Form VAF5 Visa Application Form for Overseas Territory - Cayman Islands Visa Office, Kingston, Jamaica - United Kingdom

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APPLICATION FORM FOR OVERSEAS TERRITORY VISA (VAF5 2004)
THIS FORM IS PROVIDED FREE OF CHARGE
FOR OFFICIAL
USE ONLY
SECTION 1 – WHICH OVERSEAS TERRITORY ARE YOU APPLYING TO VISIT?
Your photograph must be:
Passport style and
size (size of image
45mm x 35mm)
A recent and true
likeness, showing full
face, with no hat,
helmet or sunglasses,
SECTION 2 – WHAT TYPE OF VISA ARE YOU APPLYING FOR?
although you can wear
everyday glasses.
Visitor
Student
In colour taken against
Work Permit Holder
Settlement
a plain, evenly lit and
Temporary Residence Permit Holder
light background.
SECTION 3 – ABOUT YOU
• Please tell us your:
3.1 Full name, as it appears in your passport. Please underline your family name.
3.2 Date of birth (dd/mm/yy)
3.3 Place of birth.
3.4 Nationality
3.5 Sex
3.6 Marital status
Male 
Female
Single 
Married
Divorced 
Widowed 
Separated
3.7 What is your father’s full name?
3.8 What is your mother’s full name?
3.9 Passport number (this passport)
3.10 Issue and expiry dates
3.11 Place of issue
3.12 Is this your first passport?
3.13 Previous passport issue and expiry dates
3.14 Place previous passport was issued
Yes
No
(dd/mm/yy)
• Your contact details
3.15 Your permanent home address
3.16 Your correspondence address if different from 3.15
3.17 Home or mobile telephone number
3.18 Any home fax number
3.19 Your personal e-mail address
SECTION 4 – YOUR FAMILY
4.1 If you are married or living with your partner, what is your husband, wife or partner’s name?
4.2 What is your husband, wife or partner’s date of birth (dd/mm/yy)?
4.3 Where is your husband, wife or partner now?
4.4 What is your husband, wife or partner’s nationality?
4.5 Is your husband, wife or partner travelling with you?
Yes, on my passport
Yes, on his/her own passport
No
4.6 Do you have any children?
Yes
No
PAGE 1
APPLICATION FORM FOR OVERSEAS TERRITORY VISA (VAF5 2004)
THIS FORM IS PROVIDED FREE OF CHARGE
FOR OFFICIAL
USE ONLY
SECTION 1 – WHICH OVERSEAS TERRITORY ARE YOU APPLYING TO VISIT?
Your photograph must be:
Passport style and
size (size of image
45mm x 35mm)
A recent and true
likeness, showing full
face, with no hat,
helmet or sunglasses,
SECTION 2 – WHAT TYPE OF VISA ARE YOU APPLYING FOR?
although you can wear
everyday glasses.
Visitor
Student
In colour taken against
Work Permit Holder
Settlement
a plain, evenly lit and
Temporary Residence Permit Holder
light background.
SECTION 3 – ABOUT YOU
• Please tell us your:
3.1 Full name, as it appears in your passport. Please underline your family name.
3.2 Date of birth (dd/mm/yy)
3.3 Place of birth.
3.4 Nationality
3.5 Sex
3.6 Marital status
Male 
Female
Single 
Married
Divorced 
Widowed 
Separated
3.7 What is your father’s full name?
3.8 What is your mother’s full name?
3.9 Passport number (this passport)
3.10 Issue and expiry dates
3.11 Place of issue
3.12 Is this your first passport?
3.13 Previous passport issue and expiry dates
3.14 Place previous passport was issued
Yes
No
(dd/mm/yy)
• Your contact details
3.15 Your permanent home address
3.16 Your correspondence address if different from 3.15
3.17 Home or mobile telephone number
3.18 Any home fax number
3.19 Your personal e-mail address
SECTION 4 – YOUR FAMILY
4.1 If you are married or living with your partner, what is your husband, wife or partner’s name?
4.2 What is your husband, wife or partner’s date of birth (dd/mm/yy)?
4.3 Where is your husband, wife or partner now?
4.4 What is your husband, wife or partner’s nationality?
4.5 Is your husband, wife or partner travelling with you?
Yes, on my passport
Yes, on his/her own passport
No
4.6 Do you have any children?
Yes
No
PAGE 1
If you have answered yes to question 4.6, please give their details below
Are they travelling with you
Full name
Date and Place of birth
Nationality
Yes, on my passport
Yes, on their passport
No
SECTION 5 – PREVIOUS APPLICATIONS AND TRAVEL
5.1 Have you travelled outside your home country?
Yes
No
5.2 Have you previously visited the Overseas Territory you are now applying to visit?
Yes
No
5.3 Have you ever been refused a visa for the UK or Overseas Territories, or been refused entry to the UK or Overseas Territories or had your
leave to enter or remain cancelled?
Yes
No
5.4 Have you ever been refused a visa for another country?
Yes
No
If you have answered yes to questions 5.3 or 5.4 please complete questions 4.8-4.12 as applicable. Otherwise please go to question 4.13
5.5 Where did you make your previous application?
5.6 When did you make your previous application?
dd/mm/yy
5.7 What happened? Please give the details of any forms that were given to you
5.8 Have you ever been refused entry to, deported from, or required to leave the UK or Overseas Territories or another country?
Yes
No
If yes, please give details below
5.9 Do you have any criminal convictions in any country?
Yes
No
If you have answered yes to question 5.9 please answer questions 5.10 to 5.12. If you have answered no please go to section5.13
5.10 What was your conviction for?
5.11 When and where were you convicted?
5.12 What was your sentence?
5.13 Have you ever been concerned in the commission, preparation, organisation or support of acts of terrorism, either within or outside the United
Kingdom or an Overseas Territory, or have you ever been a member of an organisation which has been involved in or advocated terrorism in
furtherance of its aims?
Yes
No
5.14 Have you ever been concerned in the commission, preparation or organisation of genocide or crimes, including crimes against humanity and
war crimes, committed in the course of armed conflict?
Yes
No
If you have answered yes to any of the questions, please give details below.
5.15 Are you, your husband, wife or partner or any dependants included in this application, suffering from any contagious diseases of more than a
short term nature or mental disorder? If so, please give details below:
PAGE 2
SECTION 6 – ABOUT YOUR STAY IN THE OVERSEAS TERRITORY
6.1 How long do you intend to stay in the Overseas Territory?
_____________________________________
6.2 On what date do you intend to arrive?
_____________________________________
6.3 Why are you going there?
_____________________________________
6.4 What is your intended date of departure?
_____________________________________
6.5 Please give the full address and telephone number of all the places where you will be staying during your visit, and the name and relationship of
the person (s) you will be staying with
Name
Relationship (if any)
Address
Contact telephone number
SECTION 7 – YOUR FINANCES AND EMPLOYMENT DETAILS
7.1 What is your present job?
7.2 When did you start this job? (dd/mm/yy)
7.3 What is your work address?
7.4 Your employer’s telephone number
7.5 Your employer’s fax number
7.6 Your employer’s e-mail address
7.7 What is your monthly income from employment?
______________________________
7.8 Do you receive income from any other sources, including friends or family?
Yes
No
7.9 Do you own any assets, for example property?
Yes
No
If you have answered yes to questions 7.8 -7.9 please give details below
7.10 How much money is available to you for your stay?
______________________________
7.11 Who is paying for your trip?
______________________________
SECTION 8 – OTHER INFORMATION
Is there any other information you wish to give about your application
PAGE 3
SECTION 9 - DECLARATION
• To be completed by all applicants
DATA PROTECTION STATEMENT
The Foreign and Commonwealth Office is processing the personal data on this form and related data for the purposes of promoting and protecting
the interests of the United Kingdom and its citizens abroad. The data may be disclosed to other UK Government Departments and public
authorities.
Declaration
You must now read the declaration below and sign it. This must be signed by the applicant personally and not by a representative or other person
acting on his/her behalf. An application for a person under the age of 18 may be completed by the parent or legal guardian.
I hereby apply for an entry clearance for the United Kingdom or Overseas Territories for myself and any dependants listed in this form. The
information I have given is complete and is true to the best of my knowledge. I also declare that the photograph(s) submitted with this form is/are a
true likeness of myself and any dependants included in the application. I confirm that if, before this application is decided, there is a material change
in my circumstances or new information relevant to this application becomes available, I will inform the United Kingdom diplomatic post at which I
have applied.
I am aware that it is an offence under the Immigration Act 1971, as amended by the Immigration and Asylum Act 2002, to make to a person acting in
execution of the Act a statement or representation which the maker knows to be false or does not believe to be true, and to obtain or seek to obtain
leave to enter in the United Kingdom by means which include deception.
I declare that the information given on this form is correct to the best of my knowledge and belief.
Applicant’s signature: ________________________
Date: _______________________
FOR OFFICE USE ONLY
FOR OFFICIAL USE ONLY
Check 1 by
Initials
Check 2 by
Initials
ISSUE
tick
REFUSE
tick
TIER/ TIME
Number or letter
Authorised by
Name
Date
(ECO)
Category
Code
Endorsement
Pol. Reg.
Y/N
Effective from
Expiry date
Vignette number
Checked by
Name
Date
(ECM)
PAGE 4

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