UK), (iv) Criminal record check Yes No
Where the full BPSS has not yet been completed, have the applicant’s identity Yes No
and immigration status been verified?
As the first stage in completing BPSS, it is mandatory to verify identity and immigration status for all new recruits before an
application can be submitted.
• EITHER a Departmental Record Check OR a Company Record Check Yes No
This entails a check of all available records held for the applicant. If the applicant is a new recruit, this includes any
documentation provided as part of the recruitment process.
A Departmental Record Check is carried out when the applicant's employment type is RN, Army, RAF, MOD Civilian,
Other Civil Servant or Police/Civilian Staff.
A Company Record Check is carried out when the applicant's employment type is Civil Nuclear Employee, Civil Nuclear
Contractor, Contractor or Other.
Page 109
I certify that the relevant records held for the applicant have been checked for items of security interest and that:
No items of security interest were found
The following items of security interest were found:
Applicant Details
Applicant's Surname: Applicant's Forenames in full:
Applicant's Date of Birth:
Day Month Year

Forms of ID
I confirm that the applicant's identity has been verified.
Is the Subject an existing employee who has been employed for 3 years or more? Yes No
If you have answered ‘Yes’, only a company records check is required as confirmation of identity:
Company record number (optional):
Issue date (or date checked):
Day Month Year
If the Subject is not an existing employee who has been employed for 3 years or more, how did you confirm their identity?
Please include relevant dates and details. If a full passport is not produced, two other forms of identity must be checked.
Full EU passport Number Issue Date
Day Month Year
Full Non-EU Passport: Number Issue Date
Day Month Year

Driving Licence: Number Issue Date
Day Month Year
Birth Certificate: Number Issue Date
Day Month Year
Company Records: Number Issue Date

(optional) or date checked
Day Month Year
Other (1). Please provide details:
Number Issue Date

(optional) (optional)
Day Month Year
Other (2). Please provide details:
Number Issue Date

(optional) (optional)
Day Month Year
Page 110
Any Other Information
Is there any other information that you would like to make the vetting service provider aware of? Yes No
If so, please provide details:
Your Details
Your Name:
Position within organisation:
Telephone Number: Extension:
Sponsor ID:
Signed: Date:
Day Month Year
Notification of Clearance
The outcome of this application will be notified to the Sponsor as an electronic notification. Please ensure a valid email
address is provided. Alternatively, a notification will be sent in writing to the address provided below.
Sponsor's Reference:
Purchase Order Number / Joint Business Agreement Number / Account Number:
Notification address:
Name of Firm / Organisation:
Address Line 1:
Address Line 2:
Town:
Country:
Email:
If your address as a Sponsor is not the same as the notification address, please give it below:
Address Line 1:
Address Line 2:
Town:
Country:
Page 111
Contractor Details
Please complete this section if you have given the applicant’s employment type as ‘Contractor’ or ‘Civil Nuclear
Contractor’.
Contract number:
Please select your OWN employing organisation:
HM Government/HM Forces: List X Contractor:
Please identify the applicant’s status: Please identify the applicant’s status:
Non-List X Contractor List X Contractor
Non-List X Subcontractor List X Subcontractor*
Locally-employed Contractor Non-List X Subcontractor

(under an overarching contract)
Locally-employed Contractor *includes employees of your own

(NOT under an overarching contract) company, where this clearance is
needed for work they are carrying out
under sub contract to another firm.
Length of employee's time with firm:
Years Months
Please provide details of the company by which the subject is DIRECTLY employed. For a consultant or locally-employed
contractor, this may be their own business details.
Are the details of the company the same as those provided for the notification address? Yes No
If you have answered ‘Yes’, you do not need to enter them again. If your answer is ‘No’, please enter the details below:
Address Line 1:
Address Line 2:
Town:
Country:
Page 112
Subcontractor Details
Please complete this section if you have identified the applicant’s status as ‘List X Subcontractor’, ‘Non-List X
Subcontractor’ or ‘Locally-employed Contractor (under an overarching contract)’.
Please provide details of the prime contractor. (This is the company to which the Subject, or their direct employer, is sub-
contracted. For a locally employed contractor engaged under an overarching contract, it will be the company with which this is
placed.)
Is your own company the prime contractor and therefore Yes No

you have already given its details as the notification address?
If you have answered ‘Yes’, you need not enter the company’s details again. If you have answered ‘No’, please enter the
prime contractor’s details below.
Address Line 1:
Address Line 2:
Town:
Country:
Is the clearance required for access to a site only? Yes No

(For example, access to site only might only be required for Ground Maintenance staff etc.)
To whose information will the employee have access?
Site where the employee works or is to work:
Title and type of work:
Page 113
Privacy notice for processing personal data during National Security Vetting (NSV)
This privacy notice applies when the vetting provider is United Kingdom Security Vetting (UKSV). UKSV is part of
the Ministry of Defence. If you are unsure as to the identity of your vetting provider, please ask your sponsor, which
is normally the employer. This notice explains how we intend to store and handle your personal data and that of
third parties in the course of conducting NSV. This notice may be updated from time to time – the latest version will
be available on .gov.uk.
This notice applies in relation to all previous and current NSV applications processed by UKSV or its predecessors
(Defence Business Services and FCO Services) and should be read in conjunction with the NSV forms and the
document ‘Personnel Security Controls’, also available on .gov.uk.
1. The identity of the NSV data controllers and contact details

UKSV is responsible for carrying out NSV and, for some of its customers, also makes the clearance decision. In these
circumstances, with the exception of the Security Service, it is the sole data controller for the NSV process. As UKSV
is part of the Ministry of Defence, the Data Protection Officer (DPO) responsible for NSV can be contacted via the
MOD Chief Information Officer at CIO-DPA@mod.uk.
When UKSV carries out NSV, but the decision on whether to grant security clearance is taken by the sponsor (which
is normally the public authority employer), the sponsor organisation is a joint data controller with UKSV. In these
circumstances, if you wish to exercise your rights under data protection legislation, you can contact either UKSV’s
Data Protection Officer (DPO) or their counterpart in the sponsor organisation that decides whether you will be
granted security clearance. It is the sponsor’s responsibility to advise you of their DPO’s contact details.
In addition to UKSV and the sponsor organisation, the Security Service is a data controller for NSV in respect of the
check of Security Service records. The Security Service publishes advice on access to information at
https://www.mi5.gov.uk/access-to-information. It can be contacted via:
The Enquiries Desk

PO Box 3255
London SW1P 1AE
Should you be granted clearance and subsequently move to another post requiring NSV at a different organisation,
the relevant personnel security risk owner for the new organisation may review your clearance against the particular
security risks that organisation faces. In such circumstances, the new organisation replaces the initial sponsor
organisation as a joint data controller for NSV.
2. Why we will process your data

We will process your personal data and that of third parties for the purpose of carrying out NSV, including aftercare.
NSV is necessary and proportionate to safeguard the UK’s national security. We may also process your data for
ancillary purposes, for example, to facilitate an appeal to the Security and Vetting Appeals Panel, to fulfil legal and
regulatory requirements or, in an anonymised way for business monitoring and planning purposes.
3. The legal basis for the processing

UKSV and the sponsor organisation process your personal data and that of third parties in accordance with the
General Data Protection Regulation, as applied by Chapter 3 of Part 2 of the Data Protection Act 2018 (‘the Applied
GDPR’). The Security Service will process your personal data in accordance with Part 4 of the Data Protection Act
2018 (intelligence services processing).
The processing of your personal data and that of third parties is necessary for the purpose of NSV, which is carried
out for reasons of substantial public interest and in the exercise of official authority vested in the data controllers.
Conducting NSV is a function of UKSV, which is part of the Ministry of Defence, a government department.
4. How your data will be processed

Your personal data and that of third parties will be processed as described in the ‘Statement of HM Government
Personnel Security and National Security Vetting Policy’, which is included in the vetting forms and as an annex to
Page 114
the document ‘Personnel Security Controls’ available on .gov.uk. The categories of personal data which we process
are described in those documents.
5. Who we share your data with

Personal data that we collect and process for NSV is very strictly controlled and protected by a high level of physical,
cyber and personnel security measures. Your NSV personal data is kept separate from other personal data and
access is only provided for the purpose of NSV and to those with a strict ‘need to know’, such as your UKSV vetting
officer.
Conducting NSV
To conduct the various checks that form part of NSV, it may be necessary to share some of your personal data with
the relevant check provider so that they may provide further personal data to us. We only share the minimum
amount of personal data necessary to enable the provider to perform the check. In most cases this is limited to basic
identifying information (such as your name or date of birth) to ensure that the provider performs the check on the
correct individual.
To perform the component NSV checks and reach a security clearance decision, UKSV may share some of your data
with:
• Your employing department or company (to request access to relevant personnel records)
• Public authorities which maintain criminal records databases
• The Security Service
• Credit reference agencies
• Referees (e.g. supervisors, character and academic referees)
• The personnel security risk owner (to enable them to make a decision on your suitability to hold security
clearance or so that they can specify any risk mitigation measures conditional for your clearance).
Third party personal data may be processed as a result of these checks. For example, this might be provided to UKSV
by a referee.
We may also notify your sponsor or employer whether your clearance has been granted, refused or withdrawn.
Risk mitigation
On rare occasions where a security risk has been identified, UKSV or the sponsor department may consider that it is
possible to mitigate that risk to an acceptable level by sharing relevant information with someone within your line
management chain. Should this apply to you, we will not share your personal data without discussing this with you
first and obtaining your explicit consent. If we seek to do this we will give you further explanation of the reasons why
and purpose and also explain your rights with regard to providing and withdrawing consent.
If you are worried about the confidentiality of the NSV process, please contact your sponsor for advice.
Public interest matters

Very exceptionally, data supplied by you or by a third party may be sufficiently serious that the NSV data controllers
may consider it is necessary and in the public interest to share relevant information with an appropriate authority,
such as the police. This might occur when information suggests that:
• you may have committed a previously undetected criminal offence, or that an offence may be about to be
committed,
• you or others may be at risk of harm,
• action is required to safeguard national security.
Appeal
If your clearance is refused or withdrawn and you decide to appeal to the Security Vetting Appeals Panel, we will
provide the Panel with relevant personal data to enable them to consider your appeal.
6. How long we will keep your personal data

Your personal data and that of third parties will be retained for so long as is necessary for the purpose for which it
was collected (safeguarding national security). Personal data collected during the NSV process will normally be
Page 115
retained by UKSV and the sponsor organisation for six years from the date that your security clearance expires,
lapses or is withdrawn. However, it may be necessary to retain some personal data beyond this period in the
interests of national security or to defend legal proceedings which have already commenced.
7. Your data rights

You have considerable say over what happens to your personal data. Your rights and how you may exercise them are
fully detailed on the ICO website. In relation to your personal data held by UKSV or the sponsor organisation, unless
an exemption applies, you have the right:
a. to request a copy your personal data

b. to require us to restrict the processing of your data in certain circumstances
c. to request your data be deleted or corrected
d. to object to the processing of your data
e. to lodge a complaint with the independent Information Commissioner’s Office (ICO) if you think we
are not handling your data fairly or in accordance with the law. You can contact the ICO at
https://ico.org.uk/concerns, or telephone 0303 123 1113.
8. International data transfers and international organisations

As described above, for important reasons of public interest and national security, it may be necessary for UKSV to
seek information from referees some of whom may be from international organisations, EU member states, or
located in countries where the EU Commission has not issued an adequacy decision to confirm that it considers the
country provides an adequate level of data protection.
Where the sponsor organisation is an international organisation, for example NATO, or where your clearance is to
work for a contractor overseas, we will inform the organisation or contractor whether your clearance is granted,
refused or withdrawn.
9. Decisions based on automated processing

NSV decision are not based solely on automated processing, including profiling. The decision whether to grant or
refuse security clearance is taken individually by the relevant personnel security risk owner.
10. Failure to provide data

You are required to provide the personal data requested as part of NSV in order to obtain the security clearance
necessary for your role, which will be either a contractual requirement or necessary for your employment with the
sponsor organisation. If you do not provide the requested data, we will be unable to grant you security clearance
and this may impact on your employment.
11. Complaints
If you are not satisfied with the way in which your personal data is being processed by UKSV:
You can make a complaint to the Ministry of Defence Information Rights Team:
MOD Information Rights Team

Ground floor, zone D
Main Building
Whitehall
London SW1A 2HB
Email: cio-dpa@mod.uk
The team will acknowledge your complaint within 5 working days and endeavour to send you a full response within
20 working days. If the team is unable to respond fully in this time, the team will explain why and let you know when
you should get a full response.
If you are not satisfied with the response, you have the right to take your complaint to the Information
Commissioner’s Office: https://ico.org.uk/concerns/ ; telephone: 0303 123 1113.
Page 116

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NSV002 (Revised 08/201)

OFFICIAL SENSITIVE PERSONAL (when completed)

Developed Vetting (DV) Questionnaire

1. How to complete this form

2. Security Clearance Required - To be completed by all Sponsors

Date by which clearance is required:

If you have answered 'Other', please provide your gender identity:

e.Date of Birth: Country of Birth:

f. Town of Birth: g. County / Region of Birth:

h. Has your surname changed at any time since birth? Yes No

i. If you have answered 'Yes', please provide your surname at birth:

j. Reason for surname change:

Previous surname Reason for change of surname

l. Have your forenames changed at any time since birth? Yes No

If you have answered 'Yes', please provide your forename(s) at birth:

Reason for forename change:

Previous forename Reason for change of forename

4. Your Additional Details

d. Do you have a UK National Insurance Number? Yes No

If ‘yes’, please enter your National Insurance Number.

Is this a temporary NI number? Yes No

Statement of HM Government Personnel Security and National Security

NATIONAL SECURITY VETTING

• Relevant personnel records held by the employing department or company

6. The process may also take account of:

• Financial circumstances generally

9. Security clearances may be refused or withdrawn where:

ONGOING PERSONNEL SECURITY MANAGEMENT

FAILURE TO DISCLOSE RELEVANT CIRCUMSTANCES OR INFORMATION IS LIKELY IN ITSELF TO BE REGARDED AS

Fair Processing Statement

· a criminal offence has occurred or is likely to occur.

a. Is your present nationality:

If you have answered 'other', please enter your nationality:

b. Have you held this nationality since birth? Yes No

Is this: Nationality or citizenship

Nationality 1: Is/was Current or Date from: Date to:

Citizenship Previous mm yyyy mm yyyy

Nationality 2: Is/was Current or Date from: Date to:

Citizenship Previous mm yyyy mm yyyy

• Periods of no fixed abode

Type of address: Current or previous? Date from: Date to:

Overseas Previous mm yyyy mm yyyy

Please fill in the fields which are applicable:

Flat number: House number: House name:

(BFPO addresses only) Name/Rank/Number: BFPO Code:

County (or Region/Area/State for overseas addresses):

Postcode (or equivalent, where applicable, for overseas addresses):

Country (if not UK or a BFPO address):

Type of address: Current or previous? Date from: Date to:

Overseas Previous mm yyyy mm yyyy

Flat number: House number: House name:

(BFPO addresses only) Name/Rank/Number: BFPO Code:

County (or Region/Area/State for overseas addresses):

Postcode (or equivalent, where applicable, for overseas addresses):

Country (if not UK or a BFPO address):

Type of address: Current or previous? Date from: Date to:

Overseas Previous mm yyyy mm yyyy

Please fill in the fields which are applicable:

NSV002 (Revised 08/201)