POINTS BASED SYSTEM FORM (VAF9 APR 2009) APPENDIX 3: TIER 1 (ENTREPRENEUR) SELF- ASSESSMENT
This form is for use outside the UK only. This form is provided free of charge.
For official use only
READ THIS FIRST
This form must be completed in blue or black ink. Only complete after you have obtained your points score from the electronic Self-Assessment Points Calculator (www.ukba.homeoffice.gov.uk/pointscalculator ). Please follow the guidance notes carefully and complete all questions as indicated. Please ensure you submit all relevant, original documents as indicated in the sections. It is better to explain why you do not have a document than to submit a false document. Your application will be automatically refused, and you may be banned from coming to the UK for 10 years if you use a false document, lie or withhold relevant information. You may also be banned if you have breached immigration laws in the UK Please ensure you also complete the main Personal Details form.
Part 1
About you
1.1 Given name(s)
1.2 Family name
1.3 Occupation (this your current or most recent job)
Attributes: You need to score a total of 75 points from Parts 2 - 4.
You should refer to the Immigration Rules and Tier 1 (Entrepreneur) Policy Guidance.
Part 2
Access to no less than £200,000 [25 points available]
Yes Yes No No
2.1 Do you have access to funds amounting to no less than £200,000? Put a cross (x) in the relevant box 2.1 Are you relying on third party funding for any of the £200,000? Put a cross (x) in the relevant box
Part 3
Money is held in one or more regulated financial institutions [25 points available]
Yes No
3.1 Are the funds held in one or more regulated financial institutions? Put a cross (x) in the relevant box
Part 4
Money is disposable in the United Kingdom [25 points available]
Yes No
4.1 Are the funds disposable in the United Kingdom? Put a cross (x) in the relevant box
01
Table of evidence listing each piece of evidence provided
All documents must be original. For each source of funds on which you are relying to claim points you must provide a letter from the financial institution holding the funds showing: • That the money is available to you; and • That the institution is regulated by the home regulator; and • That the money is disposable in the UK. If third party funding is used, you must provide a letter from every third part granting permission for you to have access to the money and a letter of confirmation from a legal representative or legal representatives confirming that the signatures are valid (2 pieces of evidence). You must complete the following table to confirm the specified documents provided with this application to demonstrate each source of funds. One line is completed (line 0) as an example only. Source No Letter from financial institution holding the money, confirming the amount of money, that the institution is regulated by the home regulator and that the money is transferable to the UK. Name of institution 0 1 2 3 4 5 6 7 8 9 10 Letter from third party granting permission to use the money, if applicable. Legal representative’s letter confirming validity of permissions if third party money is used. Amount of money in UK Pounds Sterling in this institution
Bank of somewhere
Yes
Yes
£ X0,000 £ £ £ £ £ £ £ £ £ £
Totals
Number of pieces of evidence: >>>>>
>>>>>>>>>>>
>>>>>>>>>>>
£
Total amount of money claimed
Please nOTe: Applicants should ensure that they are familiar with the requirements for further leave to remain in this category. They should note that the requirements may be revised and such revisions my apply to migrants who already hold leave to remain in the category.
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Part 5
English Language
You need a minimum standard of English language in order to score 10 points. Without this your application will be refused. You should refer to the Tier 1 (Entrepreneur) Policy Guidance. 5.1 Put a cross (x) in one box to indicate under which category of the English language requirement you are claiming points: National of a majority English speaking country. Go to question 5.2 English language Test Go to question 5.3 Degree taught in English Go to question 5.5
5.2 National of a majority English speaking country (10 points) Antigua and Barbuda; Australia; The Bahamas; Barbados; Belize; Canada; Dominica; Grenada; Guyana; Jamaica; New Zealand; St Kitts and Nevis; St Lucia; St Vincent and the Grenadines; Trinidad and Tobago; The United States of America Enter your nationality. This should be the nationality shown in the passport/travel document you wish to use for this programme. Go to Question 5.9 5.3 English language test (10 points). Provide details of the test taken Awarding Body: Title of qualification:
Level of qualification:
Date of Award:
D
Award reference number:
D
M M
Y
Y
Y
Y
5.4 Put a cross (x) in the following box to confirm the evidence you have supplied. Original test certificate - Go to Question 5.9 5.5 Degree taught in English (10 points) The degree must be equivalent to a UK Bachelors degree or above. See Tier 1 (Entrepreneur) Policy Guidance Country of award >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> State/County/Province (if applicable)
Institution >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
Qualification
Year of Award
Duration of Study
Y
Y
Y
Y
Start
D
D
M M
Y
Y
Y
Grade
Y
End
D
D
M M
Y
Y
Y Y
Field of Study >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
5.6 Put a cross (x) in the relevant box to confirm how you verified you degree was taught in English The points-based calculator shows the degree was taught in English; Go to Question 5.9 The points-based calculator shows the qualification is equivalent to a United Kingdom degree but does not show the qualification was taught in English; Go to Question 5.7 The points-based calculator does not show the qualification is equivalent to a United Kingdom degree but a UK NARIC letter and/or certificate is enclosed; Go to Question 5.7
5.7 Put a cross (x) in the box to confirm you have included a letter from your university confirming that the degree was >> taught in English. 5.8 Put a cross (x) in the relevant box to indicate what evidence has been supplied Original degree certificate; Original academic transcript.
5.9 Put a cross (x) in the box to confirm that you claimed 10 points for your level of English Language >>>>>>>>>>>>>>>
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Part 6
Maintenance - Refer to the Tier 1 (Entrepreneur) Policy Guidance
You must have a minimum level of funds to score 10 points for your level of funds. If you do not score 10 points your application will be refused. You must have £2,800 available funds for yourself plus £1,600 for each dependant accompanying you or intending to join you in the United Kingdom within 12 months of your arrival in the United Kingdom. This money must be held in your personal bank account for at least 3 months before the date of your application and not fall below the required amount at any time during that period. Refer to the Tier 1 (Entrepreneur) Policy Guidance. 6.1 Calculate the amount of funds required for you >>>>>>> and the dependants named in the Personal Details part of this application form and enter the amount here. 6.2 Put a cross (x) in the box to confirm that you have this amount of funds available and that it has been in your personal bank account for at least 3 months prior to your making this application.
6.3 Put a cross (x) in the relevant boxes to indicate what evidence of these funds has been supplied. All documents must be original. Building society/savings account pass book Letter from a bank or building societyconfirming funds and that they have been in your bank for at least 3 months Personal bank or building society statements covering a 3 month period Letter from a regulated financial institution confirming funds and covering a 3 month period
6.4 Put a cross (x) in the box to confirm that you have claimed 10 points for your level of funds >>>>>>>>>>>>>>>>>>>>>
Part 7
Summary Sheet
Please complete the summary sheet below listing the points you have claimed and the documentation provided. You must provide the required evidence as specified in this application form and the Tier 1 (Entrepreneur) Policy Guidance. All documents must be original, unless otherwise stated. Failure to submit required evidence is likely to lead to refusal of the application. Points Scoring Area Access to £200,000 (Part 2) Financial institution is regulated (Part 3) Funds are disposable in the UK (Part 4) English language (Part 5) Maintenance (Part 6) Points Claimed Documents Provided (please list)
Total I confirm I have completed the Personal Details separate form and accept the contents of the declaration. Applicant’s signature Date
D
D
M M
Y
Y
Y
Y
YOU MUST SUBMIT A PAPER COPY OF THIS APPENDIX WITH YOUR SUPPORTING DOCUMENTS. ENSURE YOU ALSO COMPLETE THE PERSONAL DETAILS FORM EITHER ON PAPER OR ON LINE. YOU SHOULD SIGN THE DECLARATION AND SUBMIT THIS WITH YOUR OTHER DOCUMENTS
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