Countersignatures will only be
valid if you:
- Sign the white signature box
using black biro
- Keep within these marks
- Put date in date box to the left
Name, if signing on behalf of a child (title, first name and surname)
Relationship to child
Current passport number
Mobile phone number
Alternative phone number
I confirm that I have known the person named in section 2, or in the case of a child, the adult filling in section 9 (insert their name)
Profession, professional qualifications or position in the co
Your employer’s name and the address you work at (or your private address if this does not apply)
for (insert years) as (please say how - for example, employer, colleague, friend and so on).
As far as I know, the information on this form is correct. I hold either a full current British, Irish, other EU, US or
Commonwealth passport (delete as appropriate). I have read the caution and I understa
Mrs Miss Ms or title
First and middle names
It is a criminal offence to make a false statement to get a passport. If you have made a false statement on this form, you
could be prosecuted and could go to prison. Our work includes checking that the countersignature in section 10 is genuine.
I declare that I am 16 years or over (or will be within two weeks) and that:
1 I will return a lost passport
to a UK passport office if it comes into my possession;
2 I, or the person named in section 2 of this application (if different), am a British national and have not lost or given up my national status;
3 I have stated if the person named in section 2 was born of a surrogacy arrangement;
4 I do not owe any money to the UK Government for repatriation or similar relief;
5 this application does not break the
terms of any court order
to which I, and the person named in section 2 (if different)
6 as far as I know all the information I have given in this
application is correct;
7 if the application is for a child, I have parental responsibility
and I have enclosed any court orders that relate to the child’s
residence, contact or removal from the UK/country of residence;
8 I, or the person named in sec
tion 2 of this application (if
different), understand that by voluntarily applying for a British
passport, I may lose my citizenship of another country; and
9 I have read both the guidance notes and the caution above
and fully understand the consequences of my actions in
applying for a passport.
Before signing, please read the guidance booklet
Applications are only valid if you:
- Sign the white signature b
ox below using black biro
- Keep within these marks
Declaration This must be filled in by the person named in section 2. If under 16, their parent or guardian must fill this in instead.
Countersignatory If a countersignature is needed, they must fill in this section after the rest of the form has been filled in.
Caution It is a criminal offence to make a false statement to help someone get a passport. Check the form properly before
you fill in this section. If you have made any false statements on this form, or if you know that the person applying
has made any false statements on this form, you could be prosecuted and could go to prison.
Our work includes checking that your details are genuine. As a result, we may need to contact you. You should not
sign this form if you are a relative of t
he person applying.
IMPORTANT If the application is for a child, you are confirming the identity of the adult signing in section 9. You must
also be able to identify the child in order to certify the photograph.
Fill in the following in CAPITAL LETTERS and black biro. (cross (X) box Mr, Mrs, Miss, Ms, or write your title)