Passport Application Declaration
Passport Application Declaration
If we don't receive your signed declaration form, documents and photos within the next 90 days your application
will be withdrawn and you won't get a refund.
What to do next
Her Majesty's Passport Office (ONL - UK), PO Box 1270, Peterborough, PE1 9QP
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Your Passport Application
Document Checklist
Send original versions or replacement documents - unless stated, we don't accept photocopies or laminated
documents.
Documents that aren't in English or Welsh must be translated by a professional translator - send both the original
document and the translation.
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Brooke
Allen
38 Hadleigh Park Avenue
UNITED KINGDOM, SS7 1SA
2740717498
Date of Birth: 16/12/2006 Child Renewal
Return this page to: Her Majesty's Passport Office (ONL - UK), PO Box 1270
DCCL/01/05/08
Peterborough, PE1 9QP Applicant to sign:
De
ecla
larratio
tion
n Form
Reminder: It is a criminal offence to make a false statement to get a passport. This covers the information provided
online in application number 2740717498 , on this form, in your supporting documents or any information
provided during the application process. I declare that:
• To the best of my knowledge, all the information provided as part of 2740717498 submitted
on 30/03/2018 at 20:33 is correct.
• The intended holder of this passport is a British national and has not lost or given up their national status. Date:
D D M M Y Y Y Y
• The intended holder of this passport does not owe any money to the UK Government for repatriation or any
other form of consular relief.
• I, and the intended holder of this passport (if different), am in the United Kingdom and this application does
not break the terms of any court order.
• I will return any British passports issued to this child which have been declared lost or stolen to a UK passport
office if I recover them.
• I have parental responsibility for this child and I have enclosed any court orders that relate to the child's
residence, contact or removal from the UK with this application.
• I understand that by voluntarily applying for a British passport, it may result in losing citizenship of another
country.
• I understand that I may be required to provide additional information as part of this Relationship of applicant to intended passport holder
application for a passport and that if I fail to meet such requests, this application may
be treated as invalid.
Name of applicant applying on their behalf
• I have read both the relevant guidance associated with this application and the reminder
above and fully understand the consequences of my actions in applying for this child’s passport.
NOTE: PLEASE MAKE SURE YOUR SIGNATURE FITS INTO THE BOX.
Countersignature
This section must be completed by the person who is confirming the applicant's identity after they have reviewed the details
submitted with the application. By acting as a countersignatory, you are verifying that the information in application
number 2740717498 is true to the best of your knowledge. Check the information properly before signing this form. You
are also confirming the identity of the adult signing the declaration and that they are responsible for this child. You must be able
to confirm the identity of the child before certifying their photograph.
Office Use Only
In addition, you are declaring that the information included on this form about you is accurate and that you qualify to act as a
countersignatory. When we check the details submitted in this application, we also check your details are genuine. This may Nat Cert SBC
include a check of passport records or information held by third parties. We may also contact you to confirm some aspects of
the application. It is a criminal offence to make a false statement to get or help somebody get a passport. I hold a full current MC FBC
British or Irish passport (delete as appropriate).
Photos PPT
Fill in the following in CAPITAL LETTERS and in BLACK INK.
Mr Mrs Miss Ms or title Block Application
Your employer’s name and the address at which you work (or if not applicable, private address) including postcode
D D M M Y Y Y Y
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Countersignature
1/3
Application 2740717498
Information for the Applicant
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Countersignature
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Information for the Countersignatory
Application Summary
Getting started
What type of passport is needed?....................................................................................................................................................................................................................................
Renewal
Where does the applicant live?.........................................................................................................................................................................................................................................
United Kingdom
Important information before you begin..........................................................................................................................................................................................................................
I have read and agree to the statements above.
CS2EU
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Passport Photo Guidance
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Passport photos are a vital part of your application. If the photos you supply are not
suitable, your passport will be delayed. Please follow the instructions below carefully so
you can get it right first time.
1 person only
Approved No dummies
in photo
No glare
Approved Don’t smile
on glasses
PH1EU
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