Form RR (version 08/23)
Page 4 of 4
Section 3 - Declaration
Warning: to give false information on this form knowingly or recklessly is a criminal oence
punishable with up to 3 months’ imprisonment or by a ne not exceeding £5000 or both.
(Section 46(1) of the British Nationality Act 1981, as amended).
3.1 I (full name in block letters)
declare that, to the best of my knowledge and belief, the information given in this application is
correct.
I promise to inform the Home Secretary in writing of any change in circumstances which may
aect the accuracy of the information given whilst this application is being considered by the
Home Oce. I understand that information given by me will be treated in condence, but may
be submitted for checking against records held by other government departments, the security
service and other agencies, local authorities and the police, where it is necessary for immigration
or nationality purposes, or to enable these bodies to carry out their functions.
I understand that I may be liable for prosecution if I have knowingly or recklessly provided false
or incomplete information.
3.2 I understand that I will be required to submit a payment slip and the prescribed fee if
requested.
3.3 I conrm that I have enclosed the appropriate documents.
3.4 I understand that a certicate of citizenship may be withdrawn if it is found to have been
obtained by fraud, false representation or concealment of any material fact, and that this may
aect my permission to remain in the UK.
Signature Date
D D M M Y Y Y Y
Send your completed form, documentary evidence (originals not necessary) and your
original certicate of registration to support your request to the following address:
Department 201
UK Visas and Immigration
Silver Zone, 4th Floor
The Capital
New Hall Place
Liverpool
L3 9PP