SFE/BAC/1920/A
1
2019/20
x
Birth/Adoption Certicate Form
You must complete this form fully in order to receive student finance.
Applicant’s Declaration of Identity
Customer Reference Number (if you have one)
Title
Forename(s)
Surname
Date of birth
Day Month Year
Place of birth (the name of the town or village)
Birth Certificate Reference Number (if applicable)
Adoption Certificate Reference Number (if applicable)
I have enclosed my original birth or adoption certificate as confirmation of my identity.
I have also enclosed a completed Identity Confirmation Form.
Signature
Today’s
date
Day Month Year
Make sure you sign this form in ink. Digital signatures won’t be accepted
Important Information
You must ensure a person of good standing within the community, whose identity can be
verified, completes the Identity Confirmation Form.
Examples of a person of good standing include:
someone with a professional qualification i.e. teacher, accountant, engineer, solicitor, etc;
bank or building society official;
civil servant;
minister of religion; or
police officer.
This person must meet all of the following criteria:
they must have known you for at least 2 years;
they must not be related to you by birth or marriage;
they must not be in a personal relationship with you;
they must not live at the same address as you;
they must hold a current UK passport; and
they must be currently living in the UK.
If you, or the person completing the Identity Confirmation Form, require a copy of this form in
an alternative format such as large print or Braille please contact us on 0300 100 0607 to have
this arranged.
SFE/BAC/1920 2
x
Identity Conrmation Form
This form is used to confirm the applicant’s identity.
Important Information
I declare that:
I have known the applicant for at least 2 years; • I do not live at the same address as the applicant;
• I am not related to the applicant by birth or marriage; I hold a current UK Passport; and
• I am not in a personal relationship with the applicant; I am currently living in the UK.
To find out how we’ll use the information you provide go to www.gov.uk/studentfinance to read our Privacy
Notice before completing this form.
We will share the passport details you provide with HM Passport Office to confirm that they’re valid.
Your title
Mr Mrs Miss Ms
Length of time you have known the applicant
Years
Your forename(s)
Your surname
Your occupation
Your passport number
Your work address
Your work postcode Your work landline phone number
Applicant’s full name
Applicant’s Customer Reference Number
Who will use this information
The Secretary of State for the Department for
Education have transferred certain functions relating to
student finance to the Student Loans Company (SLC).
The SLC will be the data controller for the information
you provide on this form. The Department for
Education is also the data controller for this
information as it is responsible for it by law. However,
if you would like to see your information please
contact the SLC.
The information that you provide on this form will
be used to process the applicant’s application
for student finance, in particular to confirm the
applicant’s identity and therefore, whether they are
potentially eligible for student finance. The SLC may
contact you, your employer or Her Majesty’s Passport
Office to verify the information you provide on this
form. They will need to keep your information in order
to audit their assessment of the applicant’s eligibility
for student finance.
By law the SLC must protect the public funds they
handle and may use the information that you provide
to prevent and detect fraud. They may also share
this information for the same purposes with other
government departments who handle public funds.
I confirm that I believe the applicant is the person named on the enclosed birth/adoption certificate and
that he/she is known to me as the person named on this form.
Signature
Today’s
date
Day Month Year
We may contact you, your employer and Her Majesty’s Passport Office
to confirm any information you have provided on this form.
SFE/BAC/1920
3
Examples of acceptable countersignatories
Please note, the person who countersigns your form must:
be a person of good standing in the community,
have known you for more than 2 years,
not be related to you (by birth or marriage), in a relationship with you or live at your address,
live in the UK, and
hold a valid UK passport.
Please note, unless specified, a countersignature must be from a professional who is
working and has not retired.
These are common examples of people you might know who can countersign your form:
Accountant
Bank or Building Society Ofcial
Chairman/Director of a limited company
Civil servant (permanent)
Dentist
Director/Manager of a VAT-registered company
Engineer (with professional qualication)
Fire service ofcial
Manager/Personnel ofcer of a limited
company
Medical Doctor (must know applicant
personally)
Minister of a recognised religion
Nurse (RGN and RMN or holder of a BA, BSc
or Diploma in Nursing)
Ofcer of the Armed Services (active or retired)
Optician
Pharmacist
Police Ofcer
Post Ofce ofcial
President/Secretary of a recognised
organisation
Social Worker
Solicitor
Teacher/Lecturer
Vet
There are also lots of other professional people that could sign your form, for example:
Architect
Articled clerk of a limited company
Barrister
Chemist
Chiropodist
Christian Science practitioner
Director/Manager of a VAT-registered charity
Driving Instructor (approved)
Funeral Director
Journalist
Justice of the Peace
Local government ofcer
Member of Parliament
Merchant Navy ofcer
Paralegal (certied paralegal, qualied
paralegal or associate member of the Institute
of Paralegals)
Paramedic
Photographer (professional)
Personal License holder (formally known as a
licensee of a public house only)
Prison/Probation Ofcer
Salvation Army Ofcer
Surveyor
Trade union ofcer
Travel Agent (qualied)
Warrant ofcers and Chief Petty Ofcers
If, after reading this information, you’re still not sure if the person you found to countersign
your form meets the criteria at the top of the page, call us on 0300 100 0607.
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