SECTION
GET IT RIGHT
The person acting as the countersignatory must sign section 10.
GET IT RIGHT
Please enclose two photos that meet the photo guidance.
On the back of only one photo, the countersignatory must write “I certify that this is a true likeness of...”giving the full name and title of the person named in section 2. The countersignatory must sign and date this endorsement.
GET IT RIGHT
Please use the boxes at Section 8 to tell us which country’s passport your countersignatory holds, and his or her email address.
GET IT RIGHT
To avoid unnecessary delays, please do not use a label or stamp on this form.
Countersignatory
Caution It is a criminal offence to make a false statement to help someone get a passport. Check the form properly before you fill in this section. If you have made any false statements on this form, or if you know that the person applying has made any false statements on this form, you could be prosecuted and could go to prison.
Our work includes checking that your details are genuine. As a result, we may need to contact you. You should not sign this form if you are a relative of the person applying.
IMPORTANT If the application is for a child, you are confirming the identity of the adult signing in section 9. You must also be able to identify the child in order to certify the photograph.
Fill in the following in CAPITAL LETTERS and black biro. (cross (X) box Mr, Mrs, Miss, Ms, or write your title)
Mr Mrs Miss Ms or title
First and middle names
Surname
I confirm that I have known the person named in section 2, or in the case of a child, the adult filling in section 9 (insert their name)
for (insert years) as (please say how - for example, employer, colleague, friend and so on). yrs
As far as I know, the information on this form is correct. I hold either a full current British, Irish, other EU, US or Commonwealth passport (delete as appropriate). I have read the caution and I understa nd it.
Profession, professional qualifications or position in the community
Your employer’s name and the address you work at (or your private address if this does not apply)
Postcode |
Mobile phone number |
Current passport number |
Alternative phone number |
|
Date |
DD/MM/YYYY |
|
|
|
|
|
Countersignatures will only be |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
valid if you: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
- Sign the white signature box |
|
|
|
|
|
By countersigning this application, you |
using black biro |
|
|
|
|
|
|
|
|
|
agree to us checking passport records |
- Keep within these |
|
marks |
|
|
|
|
|
|
|
to confirm your countersignature. |
- Put date in date box to the left |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|