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TIER 4 (G)

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I9; Date of the judgement or civil penalty<br />

D D M M Y Y Y Y<br />

TIeR 4 (GeneRAl) APPlICATIOn FORM<br />

I10; Which country was the judgement issued in?<br />

I11; Have you ever been charged or indicted in any country with a criminal offence for which<br />

you have not yet been tried in court? (ht)<br />

Yes go to I12 No go to I13<br />

I12; Please provide details of the offence:<br />

I13; In either peace or war time, have you ever been involved in, or suspected of involvement<br />

in, war crimes, crimes against humanity or genocide? (ht)<br />

Yes go to I14 No go to I15<br />

I14; Please provide details:<br />

I15; Have you ever been involved in, supported or encouraged terrorist activities in any<br />

country? (ht)<br />

Yes go to I16 No go to I17<br />

I16; Please provide details:<br />

Tier 4 (G) Application Form (version 10/12) - page 19

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