FLR(DL)
version 04/16
Application for 1) further leave to
remain or settlement in the UK by a
person granted Discretionary Leave
following the refusal of asylum, and 2)
a Biometric Immigration Document
A person who
was granted
Discretionary
Leave following
refusal of an
asylum claim
In accordance with paragraph 34 of the Immigration Rules, this form is a
specified form for the purpose of the Immigration Rules as of 18 April 2016 and
must be used for all applications made on or after that date for the purposes
stated on this page and listed in section 3.
Please check on the UK Visas and Immigration webpage at www.gov.uk/
government/organisations/uk-visas-and-immigration that this is the current form
for use on the date that you apply.
DUTY TO STATE ALL REASONS TO REMAIN IN THE UNITED KINGDOM
All your reasons or grounds for wishing to stay in the United Kingdom must be
stated in this application. This requirement is being given under section 120
of the Nationality, Immigration and Asylum Act 2002. If you do not tell us now
of any reasons or grounds for remaining in the United Kingdom and you tell
us later without good reason, you will lose any right of appeal you may have
otherwise qualified for if we refuse your claim. You can use the box at the end of
section 6.
As part of your application you may be required to pay the Immigration Health
Surcharge. Before going any further, you should check the Gov.UK website at
www.gov.uk to confirm if an Immigration Health Surcharge assessment is required
as part of your application. You must complete this before submitting your
application and enter the reference number in this application.
Please read the Guidance Notes at the end of this form before completing it.
This form is
to be used for
applications
made on or after
18 April 2016
FLR(DL) Application Form
In accordance with paragraph 34 of the Immigration Rules, this form is a specified form for the
purpose of the Immigration Rules as of 18 April 2016 and must be used for all applications made on
or after that date for the purposes stated on this page.
You also need the separate guidance documents listed below, which you should read before making
your application:
DL guidance notes at the end of this form
UK Visas & Immigration photograph guidance
If you do not already have these documents, you can get them from our website at www.gov.uk/
government/organisations/uk-visas-and-immigration
Our application forms change periodically. If you obtain this form some time before applying, please
check that it is still the version which must be used when you are ready to apply.
Do not complete this form if you are applying for leave to remain in one of the following
categories:
Family life as a partner (10 year route)
Family life as a parent (5 year & 10 year routes)
Private life in the UK (10 year route)
Complete application form FLR(FP)
You must apply by post if you are using this form, send your application to the following address:
Home Office
FLR(DL)
PO Box 589
Durham
DH99 1AB
This form is for the following categories:
An application for further leave from a person refused asylum and granted Discretionary Leave.
An application for settlement from a person refused asylum and granted Discretionary Leave.
An application for further leave from a person refused asylum and granted Exceptional Leave to
Remain
An application for settlement person refused asylum and granted Exceptional Leave to Remain.
FLR(DL) form (Version 04/2016) - page 1
FLR(DL) Application Form
Payment Guidance
The Fee
If you are a single applicant applying for further leave on form FLR(DL) and no dependants are
applying with you, the normal specified fee is £811 for standard applications made by post.
Number of applicants
Yourself and 1 dependant
Yourself and 2 dependants
Yourself and 3 dependants
Yourself and more than 3 dependants
Standard
£1622
£2433
£3244
Add £811 to the amount above for each additional
dependant
If you are a single applicant applying for settlement on form DL and no dependants are applying
with you, the normal specified fee is £1875 for standard applications made by post.
Number of applicants
Yourself and 1 dependant
Yourself and 2 dependants
Yourself and 3 dependants
Fee for each additional dependant
Standard
£3750
£5625
£7500
£1875
For more information about the current fees, please see the FLR(DL) guidance notes - version
06/2015 at the end of this form.
Please note that your application will be rejected as invalid if you do not pay the specified fee.
The fee charged is for the processing and consideration of the application. This fee will be payable
once the application form is received by the Home Office or its payment processing agent,
regardless of the outcome of the application. If your application contains errors or is missing
information it may be rejected as invalid. Your application will not be considered and your fee will be
refunded less an administration fee of £25 for each person included in the application.
We cannot begin the consideration process until the payment has cleared. We allow 5 working days
for payments made by cheque to clear, credit/debit cards and postal orders will clear immediately.
If you are claiming an exemption from paying the fee because you are applying to stay in the UK
under European Convention on Human Rights and want to apply for a fee exemption because
you are destitute and unable to pay the fee, tick the box at item 5 on the payment details page to
confirm this. (Information about what we mean by destitute can be found on our website).
If you tick the Nil payment box you will need to complete Appendix 1 FLR (FP). Failure to complete
Appendix 1 FLR (FP) will result in your application being rejected if you have not sent a fee.
If you are applying under one of the above categories failure to tick the box at item 5 on the
payment details page will result in your application being rejected if you have not sent a fee.
FLR(DL) form (Version 04/2016) - page 2
FLR(DL) Application Form
Biometric Enrolment Fee
As part of your application you are required to enrol your biometric information. You will be charged
an additional handling fee for this service, payable to the Post Office Ltd. You must pay the fee
by cash or debit card when you attend Post Office Ltd to enrol your biometrics. Each dependant
included on your application must also pay this fee when they enrol their biometric information. Do
not send the biometric enrolment fee with your application fee.
Applicants on some immigration routes are exempt from paying an enrolment fee at the Post Office
Ltd. If you are in one of these categories you will be informed of this when we send you a biometric
notification letter.
Your application may be rejected as invalid if you do not enrol your biometrics when requested. For
more information about enrolling biometrics and the current fee, please visit the following section of
our website: www.gov.uk/biometric-residence-permits
Who May Apply With You?
You may include your spouse, civil partner, unmarried or same-sex partner and/or children under
the age of 18 if they are applying as your dependants. However, they must pay the full specified fee
if they apply separately. However, children who were initially granted leave in this category at a time
when they were under 18 but who are now over 18, may continue to be included as a dependent
child (subject to an adult fee). See DL Guidance Notes at the end of this form for more information.
How can you pay?
You must pay by one of the methods specified below:
•Cheque
•Postal Order
•Credit Card - Visa (including Electron), MasterCard or American Express (Amex)
•Debit Card – Delta, Maestro* (including Solo)
•Banker’s draft (payable to the Home Office)
*Maestro - We will only accept Maestro cards issued in the UK for postal applications.
Cheques and Postal Orders
You must make the cheque or postal order payable to Home Office Leave to Remain and cross the
cheque or postal order(s) A/C Payee only.
Write the full name, nationality and date of birth of the main applicant on the back of each cheque
and/or each postal order and keep the postal order stub(s).Make sure that the date and the amount
(words and figures) are correct and that the cheque is signed properly.
Attach your cheque or postal order(s) to the front of the application form.
Completing the payment details page
To ensure that your payment is processed without any delay please complete the correct payment
details page and note the points below when doing so.
1-2 The address at 1 should be the contact address in the UK for any correspondence. If it is not
your home address (eg a solicitor or other authorised immigration adviser may be submitting the
application), give the contact name at 2.
FLR(DL) form (Version 04/2016) - page 3
FLR(DL) Application Form
3 This should be the full name of the main applicant as given in his or her passport or travel
document.
4 Date of birth - for example, 3 January 1980 should be written 03 01 1980 in the spaces
provided.
5 If you do not select a fee then we cannot take a payment and your application will be rejected as
invalid.
8-11
Complete only if paying by card.
11 The card security number is a three-digit security code known as the card verification value
(CVV). It consists of the last three numbers on the signature strip on the back of the card as shown
below.
AMERICAN EXPRESS
AUTHORISED SIGNATURE
4567 123
123
CVV
12
CVV
1234
1234 123456 12345
1234
It is the cardholder as named on the credit or debit card who must sign and date.
Please note that when making large or multiple payments using your credit card, the anti-fraud
measures that banks operate sometimes stop the full payment being taken. This is can happen
for a number of reasons. To prevent this you may inform your bank of your intention to make large
or multiple payments in advance so that your bank allows the full payment to be taken when you
submit your application.
Please be aware that not all banks offer this service.
FLR(DL) form (Version 04/2016) - page 4
FLR(DL) Application Form
Payment Details: FLR(DL)
Please complete this page in block capitals and black ink after first reading the payment guidance.
1. Contact address in the UK for correspondence:
Postcode:
2. Contact name in the UK if different from that of the applicant:
3. Applicant’s full name:
4. Date of Birth (dd/mm/yyyy):
Application for further leave:
single applicant - no dependants
main applicant and one dependant
main applicant and two dependant
Application for settlement:
single applicant - no dependants
main applicant and one dependant
main applicant and two dependant
Main applicant and
Amount - please tick the amount you are
paying. If no fee is ticked we cannot take
a payment and your application will be
rejected as invalid.
£811
£1,622
£2,433
If more than 2 dependants are applying with
you enter the number and correct amount
below.
£1,875
£3,750
£5,625
dependants
£
If you are claiming an exemption from paying the fee tick this box:
How are you paying? Please tick a box.
Postal order
Cheque
Debit or credit card
Banker’s draft
Paying by cheque - please give cheque details below
Cheque number
Account number
Sort code
-
-
Paying by card - please complete 8-12 below
Which card are you using for payment? Please tick a box
Visa/Electron
Mastercard/Amex
Maestro/Solo
Delta
9. Name on card
10. Card number
11. Card details
Valid from
/
12. Cardholders signature
Expiry date
/
CVV number
Date
FLR(DL) form (Version 04/2016) - page 5
Issue No. if
available
FLR(DL) Application Form
Section 1 - Applicant’s Details
Photographs - You must provide two identical photographs of yourself with your full name on the
back of each one. Please place the photographs, full name on the back of each one. Please place
the photographs, together with those of any dependants included in section 2, in a small sealed
envelope and attach it across this space with a staple or paper clip at the right-hand side of the
page/envelope. Please make sure that the staple or paper clip does not damage or mark the
photographs. All photographs must be as specified in the separate photograph guidance.
A1. Title - please select from the following list:
Mr
Mrs
Miss
Ms
Other (please state)
A2. First name(s) as stated in your passport or travel document:
A3. Last name(s) or family name(s) as stated in your passport or travel document:
A4. If you are known, or have ever been known, by any other name(s) than those given
above, please give details below and send the evidence showing the name change:
Name known by
Nationality at the
time of using this
name
Dates from and to
Please photocopy this page if more space is needed.
A5. Date of birth:
D
D
A6. Gender:
Male
M
M
Y
Y
Y
Y
Female
A7. Village, town or city of birth:
A8. Country of birth:
A9. Nationality:
FLR(DL) form (Version 04/2016) - page 6
Evidence sent
FLR(DL) Application Form
A10. Relationship status - please select from the following list:
Married or civil partner
Single
Unmarried partner
Widowed or surviving civil partner
Divorced or dissolved civil partnership
Separated or separation order
A11. Your Home Office reference number(s) (if known):
Reference number 1:
Reference number 2:
Reference number 3:
A12. Please provide your Immigration Health Surcharge reference number (IHS):
I
H
S
A13. Your UK National Insurance number (if known):
A14. If you have had a previous UK National Insurance number (please state):
A15. BRP Reference Number:
A16. Home address in the UK: (Please let us know if this changes. See Note 10 - Guidance
Notes)
Postcode:
A17. Date you started living at this address:
D
D
M
M
Y
Y
Y
Y
If you have lived at the address above for less than five years please provide your previous
address details and the dates you lived there.
Previous address 1:
Postcode:
From
D
D
M
M
Y
Y
Y
Y
To
D
D
FLR(DL) form (Version 04/2016) - page 7
M
M
Y
Y
Y
Y
FLR(DL) Application Form
A17. Telephone numbers:
Preferred contact (tick)
Home:
Work:
A18. Email address:
A19. Correspondence address (if different from above):
Postcode:
A20. Have you ever lived in Northern Ireland
in the last 5 years?
Yes
Go to A21
No
Go to A 22
A21. Previous home address(es) in Northern Ireland and the date(s) you lived there:
Previous address 1
Postcode:
From
D
D
M
M
Y
Y
Y
Y
To
D
D
M
M
Y
Y
Y
Y
M
M
Y
Y
Y
Y
Previous address 2
Postcode:
From
D
D
M
M
Y
Y
Y
Y
To
D
D
A22. If you have completed A19 and the address is that of your immigration adviser, please
state their Office of the Immigration Services Commissioner (OISC) number
FLR(DL) form (Version 04/2016) - page 8
FLR(DL) Application Form
Section 2 - Which Category?
You must tell us which category you are applying for further leave in. You can only apply for leave
in certain categories using this form. You must read the DL Guidance notes before completing this
section.
B1. Please tick a box below to show us the category in which you are applying for an extension of
stay in the UK.
Unaccompanied Asylum Seeking Child (UASC)
Human Rights (Not family or medical)
Other purpose / reason
If you are applying for further leave or settlement for other reasons you must briefly explain why
below. You will also need to provide a letter or other document explaining in more detail why you are
applying including any exceptional circumstances.
FLR(DL) form (Version 04/2016) - page 9
FLR(DL) Application Form
Section 3 - Your history and circumstances since you were granted
limited leave to enter or remain
C.1 When does your limited leave to enter or remain expire? Please do not submit your
application earlier than 1 month before the expiry date of your current leave. See the Guidance
Notes (Note 1).
D
D
M
M
Y
Y
Y
Y
C.2 If your limited leave has already expired, please explain why you overstayed your leave to
remain and did not apply for further leave or settlement earlier.
C.3 Do you currently hold a national passport or other travel document?
Yes
Go to C5
No
Go to C4
C4. If you have answered no to question C3, you must explain why you do not have a national
passport or other travel document. If you have tried to obtain a national passport or other travel
document and have been refused, you must explain the reasons below.
C.5 Have you spent any time outside of the United Kingdom since you were granted limited leave?
Yes
No
Go to Section 4
If you have answered yes to question C.5, you must complete the details below:
Dates of travel (list both
Reason(s) for travelling
departure and return dates)
FLR(DL) form (Version 04/2016) - page 10
FLR(DL) Application Form
Your application will be considered in accordance with the published Asylum instruction
on Discretionary Leave (which replaced Exceptional Leave to Remain on 1 April 2003). The
Asylum Instruction may be viewed on the Home Office website https://www.gov.uk/visasimmigration.
We will make a decision about whether or not you qualify for further leave to remain or
settlement in the United Kingdom on the basis of the information about your circumstances
that you have already provided and any new information which you submit with this
application form.
There is no need to send us any information that you provided when you made your asylum
and/or human rights claim, or during any subsequent appeals, or in connection with any
other application for further leave to remain in the UK which you may have made.
You should tell us immediately if there are any changes in your circumstances that are
relevant to this application, or if any new information relevant to this application becomes
available. See the Guidance Notes (Note 10).
If you wish to send us any documents, you should send us the original version together with
a description of what it is and an English translation if it is not in English.
FLR(DL) form (Version 04/2016) - page 11
FLR(DL) Application Form
Section 4 - Dependants who are also applying
D.1 Do you have any dependants living in the UK?
Yes
No
If you have answered yes to question D.1, this is where you give their details. ‘Partner’ means your
spouse, civil partner, unmarried or same-sex partner.
Children aged 18 or over must apply separately unless they were included in your last grant of
leave.
See guidance notes (Note 4) for information on who you can include as a dependant on this form.
Photographs - You must provide two identical photographs of each dependant who is applying.
Write the dependant’s full name on the back of each photograph and enclose them in an envelope
attached to section1 as instructed there.
If you need more space please continue on another sheet and send it with your application.
Your partner’s full name
D.1 Your partner’s full name
D.2 Your partner’s nationality
D.3 Your partner’s BRP Reference Number
D.4 Your partner’s place of birth - town or city and country
D.5 Partner’s date of birth
D D
D.6 Partner’s gender - please tick male
M M
Y Y Y Y
female
D.7 Relationship to you - please tick
Spouse
Civil Partner
D.8 Are you and your partner living together?
If No, where does your partner live?
Unmarried partner
Yes
Same-sex partner
No
Postcode
D.9 How long have you and your partner been in a relationship?
D.10 Have you and your partner ever lived together outside of the UK? if yes please provide details.
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FLR(DL) Application Form
D.11. Could you and your partner live together outside of the UK if necessary? If not please provide
reasons.
D.12. You must provide evidence that you and your partner are living together. See Guidance Note
In this section include any children under the age of 18 who are living with you in the UK and who
are applying as your dependants.
If more than 2 children are applying, please give their details on a photocopy of this page, enclose
it with this form and place the photographs in a sealed envelope attached to section 1 as instructed
there.
Child 1
Child 2
Name
Date of birth (dd/mm/yyyy)
Place of Birth
Gender
Nationality (including if they
have dual nationality)
Passport or travel document
Issuing authority
Date of issue (dd/mm/yyyy)
Date of expiry (dd/mm/yyyy)
List all languages that your
child speaks
How long has this child resided
in the UK
Does this child live with you
at the address provided in
question A.15?
Who is financially responsible
for this child?
If your spouse/partner is not
the other parent of this child,
provide details of the other
parent. Include name, where
they live, their nationality and
their level of contact or parental
responsibility.
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FLR(DL) Application Form
Please include any further information you think may be relevant to the consideration of this
application. Continue on a separate page if necessary.
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FLR(DL) Application Form
Section 5 - Personal history
Personal history (criminal convictions, war crimes, etc.)
It is mandatory to complete section 5. If it is not complete the application will be invalid and
will be returned to you.
This section asks about any criminal convictions, cautions, any civil judgements or civil
penalties made against you or any dependants who are applying with you and details of any
involvement you or any dependants who are applying with you may have had in war crimes,
genocide, crimes against humanity or terrorism. If you fail to answer all of these questions
as fully and accurately as possible, your application may be refused.
It is an offence under Section 26(1)(c) of the Immigration Act 1971 to make a statement or
representation which is known to be false or is not believed to be true. Information given will
be checked with other agencies.
E1. Have you or any dependants who are applying with you been convicted of any
criminal offence in the UK or any other country?
Yes
- go to question E2
No
- go to question E3
E2. Please give details below for each criminal conviction, starting with the most recent one.
If you have received more than two convictions, please photocopy this page and enclose it
with this form.
Note: We will carry out criminal record checks on all applicants and dependants. You must
give details of all unspent and spent criminal convictions. This includes road traffic offences
but not fixed penalty notices (such as speeding or parking tickets) unless they were part of a
sentence of the court. This includes all drink-driving offences.
Criminal conviction 1
Name:
Country where convicted:
Nature of the offence:
Sentence given:
Date sentenced:
D
D
M
M
Y
Y
Y
FLR(DL) form (Version 04/2016) - page 15
Y
FLR(DL) Application Form
months
If you were sentenced to a period of imprisonment, what was the
length of the prison sentence imposed (in months)?
Criminal conviction 2
Name:
Country where convicted:
Nature of the offence:
Sentence given:
D
Date sentenced:
D
M
M
Y
Y
Y
Y
If you were sentenced to a period of imprisonment, what was the
length of the prison sentence imposed (in months)?
months
E3. Have you or any dependants who are applying with you been subject to, or received, any
other penalty in relation to a criminal offence; for example caution, reprimand, warning, or similar
penalties in the UK or any other country?
Yes
- go to question E4
No
- go to question E5
E4. Give details of each penalty you have received, starting with the most recent one. If you or
any dependants who are applying with you have received more than two such penalties, please
photocopy this page and enclose it with this form.
Details of penalty 1
Name of person:
Country where penalty given:
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FLR(DL) Application Form
Offence:
Type of penalty (e.g caution, reprimand, warning or other - please state):
D
Date of penalty:
D
M
M
Y
Y
Y
Y
Details of penalty 2
Name of person:
Country where penalty given:
Offence:
Type of penalty (e.g caution, reprimand, warning or other - please state):
Date of penalty:
D
D
M
M
Y
Y
Y
Y
E5. Have you or any dependants applying with you had any UK court judgment against you
for non-payment of a debt, or received a civil penalty under UK Immigration Acts?
Yes
- go to question E6
No
- go to question E7
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FLR(DL) Application Form
E6. Give details for each UK court judgment or civil penalty under UK Immigration Acts,
starting with the most recent one. If you or any dependants applying with you have received
more than two court judgments and/or civil penalties under the UK Immigration Acts, please
photocopy these pages, complete the details, and enclose them with this form.
Details of court judgment or civil penalty 1
Name of person:
Specify whether you had a court judgment or civil penalty
Date of court judgment or civil penalty:
D
D
M
M
Y
Y
Y
Y
D
M
M
Y
Y
Y
Y
Details of court judgment or civil penalty 2
Name of person:
Specify whether you had a court judgment or civil penalty
Date of court judgment or civil penalty:
D
You must answer questions E7 to E12 below even if you have answered no to question E1
For help in answering these questions, please see the definitions at the end of this section.
E7 Have you or any dependants who are applying with you Yes
been arrested and charged in any country with any criminal
offence and are awaiting, or are currently on trial?
No
E8 In times of either peace or war, have you or any
dependants who are applying with you ever been involved,
or suspected of involvement, in war crimes, crimes against
humanity or genocide?
Yes
No
E9 Have you or any dependants who are applying with you
ever been involved in, supported or encouraged terrorist
activities in any country?
Yes
No
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FLR(DL) Application Form
E10 Have you or any dependants who are applying with you Yes
ever, by any means or medium, expressed views that justify
or glorify terrorist violence or that may encourage others to
terrorist acts or other serious criminal acts?
No
E11 Have you or any dependants who are applying with you Yes
ever engaged in any other activities which might indicate
that you may not be considered to be persons of good
character?
No
E12 If you have answered yes to any of the questions E.7, E.8, E.9, E.10, or E.11 you must
give further details in the space provided below. If you need more space, continue on a
separate sheet and enclose it with this form.
E.13 How long have you lived in the UK?
Years
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Months
FLR(DL) Application Form
Definitions
For the purposes of answering questions E.7 to E.12, the following information provides guidance
on actions which may constitute war crimes, crimes against humanity, genocide, or terrorist
activities.
This guidance is not exhaustive. The full definitions of war crimes, crimes against humanity
and genocide can be found in Schedule 8 of the International Criminal Court Act 2001 at www.
legislation.gov.uk/ukpga/2001/17/schedule/8 or purchased from The Stationery Office (telephone
0870 600 5522). It is your responsibility to satisfy yourself that you are familiar with the definitions
and can answer the questions accurately on behalf of yourself and any dependants who are
applying with you.
War crimes
Grave breaches of the Geneva Conventions committed during an armed conflict. This includes an
internal armed conflict and an international armed conflict. The types of acts that may constitute
a war crime include wilful killing, torture, extensive destruction of property not justified by military
necessity, unlawful deportation, the intentional targeting of civilians and the taking of hostages.
Crimes against humanity
Acts committed at any time (not just during armed conflict) as part of a widespread or systematic
attack, directed against any civilian population with knowledge of the attack. This would include
offences such as murder, torture, rape, severe deprivation of liberty in violation of fundamental rules
of international law and enforced disappearance of persons.
Genocide
Acts committed with intent to destroy, in whole or in part, a national, ethnic, racial or religious group.
Terrorist activities
Any act committed, or the threat of action, designed to influence a government or intimidate the
public and made for the purposes of advancing a political, religious or ideological cause and that
involves serious violence against a person; that may endanger another person’s life; creates a
serious risk to the health or safety of the public; involves serious damage to property; is designed to
seriously disrupt or interfere with an electronic system.
Organisations concerned in terrorism
An organisation is concerned in terrorism if it commits or participates in acts of terrorism; prepares
for terrorism; promotes or encourages terrorism (including the unlawful glorification of terrorism); or
is otherwise concerned in terrorism.
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FLR(DL) Application Form
Section 6 - Biometric Residence Permits
It is mandatory to complete this section. If it is not complete, the application will be invalid and will
be returned to you.
In accordance with regulation 3 of the Immigration (Biometric Registration) (Amendment)
Regulations 2012 anyone applying for leave to remain in the UK in the categories for which this
application form is specified must also apply for a biometric immigration document, otherwise known
as a biometric residence permit. This also applies to applications made at the same time by any
dependants of the main applicant. For information about biometric residence permits, please see
the separate FLR(DL) guidance notes, which you must read before completing this form
If you have a current grant of leave on a Biometric Residence Permit you must provide your
Biometric Residence Permit for the application to be valid and complete.
F1. Have you been issued with a
BRP?
go to
No
question F2
Yes
go to question F5
F2. BRP number
F3. Where is your BRP now? (please tick)
I am submitting it with this
application
Expired and returned
to the Home Office
Stolen
go to question F4
Elsewhere in the
Home Office
Lost
go to F5
go to question F4
F4. Have you reported this to the Home Office card management services?
Yes
No
F5. Which age group do you belong to (at the date of submitting your application)?
15 years & under
go to F6
16 years & over
go to Section 7
F6. What is the title of the person accompanying you to have your biometric details
taken?
Mr
Mrs
Miss
Ms
Other please state
F7. First name(s) or given name(s)
F8. Last name(s) or family name(s)
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FLR(DL) Application Form
F9. Their date of birth
D
D
M
M
Y
Y
Y
Y
F10. Their place of birth
F11. Relationship to you
F12. Is this person your parent or legal guardian
Yes
go to Section 7
No
go to F13
F13. Explain why your parent or legal guardian will not be accompanying you
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Section 7 - Photographs and documents
Photographs
It is mandatory to provide the relevant photographs specified below. Please note that this
application will be invalid if you do not provide them.
In accordance with paragraph 34 of the Immigration Rules, you must provide your original, valid
passport, travel document or national identity card as evidence of your identity and nationality,
unless it is not available for reasons beyond your control. If your document is lost or stolen,
you should replace it before making your application unless there are reasons beyond your
control why you cannot (See note 2 below).
You should provide all previous passports, travel documents or national identity cards that you
have used to travel to or remain in the UK.
The photographs must be in the format specified in the separate UK Visas and Immigration
photograph guidance provided with this form. If they are not, they may be rejected as unacceptable
and you will have to provide others which are acceptable. This will delay consideration of your
application.
Two recent identical passport-size photographs of yourself with your full name written on the
back of each photograph. Please see the separate photograph guidance on the approved
format.
Two recent identical passport-size photographs of each dependant included in section 4 and
applying for an extension of stay in the UK with you, with their full name written on the back
of each photograph.
Documents
You must provide the documents specified below which are relevant to your application. If you do
not, we reserve the right to decide your application on the basis of the information and documents
provided. Tick the relevant boxes to show the documents you are providing. They must be originals.
All applicants must provide the relevant documents specified in 7A. You must also provide the
relevant documents specified in 7B or 7C for the category in which you are applying.
Please note that in some cases, we may have to ask for other documents in addition to those
specified in this form.
Passports and Immigration
7A All applicants
Your current passport or travel document. If you last entered the UK on a previous
passport or travel document, please also provide this document if you have it.
The current passport(s) or travel document(s) for each dependant included in section
2 and applying for an extension of stay in the UK with you. If they last entered the UK
on previous passport(s) or travel document(s), please also provide these documents if
you have them
Your Biometrics residence permit if you have been issued with one since entering the
UK. See Note 4.
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FLR(DL) Application Form
The Biometrics residence permit for each dependant included in section 2 and
applying for an extension of stay in the UK with you if they have been issued with them
since entering the UK. See Note 4.
Note 4 Residence permits have been issued to certain foreign nationals since 25 November
2008 when they have been given permission to remain in the UK. Unless reported lost or
stolen, they should be enclosed with any application for further permission to remain in the UK.
Your Police Registration certificate if you have been asked to register with the Police.
The Police registration certificate(s) of each dependant included in section 2 and
applying for an extension of stay in the UK with you if they have been asked to register
with the police
7B Dependant of a person who has limited leave to enter or remain in the UK other than
under the points based system
If you are applying as the dependant of such a person, in addition to the relevant documents in 8A,
you must provide:
Your marriage or civil partnership certificate if you are applying as the person’s spouse
or civil partner.
Documents showing that you have lived together for 2 years or longer if you are
applying as the person’s unmarried or same-sex partner
Your full birth certificate showing your parents’ names if you are applying as the
person’s child.
7C Other purposes/reasons not covered by other application forms. If you are applying
for an extension of stay for other purposes/reasons, in addition to the relevant
documents in 7A, you must provide:
A letter or other document explaining why you are applying for an extension of stay,
together with any relevant documents in support of your case.
Please list the documents you are providing in the space below.
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If you cannot provide any photographs or all the documents that we have asked for, please still
complete and submit this application form, but use this space to explain why some of the items
cannot be sent in. You should also tell us when you will provide them. We will not be able to
complete your application until you have provided everything that we have asked for.
Is there any other information concerning you or your family which you wish to be considered
as part of your application?
If so, please give details in the box provided
Please continue on a separate sheet if necessary and provide any relevant documentary evidence
relating to any issues you raise.
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Section 8 - Consent for the Home Office to request verification
checks
From the applicant:
I understand that you will check whether the information and supporting documentation that I
have supplied to the Home Office from a bank or utility company is correct. ‘Correct’ means that
documents are unaltered originals issued by the bank or utility company and that the information on
them is correct and applies to me or the person named as a customer on the document.
I agree to the bank or utility company, without seeking any further consent from me, telling you
whether the information or documentation I have supplied is correct or in what way (if any) it is not
correct.
I agree to the bank’s or utility company’s disclosure to the Home Office of any relevant personal
data they hold on me for the above purposes. If I have not supplied correct information or
supporting documentation to the Home Office the bank or utility company may disclose my relevant
correct personal data.
If the information or supporting documentation also contains personal data relating to a joint
customer or customers of mine on the bank or utility company account, or relates to another person
who is to provide financial support, I confirm that I have obtained the consent of those persons to
the disclosure of their personal data to the extent reasonably necessary for the above purposes.
I understand that the information obtained may be used as part of the decision making process
about my application and may, if necessary, be disclosed to a court.
[I understand that providing information or documentation that is not correct will normally result in
my application being refused and may lead to my prosecution for a criminal offence.]
Name and address of applicant
Postcode
Signature
Date
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Section 8 (Continued) - Consent for the Home Office to request
verification checks
If the account with the bank or utility company is in the joint names of the applicant and
other people, each of those others should sign the following declaration :
The above-named person (‘the applicant’) has given the Home Office documentation about his or
her accounts with banks or utility companies (a ‘company’) so that the Home Office can check that
is correct. I am a joint customer with the applicant on some or all of those accounts. Information
about the applicant may thus also reveal information about me.
I agree to the company giving the Home Office relevant personal data it holds about me in relation
to the account. This only covers data about me as joint customer with the applicant (and not
about any other accounts I hold in my sole name) and limited to what is necessary to confirm that
the documentation the applicant has supplied is correct. If that documentation is not correct, the
company may give the Home Office details of any inaccuracies / discrepancies in the information
that the applicant has provided, and may also disclose to the Home Office the correct information
that they have on record about the account.
I agree that this information may be used as part of the decision making process about the
application and may, if necessary, be disclosed to a court.
Name and address of joint customer
Postcode
Signature
Date
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Section 8 (Continued) - Consent for the Home Office to request
verification checks
If the account with the bank or utility company relates to another person who is to provide the
applicant with financial support, that person* should sign the following declaration:
I am a friend or relative whom the above-named person (‘the applicant’) has stated will provide
financial support. The Home Office is verifying this by checking the documentation which the
applicant has supplied about my accounts with banks or utility companies (a ‘company’). The
company may thus reveal information about me to the Home Office or to the applicant.
I agree to the company giving the Home Office relevant personal data it holds about me in relation
to my account. This is limited to what is necessary to confirm that the documentation the applicant
has supplied is correct. If that documentation is not correct, the company may give the Home Office
details of any inaccuracies / discrepancies in the information that the applicant has provided, and
may also disclose to the Home Office the correct information that they have on record about the
account.
I understand that this may involve the applicant obtaining further details about the account.
I agree that this information may be used as part of the decision making process about the
application and may, if necessary, be disclosed to a court.
Name and address of third party
Postcode
Signature
Date
*If the account is a joint account, all customers should sign.
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Section 9 - Declaration
You must now read the declaration below and sign it. This must be signed by you (the
applicant) and not by a representative or other person acting on your behalf. If you are under
18, your parent or guardian may sign.
It is mandatory for the declaration to be signed.
Please note that this application will be invalid if it is not signed as specified above.
I hereby apply for an extension of stay in the UK for myself and any dependants listed in this form.
The information I have given in this form is complete and is true to the best of my knowledge.
I confirm that the photographs submitted with this form are a true likeness of myself and any
dependants who are applying with me, as named on the back of each photograph and that I have
had the opportunity to see the UK Visas and Immigration photograph guidance.
I confirm that if, before this application is decided, there is a material change in my circumstances or
new information relevant to this application becomes available, I will inform the Home Office.
I understand that all information provided by me to the Home Office will be treated in confidence;
that it may be disclosed to other government departments, agencies, local authorities, the police,
foreign governments and other bodies for immigration purposes or to enable them to perform their
functions; and that, if such bodies provide the Home Office with any information about me which
may be relevant for immigration purposes, it may be used in reaching a decision on my application.
I understand that my details may in certain circumstances be passed to fraud prevention agencies
to prevent and detect fraud and money laundering. I also understand that such agencies may
provide the Home Office with information about me. Further details explaining when information
may be passed to or from fraud prevention agencies and how that information may be used can be
obtained from the Home Office website.
I understand that documents provided in support of this application will be checked for authenticity;
and that false documents will be retained and may result in my application being refused and in my
prosecution and subsequent removal from the United Kingdom.
I understand that the Home Office may also use the information provided by me for training
purposes.
I am aware that it is an offence under the Immigration Act 1971, as amended by the Immigration
and Asylum Act 1999 and the Nationality, Immigration and Asylum Act 2002, to make to a person
acting in execution of any of those Acts a statement or representation which I know to be false or
do not believe to be true, or to obtain or to seek to obtain leave to remain in the United Kingdom by
means which include deception.
I understand that if I am informing the Home Office that I have changed my gender, these details
may in certain circumstances be shared with other Home Office colleagues. I consent to this, where
necessary and understand that this information will only be shared in limited circumstances relating
to identity and security in line with Section 22 of the Gender Recognition Act. I am aware they will
otherwise be treated in confidence and that my rights under the Equality Act 2010, Data Protection
Act 1998 and Article 8 of the European Convention on Human Rights will be unaffected
Applicant’s signature
Parent/legal guardian’s signature (if
applicant is under 18)
Date (dd/mm/yyyy)
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FLR(DL) Application Form
Your Personal Checklist for Form FLR(DL) (Discretionary Leave – Extension Or
Settlement)
Please make the following checks before submitting your application. They should help to ensure
that it is complete.
• Are you sure that Form DL (Discretionary Leave – Extension or Settlement) is the right form
for your application? See Note 1 of the Guidance Notes.
• Do you have no more than 1 month until your current leave expires? See Note 1 of the
Guidance Notes.
• Have you completed all sections of the form correctly as instructed? See Note 4 of the
Guidance Notes.
• If you have used additional sheets of paper have you attached them?
• Have you sent us all of the following documents which you or your dependants hold, listed in
Section 7
i.
Current national passport(s)
ii.
Travel document(s)
iii.
Immigration Status Document(s) (ASL.2151, ASL.2152 or ASL.2150)
iv.
Relevant Birth or Marriage certificates
• Have you retained photocopies of all the original documents you will send with this
application?
• If you are unable at present to send us any of the documents or photographs listed in Section
7, have you given an explanation and said when you will be able to send them?
• Have you signed and dated the declaration in Section 9 of the form?
Finally, please make sure that the application is addressed appropriately as on page 1 of this
application form and in Note 5 of the Guidance Notes.
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FLR(DL) Application Form
Form FLR(DL) (Discretionary Leave - Extension or Settlement):
Guidance notes and other relevant information
These notes and other information are intended to help you make an application for a further period
of Discretionary Leave or settlement following the refusal of an asylum application in the United
Kingdom (UK) on Form FLR(DL) (Extension or Settlement).
1.
For which applications must you use Form FLR(DL) ?
This form is for anyone who, following refusal of asylum has been granted:
• Discretionary Leave or
• Less than four years Exceptional Leave;
and is now applying for a further period of Discretionary Leave or settlement, in accordance with the
published Home Office Asylum Instruction on Discretionary Leave.
This form must not be used by applicants applying for further leave on Article 3 medical grounds who
must use the FLR(O) form.
This form must not be used to apply for asylum or humanitarian protection. Advice on claiming
asylum/humanitarian protection can be found on the Home Office website.
Copies of the Asylum Instructions may be viewed on the Home Office website: https://www.gov.uk/
visas-immigration.
You have to be in the UK to make an application using this form. Please do not send in your
application more than 1 month before your current leave expires, or it is likely to be refused as you
will not have completed the required period of leave if you apply too early.
You can use this form to make your own application and an application on behalf of any dependants.
2.
Making sure that your application is complete
This is very important. The decision on your application is likely to be delayed if you do not provide all
the necessary information and documentation. To make sure that your application is complete, you
need to do the following:
• Answer all the questions and complete or tick any boxes that apply to you personally, as well
as to any dependants included in the application.
• Provide the documents and photographs needed in support of your application and those
of any dependants included in the form. [Documents must be originals. You should retain
photocopies of any original documents you submit with this application.]
• If you cannot provide a document or photograph at present, please explain the reason(s) and
tell us when you will be able to let us have the missing item.
• Ensure the correct payment has been made towards the Immigration Health Surcharge,
if applicable. You will need to assess the likely cost using the online portal www.gov.uk/
healthcare-immigration-application.
• Sign and date the declaration in Section 9.
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FLR(DL) Application Form
3.
Completing Form DL (Discretionary Leave – Extension or Settlement)
Please write in English in block letters and in black ink when completing the form. The notes below
are designed to help you complete each section.
Section 1 must be completed in full in all cases. If the application includes dependants, the details
of the main applicant must go in section 1. Details of the dependants should go in Section 4. If an
immigration adviser is assisting you with your application, the adviser’s address should be given at
1.9.
Section 2 - You must tell us which category you are applying for further leave in. You can only apply
for leave in certain categories using this form. You must read the Discretionary Leave guidance on
the Home Office website and provide a letter or other document explaining in detail why you are
applying including any exceptional compassionate circumstances that apply in your case.
Section 3 must be completed in full in all cases. The date needed in answer to the question at 3.1
is the date that the main applicant’s limited leave expires. There is no need to include information
which was submitted in connection with your asylum claim and/or any subsequent appeal and/or
any subsequent application for leave. If, after your application is made, your circumstances change
or you have new information which you would like to be considered, please submit this as soon as
possible (see Note 10).
Section 4 must be completed in full in all cases where you have family living with you in the United
Kingdom.
Dependants for the purpose of this application include;
• Any dependant included in your original grant of leave who was granted leave at the same
time that you were.
• Any child born to you in the UK who is not a British Citizen.
You can only include your children if they are under 18 years of age at the date of application unless
they were granted leave at the same time as you.
You cannot include the following as dependants:
• A spouse, civil partner, same sex partner or any other dependant who already has leave in the
UK in another category
• A spouse, civil partner, same sex partner or other dependant who is currently in the UK with no
valid leave.
Section 5 must be completed as indicated in all cases.
Section 6 must be completed in all cases.
Section 7 must be completed in all cases. If any dependants are included in the application, please
make sure that you provide their documents and photographs, and tick the relevant boxes.
You should send us two identical, recent passport-size photographs of yourself and of each of
your dependants applying on the same form. Write the name of that person on the back of each
photograph.
You should not pin, staple, glue or tape the photographs to your application form.
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FLR(DL) Application Form
See the UK Visas and Immigration Photographic guidance for more information, available on our
website: https://www.gov.uk/visas-immigration.
Section 8 must be completed in all cases. Where more than one applicant is included on the form,
the signature must be that of the main applicant.
Personal Checklist. This is a final reminder to help you make sure that you have done everything
correctly, including the address where you should send the application.
After completing the form, please make sure that you submit all pages up to and including Section 8.
Please keep the Personal Checklist at the end of the form.
Section 9 must be completed in all cases.
4.
Applying by post
Your completed application must be sent to the following address:
Home Office
FLR(DL)
PO Box 589
Durham
DH99 1AB
It is very important that you address the envelope exactly as above when using the FLR(DL) Form.
We recommend that you use Recorded Signed For or Special Delivery, as this helps us to record the
receipt of your application. Please make sure that you keep a record of the Recorded Signed For or
Special Delivery number.
5.
Obtaining another form
You can download application forms from the Home Office website: https://www.gov.uk/visasimmigration.
6.
Choosing an immigration adviser
This form is designed to let you to make your own application. If you need help in completing it or in
dealing with any other aspect of your application, you may wish to engage an immigration adviser.
However, you should take care when choosing one.
Office of the Immigration Services Commissioner (OISC)
Immigration advisers are regulated by the Office of the Immigration Services Commissioner (OISC).
Their website at www.oisc.gov.uk contains a list of authorised advisers. It also has links to websites
for solicitors, barristers and legal executives.
If you have a complaint about an immigration adviser or need other information, the OISC contact
details are:
Office of the Immigration Services Commissioner
5th Floor
21 Bloomsbury Street
London
WC1B 3HF
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FLR(DL) Application Form
Telephone: 0345 000 0046
7.
How long will it take to process your application?
Your application will be dealt with as quickly as possible. If you fail to submit all the necessary
documents with your application, there may be a delay in dealing with your application while we wait
for you to submit these documents.
If you submit your application out of time we may need to make further enquiries, and there may be a
delay in considering your application while these are made.
If your application needs to be referred to an asylum-trained caseworker, because a full review of
your status is necessary, the application process may take longer.
8.
How will your passport (s) and other documents be returned?
Your passport(s) and any other documents we return to you will be returned by Recorded Signed For
Delivery in all cases.
9.
Contacting us after you have applied
If you have to send us a document which you cannot provide when making your application, or if you
need to tell us anything else, including a change of address or circumstances, before you hear from
us, please use the following address:
Status Review Unit (FLR DL)
Complex Casework Directorate
UK Visas and Immigration
Department 152
PO Box 306
Liverpool
L2 0QN
Please make sure that you give the following details in your letter: the applicant’s full name (as
it appears on the application form), date of birth, nationality, the Recorded Signed For or Special
Delivery number (if you used such postage), the date on which the application was posted and
your Home Office reference if you have one. If you need your passport because you have to travel
urgently and unexpectedly, use the return of documents request form at
www.gov.uk/visa-documents-returned.
10.
Other application forms
Other application forms on which to apply for an extension of stay or indefinite leave to remain in the
UK can be downloaded from the Home Office website:
https://www.gov.uk/visas-immigration
This form and the accompanying guidance notes may be included or reproduced in any non-Home
Office website or publication. However, such inclusion or reproduction does not constitute an
endorsement of any services offered or provided by the owners of the website or publication, or of
the content of the website or publication.
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11.
Biometric Residence Permits
A leaflet explaining the Biometric Residence Permit including the application process is available to
download at the following location:
www.gov.uk/biometric-residence-permits
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