Application Form
Page 3 of 5
JOB TITLE COMPANY NAME, ADDRESS OF WORKPLACE & POSTCODE
WORK LANDLINE
2
Verifier details
PLEASE USE CAPITAL LETTERS AND BLACK INK ONLY
FIRST NAME
LAST NAME
Route 1 Verifiers
Route 1 is for applicants who have official ID documents
with copies for you to sign as detailed below in the
Verifier consent section
Examples of route 1 Verifier professions include: Director
of a Limited Company, Doctor, Lecturer, Teacher. Use
UK passport office occupations list as guidance
Route 2 Verifiers
Route 2 is for applicants who DON’T have official ID
documents and wish you to check their details on this
form match your official records as detailed below in the
Verifier consent section
Route 2 Verifiers must have one of the following
professions:
Teacher, Tutor, Head of Year, Administrator at your
school, college or university, Doctor, Nurse, Dentist,
Social Worker, Certified Solicitor, a bank or building
society staff member at your branch, your Job Centre,
DWO Advisor, your Prison or Probation Officer
Please tick below for route 1 applicants only
The Applicant is known to me personally and
I have written on a photocopy of their original ID
“I certify that I have seen the original of this copy
and this matches the name and date of birth on this
application form’’ adding my name, signature and
the date
OR The Applicant is NOT known to me personally
and I have written on a photocopy of their original
Photographic ID “I certify that I have seen the
original of this copy and this matches the name and
date of birth on this application form’’ adding my
name, signature and the date
Please tick below for route 2 applicants only
I certify that The Applicant’s full name, date of birth,
age, gender and home address as declared on this
application form match the records held at this
office / organisation
I certify that The Applicant is the person pertaining
to our records
Verifier consent
Please read and tick the applicable terms below, then
sign in the box at the bottom of this page to certify this
applicant
I am NOT related to The Applicant by either marriage
or birth
I am NOT in a personal relationship with The
Applicant
I understand that providing false information is a
criminal offence (Fraud Act 2006). I consent to
being contacted at my workplace by telephone to
confirm the information supplied and acknowledge
that this applicant has consented to me confirming
their personal details
I do NOT live at the same address as the applicant
I am over 25 years of age
I am in employment in the UK
I am not self-employed, working from home or retired
I have written on the reverse of one photo “I certify
that this is a true likeness of ……’’ adding my name,
signature and the date
All Verifiers MUST be available for us to call
VERIFIER SIGNATURE
click to sign
signature
click to edit