TIER 4 (G)

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TIeR 4 (GeneRAl) APPlICATIOn FORM Section D - Details of your Representative In this section you will be asked to provide information about your representative such as their name, address and contact details. It also asks whether or not they are appropriately registered or regulated to provide immigration advice. If you have a representative, then they will also need to complete the representative’s declaration at section Q of this form. D1. Do you have a representative acting on your behalf on this application? Yes - go to D2 No - go to Section E D2. What is the name of your representative? (ht) D3. What is the name of your representative’s organisation? (ht) D4. Is your representative based in the UK? Yes - go to D5 No - go to D6 D5. What is their UK address? House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Postcode: Now go to D7 D6. What is their overseas address? House number/name Address line 1 Address line 2 Address line 3 Town/City County/District Country Postcode: D7. Please provide your representative’s contact details: Work telephone number Mobile telephone number E-mail address line 1 E-mail address line 2 Fax number Tier 4 (G) Application Form (version 10/12) - page 10
TIeR 4 (GeneRAl) APPlICATIOn FORM D8. Is your representative regulated by the Office of the Immigration Services Commissioner? (ht) Yes - go to D9 No - go to D10 D9. What is their OISC registration number? Now go to D11 D10. What is the reason that they are not OISC registered? They are authorised by designated professional body or regulator They are registered or authorised in an EEA State They are supervised They are exempt or employed or supervised by exempt person They are specified by an order I don’t know D11. Is your representative listed with one of the UK Border Agency’s Public Enquiry Office (PEO) services? Yes No Now go to Section E Tier 4 (G) Application Form (version 10/12) - page 11
Page 1 and 2: APPLICATION FOR A GRANT OF LEAVE AN
Page 3 and 4: A. Payment Details TIeR 4 (GeneRAl)
Page 5 and 6: Dependant 1 - First name Last name
Page 7 and 8: TIeR 4 (GeneRAl) APPlICATIOn FORM Y
Page 9: TIeR 4 (GeneRAl) APPlICATIOn FORM S
Page 13 and 14: TIeR 4 (GeneRAl) APPlICATIOn FORM S
Page 17 and 18: H7; What date did you move to this
Page 19 and 20: I9; Date of the judgement or civil
Page 23 and 24: TIeR 4 (GeneRAl) APPlICATIOn FORM J
Page 25 and 26: K10. Have you claimed Housing Benef
Page 27 and 28: L9. What date does your course end?
Page 29 and 30: TIeR 4 (GeneRAl) APPlICATIOn FORM M
Page 35 and 36: Section P - Your Declaration TIeR 4
Page 37: SUMMARY SHeeT TIeR 4 (GeneRAl) APPl

TIER 4 (G)

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