20180515-Form NSV002 v1.1
20180515-Form NSV002 v1.1
20180515-Form NSV002 v1.1
Ensure you answer ALL the questions. You can use the abbreviation NA (Not Applicable)if a question does not
apply to you. Not Known - If you do not know the answer, or you cannot provide the information needed, write NOT KNOWN
in the first line only of the relevant question. Please provide an explanation why the information is unknown to you
in the appropriate boxes or on the continuation sheets (pages 105 to 107). Unanswered questions or Not Known
replies may cause delay to the processing of this questionnaire.
YOU MUST READ THE PRIVACY NOTICE ON PAGE 114 BEFORE COMPLETING THE FORM
Precedence (how urgent is the requirement for clearance?) Routine Priority Immediate
If you have requested Priority or Immediate clearance, please provide justification below :
I certify that this Priority/Immediate application is supported by a letter of justification, signed at the appropriate level
dd mm yyyy
If the employee requires this clearance to access classified information from NATO/EU/Other countries or international
organisations, please tick appropriate box. NATO EU Other (please specify)
(NATO, EU, and Other countries/international organisations clearances are only required if the employee has a specific
need to access classified information or sites belonging to these bodies.)
3. Your Details
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx) b. Gender: Male: Female: Other:
c. Full Forenames:
Failure to declare all forenames will result in your application for security clearance being delayed or cancelled. Please tick the
box to confirm that you have declared all forenames, including any middle names.
d. Surname (now):
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
k. Apart from the surname(s) you have already declared, have you ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames you have had and the reason for change.
m. Apart from the forename(s) you have already declared, have you ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames you have had and the reason for change.
c. Staff or Service Number (if you do not currently have one, please leave this field blank)
(For example, Civil Service staff number, HM Forces service number, Police collar/employee number)
If you do not have a UK NI number (either temporary or permanent) please provide a brief explanation:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
1. It is HM Government’s policy that all areas of government and the national infrastructure should include in their recruitment
processes certain basic checks. These checks include verification of the applicant’s identity, employment history, their right to work
in the UK and, if appropriate, checks of any unspent criminal records. Within government these controls are described in the
Baseline Personnel Security Standard. In addition, the Centre for the Protection of National Infrastructure (CPNI) produces a range
of relevant guidance on personnel security and makes similar advice available to the wider national infrastructure.
2. National security vetting comprises a range of additional checks and may be applied where a risk assessment indicates it is
proportionate to do so. The risk assessment process takes account of the access an individual may have to sensitive assets
(physical, personnel or information) at risk from a wide range of threats. These threats include: terrorism, espionage, or other
actions that could threaten the United Kingdom. The requirements of international agreements concerning the protection of allies’
information may also inform such assessments.
3. It is government policy that individuals should not be expected to hold an existing security clearance in order to apply for posts
that require vetting, except where such posts are short term and need to be filled urgently.
4. There are three different types of national security vetting clearance: Counter Terrorist Check (CTC), Security Check (SC) and
Developed Vetting (DV). Before any such clearance is undertaken the requirements of the Baseline Personnel Security Standard
must be met. Whilst the information required and the range and depth of checks undertaken at each level may vary, they are all
intended to allow Government departments and agencies, the Armed Forces and police forces to assess whether individuals who
are to be employed in sensitive posts or critical functions might represent a security risk either directly or indirectly.
CHECKS
5. Individuals subject to national security vetting (including UK nationals taking up sensitive posts in international organisations) will
be asked to provide via questionnaire personal information about themselves, partners, family members and other associates. It
may be checked, and retained for future checks, against:
7. Interviews with the vetting subject and referees may be carried out to establish good character and to verify information that has
been provided.
DECISION MAKING
8. National security vetting decisions may only be taken by Government departments, agencies, the Armed Forces or police forces.
All the available information is taken into account to reach a reasoned decision on an individual’s suitability to hold a security
clearance.
• There are security concerns related to an individual’s involvement or connection with activities, organisations or individuals
associated with the threats described in this Statement (or any similar new threats that emerge);
• Personal circumstances, current or past conduct indicate that an individual may be susceptible to pressure or improper influence;
• Instances of dishonesty or lack of integrity cast doubt upon an individual’s reliability;
• Other behaviours or circumstances indicate unreliability."
10. Wherever possible existing employees will have an opportunity to discuss, comment on and challenge any adverse information
that arises. However in certain circumstances it may not be possible to share such information as this could compromise national
security, the public interest or third party confidentiality.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
AVENUES OF APPEAL
11. Existing employees who are subject to national security vetting and either refused a security clearance or whose clearance is
withdrawn may appeal against such decisions. All departments and agencies that carry out national security vetting must provide
for an internal appeal process. Where individuals remain dissatisfied they may appeal to the Security Vetting Appeals Panel, an
independent body.
12. The Panel will consider the case, review the information and invite the appellant and the organisation to make representations.
The Panel will make recommendations to the Head of Department or organisation in the light of its findings as to whether the
decision should stand or be reviewed. The Panel may also comment on the security vetting procedures and adequacy of the
internal appeal arrangements.
13. There are no national security vetting appeal routes for applicants for employment who are refused a security clearance.
Separate arrangements exist for applicants, employees and contractors of the security and intelligence agencies, who may
complain to the Investigatory Powers Tribunal. Any individual may apply to an Employment Tribunal if they feel that they have been
discriminated against in any part of the recruitment process.
14. The national security vetting process provides an assessment of the vetting subject at the time the process is carried out but
active ongoing personnel security management is required to ensure that a security clearance maintains its currency. As a
minimum this will involve active consideration of the vetting subject’s continuing conduct in respect of security matters; it will also
require checks to be repeated at regular intervals.
Please note that any information provided will be treated in strict confidence. In cases where a potential risk is identified, and a
decision taken to 'manage the situation' rather than refuse security clearance, those tasked with managing that risk will need the
appropriate information in order to do this effectively.
You will now be asked to supply “personal” and “sensitive personal” data as defined byFXUUHQW'DWD3URWHFWLRQOHJLVODWLRQ
You will be supplying this data to the appropriate Vetting Authority (VA) where it will be processed exclusively for
the purpose of security vetting, in accordance with HM Government's vetting policy, save that, in the highly
unlikely event that data supplied by you discloses or suggests that:
then the vetting authority may pass on that information alone to the appropriate person(s). Subject to this, the
vetting authority will protect the information you provide and will ensure that it is not passed to anyone who is not
authorised to see it.
We handle all personal information that we have gathered during the vetting process in confidence. In a very
small number of cases, if we think we have found a serious risk to national security, we may discuss the case with
the relevant security authorities. In an even smaller number of risky cases, and only with your agreement, relevant
information may be shared with the personnel management authority of the organisation which will employ you/is
employing you, where this will help your employer to manage a particular risk that we have identified. If you are
worried about confidentiality, please contact your sponsor for advice.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
5. Your Nationality
In this section you are required to provide details of your current and any former Nationality.
If applicable you must provide full details of the date of naturalisation or when you took up residency in the UK. If
naturalised, please ensure that you provide details of your current and previous nationality.
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have you held this nationality? Since
mm yyyy
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do you currently hold, or have you ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that you currently hold or have previously held.
Nationality Current
Nationality Current
6. Your Citizenship
British Naturalisation
a. Are you British naturalised? Yes No
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not your birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If you are not a British Citizen, and you are currently living in the UK, please enter the date of taking up permanent
residence in the UK. (This is not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
7. Your Addresses
In this section you are asked to provide address details to cover the past 10 years. This should include:
You do not need to provide details of hotels etc. at which you may have spent a short period on holiday.
Please provide your current permanent home address first and work backwards.
Address 1:
UK Current
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Address 2:
UK Current
BFPO
No fixed abode
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Address 3:
UK Current
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Address 4:
UK Current
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
a. If we need to contact you, would you prefer to be contacted at: Home Work
We will try to meet your contact preference where possible but this cannot always be guaranteed.
b. Please provide your contact telephone numbers (in order of preference). If you are not providing a contact email
address, you must enter at least TWO separate telephone numbers.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Alternative contact number 2:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
b. Do you wish to be interviewed at a work address other than the one you have provided in Section 9? Yes No
Address Line 1:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Address Line 2:
Address Line 3:
Town:
dd mm yyyy
Where did it take place?
Town:
County/region:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
If your spouse or partner is deceased, where the form asks for current information please provide details as at the time of
their death.
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
h. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
j. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
If you have answered 'Yes', please give the date of adoption (if
the full date is not known, please give the year)
dd mm yyyy
p. Occupation:
q. Do you have any other information about this person that you feel may be relevant? Yes No
(for example, if they hold/held security clearance or are/were in Government employment)
In this section you are required to provide details of your partner’s nationality and any former nationality.
If applicable you must provide full details of the date of naturalisation or when they took up residency in the UK. If British
naturalised, please ensure that you provide details of all their nationalities including previous nationality.
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held.
Nationality Current
Nationality Current
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If they are not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not necessarily
the same as the date of the permission to stay in the UK)
dd mm yyyy
Please provide address details for this partner to cover the past 5 years. This should include:
You do not need to provide details of hotels etc. at which they may have spent a short period on holiday. Please provide
their current permanent home address first and work backwards.
Address 1:
UK Current
BFPO
No fixed abode
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Address 2:
UK Current
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
UK Current
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
If you have answered ‘Yes’, please provide details below. If this includes more than one partner during the last 3 years
please tick here and enter additional details on the continuation sheets in the same format.
If you do not know full details of this individual, and you are unable to obtain them, please tick here and give an
explanation:
If you answered ‘No’, please go to 13b. If you answered ‘Yes’, please answer the following questions:
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Town:
County/region:
Country:
dd mm yyyy
Court at which Decree Nisi
and Decree Absolute /
Conditional Order and Final
Order granted:
dd mm yyyy
Until what date were you cohabiting?
dd mm yyyy
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
e. Has their surname changed at any time since birth? Yes No
h. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
j. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
If you have answered 'Yes', please give the date of adoption (if
the full date is not known, please give the year)
dd mm yyyy
p. Occupation:
q. Do you have any other information about this person that you feel may be relevant? Yes No
(for example, if they hold/held security clearance or are/were in Government employment)
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Your Partner’s Nationality
In this section you are required to provide details of this partner’s nationality and any former nationality.
If applicable you must provide full details of the date of naturalisation or when they took up residency in the UK. If British
naturalised, please ensure that you provide details of all their nationalities including previous nationality.
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held.
Nationality Current
Nationality Current
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If they are not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not necessarily
the same as the date of the permission to stay in the UK)
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Your Partner’s Addresses
Please provide address details for this partner to cover the past 5 years. This should include:
You do not need to provide details of hotels etc. at which they may have spent a short period on holiday. Please provide
their current permanent home address first and work backwards.
Address 1:
UK Current
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Address 2:
UK Current
BFPO
No fixed abode
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Address 3:
Type of address: Current or previous? Date from: Date to:
UK Current
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
14. Marriages/civil partnerships more than 3 years ago
Have you had any other marriages or civil partnerships that ended MORE THAN 3 YEARS AGO? You need not enter details
of anyone you have already included on this form. Yes No
If you have answered ‘No’, please go to Section. If you have answered ‘Yes’, please answer the following questions. If you
had more than one spouse or partner prior to the last 3 years, please tick here and enter additional details on the
continuation sheets in the same format.
dd mm yyyy
Where did it take place?
Town:
County/region:
Country:
dd mm yyyy
Court at which Decree Nisi
and Decree Absolute /
Conditional Order and Final
Order granted:
Details of any other step parents, foster parents, adoptive parents, legal guardians, etc. are also required. Details of
natural father and natural mother must be provided, even if full details are not known.
If a parent is deceased, where the form asks for current information please provide details as at the time of their death.
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx):
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
dd mm yyyy
l. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
n. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Your natural father’s nationality
In this section you are required to provide details of this parent’s nationality and any former nationality. If applicable you
must provide full details of the date of naturalisation or when they took up residency in the UK. If British naturalised,
please ensure that you provide details of all their nationalities including previous nationality.
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held.
Nationality Current
Nationality Current
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If your father is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not
necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Your father’s address
Please provide your father’s current permanent address below.
UK
Overseas mm yyyy
BFPO
No fixed abode
Address Line 1:
Address Line 2:
Address Line 3:
Town:
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
g. Town of Birth: h. County / Region of Birth:
l. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
n. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Page 25
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held.
Nationality Current
Nationality Current
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If your mother is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not
necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
UK
Overseas mm yyyy
BFPO
No fixed abode
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Address Line 1:
Address Line 2:
Address Line 3:
Town:
If you have answered ‘No’, please go to Section 16. If you have answered ‘Yes’, please answer the following questions.
First Individual
a. Type of relationship:
If you do not know full details of this individual, please tick here and give an explanation:
dd mm yyyy
c. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
i. Town of Birth: j. County / Region of Birth:
n. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
p. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
Their nationality
In this section you are required to provide details of this parent’s nationality and any former nationality. If applicable you
must provide full details of the date of naturalisation or when they took up residency in the UK. If British naturalised,
please ensure that you provide details of all their nationalities including previous nationality.
British (including English, Scottish, Welsh and Northern Irish) Irish Other
Page 28
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
If you answered ‘no’, from what date have they held this nationality? Since
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held:
Nationality Current
Nationality Current
Their citizenship
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If this parent is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not
necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
Their address
Please provide this parent’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode
Please fill in the fields which are applicable:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Second Individual
a. Type of relationship:
If you do not know full details of this individual, please tick here and give an explanation:
c. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
n. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
p. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
Their nationality
In this section you are required to provide details of this parent’s nationality and any former nationality. If applicable you
must provide full details of the date of naturalisation or when they took up residency in the UK. If British naturalised,
please ensure that you provide details of all their nationalities including previous nationality.
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
Page 31
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held:
Nationality Current
Nationality Current
Their citizenship
British Naturalisation
a. Is this parent British naturalised? Yes No
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If this parent is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not
necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
Their Address
Please provide this parent’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Town: County (or Region/Area/State for overseas addresses):
Details of their natural father and natural mother must be provided, even if full details are not known. If their parents are
separated, and either parent is living with a new partner (or has done so within the last 3 years), details of their parent's
partners are required. Details of any other step parents, foster parents, adoptive parents, legal guardians, etc. are also
required.
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
dd mm yyyy
l. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
m. Have their forenames changed at any time since birth? Yes No
n. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held.
Nationality Current
Nationality Current
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If your partner’s father is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is
not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
UK
Overseas mm yyyy
BFPO
No fixed abode
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Page 35
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Details About Your Partner’s Natural Mother
If you do not know full details of your partner’s natural mother, please tick here and give an explanation:
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
dd mm yyyy
l. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
n. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
Page 36
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Your partner’s natural mother’s nationality
In this section you are required to provide details of this parent’s nationality and any former nationality. If applicable you
must provide full details of the date of naturalisation or when they took up residency in the UK. If British naturalised,
please ensure that you provide details of all their nationalities including previous nationality.
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held.
Nationality Current
Nationality Current
British Naturalisation
a. Is your partner’s mother British naturalised? Yes No
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If your partner’s mother is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This
is not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Your Partner’s Mother’s Address
Please provide your partner’s mother’s current permanent address below.
UK
Overseas mm yyyy
BFPO
No fixed abode
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
If you have answered ‘No’, please go to Section 17. If you have answered ‘Yes’, please answer the following questions.
First Individual
a. Type of relationship:
If you do not know full details of this individual, please tick here and give an explanation:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
c. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
dd mm yyyy
m. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
o. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
Page 39
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Their nationality
In this section you are required to provide details of this parent’s nationality and any former nationality. If applicable you
must provide full details of the date of naturalisation or when they took up residency in the UK. If British naturalised,
please ensure that you provide details of all their nationalities including previous nationality.
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held:
Nationality Current
Nationality Current
Their citizenship
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If this parent is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not
necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Their Address
Please provide this parent’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
Second Individual
a. Type of relationship:
If you do not know full details of this individual, please tick here and give an explanation:
c. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
dd mm yyyy
m. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
p. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
dd mm yyyy
Page 42
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Their nationality
In this section you are required to provide details of this parent’s nationality and any former nationality. If applicable you
must provide full details of the date of naturalisation or when they took up residency in the UK. If British naturalised,
please ensure that you provide details of all their nationalities including previous nationality.
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Is this: Nationality or citizenship
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held:
Nationality Current
Nationality Current
Their citizenship
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If this parent is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is not
necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
Page 43
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Their Address
Please provide this parent’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
If you do not know full details of this individual, please tick here and give an explanation:
Page 44
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
a. Full Forenames b. Surname (now)
k. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
Previous forename Reason for change of forename
dd mm yyyy
Page 45
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Their nationality
In this section you are required to provide details of this brother/sister’s nationality and any former nationality. If
applicable you must provide full details of the date of naturalisation or when they took up residency in the UK. If British
naturalised, please ensure that you provide details of all their nationalities including previous nationality.
a. Is their present nationality:
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held:
Nationality: Is/was Current or Date from: Date to:
this: previous?
Nationality Current
Nationality Current
Their citizenship
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If this brother/sister is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is
not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
Page 46
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Their address
Please provide this brother/sister’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
If you do not know full details of this individual, please tick here and give an explanation:
dd mm yyyy
Page 47
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
f. Town of Birth: g. County / Region of Birth:
k. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
Previous forename Reason for change of forename
dd mm yyyy
Their nationality
In this section you are required to provide details of this brother/sister’s nationality and any former nationality. If
applicable you must provide full details of the date of naturalisation or when they took up residency in the UK. If British
naturalised, please ensure that you provide details of all their nationalities including previous nationality.
a. Is their present nationality:
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
Page 48
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
(Nationality is the status of belonging to a particular nation, whether by birth or naturalisation. Citizenship is a particular type of
nationality. If you have citizenship in a country, you have the right to live there, work, vote, and pay taxes.)
c. Do they currently hold, or have they ever previously held, any other nationalities or citizenships? Yes No
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held:
Nationality 1: Is/was Current or Date from: Date to:
this: previous?
Nationality Current
Nationality Current
Their citizenship
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If this brother/sister is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is
not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
Their address
Please provide this brother/sister’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode
Please fill in the fields which are applicable:
Address Line 1:
Page 49
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Address Line 2:
Address Line 3:
If you do not know full details of this individual, please tick here and give an explanation:
dd mm yyyy
k. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
Page 50
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
l. Have their forenames changed at any time since birth? Yes No
m. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
Previous forename Reason for change of forename
dd mm yyyy
Their nationality
In this section you are required to provide details of this brother/sister’s nationality and any former nationality. If
applicable you must provide full details of the date of naturalisation or when they took up residency in the UK. If British
naturalised, please ensure that you provide details of all their nationalities including previous nationality.
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held:
Nationality: Is/was Current or Date from: Date to:
this: previous?
Nationality Current
Nationality Current
Page 51
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Their citizenship
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If this brother/sister is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is
not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
Their address
Please provide this brother/sister’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
Page 52
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
If you do not know full details of this individual, please tick here and give an explanation:
dd mm yyyy
f. Town of Birth: g. County / Region of Birth:
k. Apart from the surname(s) you have already declared, have they ever had any other surnames?
Yes No
If you have answered ‘Yes’, please add all other surnames they have had and the reason for change.
Previous surname Reason for change of surname
m. Apart from the forename(s) you have already declared, have they ever had any other forenames?
Yes No
If you have answered 'yes', please add all other forenames they have had and the reason for change.
Previous forename Reason for change of forename
dd mm yyyy
Page 53
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Their nationality
In this section you are required to provide details of this brother/sister’s nationality and any former nationality. If
applicable you must provide full details of the date of naturalisation or when they took up residency in the UK. If British
naturalised, please ensure that you provide details of all their nationalities including previous nationality.
a. Is their present nationality:
British (including English, Scottish, Welsh and Northern Irish) Irish Other
If you answered ‘no’, from what date have they held this nationality? Since
mm yyyy
If you answered ‘yes’, please enter any other nationalities/citizenships that they currently hold or have previously held:
Nationality 1: Is/was Current or Date from: Date to:
this: previous?
Nationality Current
Nationality Current
Their citizenship
British Naturalisation
If you answered ‘yes’, please provide the number and date of certificate. (Please note this is not their birth certificate number)
Number: Date:
dd mm yyyy
British Residency
b. If this brother/sister is not a British Citizen, please enter the date of taking up permanent residence in the UK. (This is
not necessarily the same as the date of the permission to stay in the UK)
dd mm yyyy
Page 54
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Their address
Please provide this brother/sister’s current permanent address below.
UK mm yyyy
Overseas
BFPO
No fixed abode
Please fill in the fields which are applicable:
Address Line 1:
Address Line 2:
Address Line 3:
First Co-resident
If you do not know full details of this individual, please tick here and give an explanation:
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
Page 55
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
b. Full Forenames: c. Surname:
c. Please provide either their age or date of birth (you only need to provide one).
:
Date of Birth: Age
dd mm yyyy
Present nationality: Occupation:
Second Co-resident
If you do not know full details of this individual, please tick here and give an explanation:
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
c. Please provide either their age or date of birth (you only need to provide one).
Date of Birth: Age:
dd mm yyyy
Present nationality: Occupation:
Third Co-resident
If you do not know full details of this individual, please tick here and give an explanation:
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
c. Please provide either their age or date of birth (you only need to provide one).
Date of Birth: Age:
dd mm yyyy
Fourth Co-resident
If you do not know full details of this individual, please tick here and give an explanation:
a. Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
c. Please provide either their age or date of birth (you only need to provide one).
Date of Birth: Age:
dd mm yyyy
Present nationality: Occupation:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
19. Current Employment/Current Service
What is your current employment status? You may select more than one employment. For example, if you have a civilian job
but are also a reservist.
Select all that apply.
Employed in HM Government Service, the Civil Nuclear Industry, Police Forces and the devolved administrations
Please complete Section 19/1
Serving in HM Forces – Regular Please complete Section 19/2
Serving in HM Forces – Reserves Please complete Section 19/2
In other full or part-time employment (excepting self-employment) Please complete Section 19/3
Self-employed Please complete Section 19/4
Unemployed Please complete Section 19/5
Please provide details (including current contact information where known) of all the immediate supervisors, both current
and previous, that you have had with this employer since you joined them or within the last 5 years, whichever is shorter.
Give your present supervisor first and work backwards. If you have had more than 4 supervisors, please use the
continuation pages
Current Supervisor
Forename(s) Surname: Date from:
mm yyyy
Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx):
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Forename(s) Surname: Tick here if details not fully known
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Current contact email address (if known): Telephone:
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Page 58
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Section, Unit, Branch or Establishment (if applicable):
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Please provide details (including current contact information where known) of all the immediate supervisors, both current
and previous, that you have had in each posting with HM Forces (Regular or Reserve) since you began serving with them
or within the last 5 years, whichever is shorter. This should be the person who directly supervises you and sees you most
frequently. It must be someone of Petty Officer/SNCO rank (or equivalent grade) or above.Give your present supervisor
first and work backwards. If you have had more than 4 supervisors, please use the continuation pages.
Current Supervisor
Forename(s) Surname: Date from:
mm yyyy
Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx):
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 59
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Previous Supervisor
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 60
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Previous Supervisor
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Please provide details (including current contact information where known) of all the immediate supervisors, both current
and previous, that you have had with this employer within the last 12 months. This should be the person who directly
supervises you and sees you most frequently. Give your present supervisor first and work backwards. If you have had
more than 4 supervisors, please use the continuation pages.
Page 61
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Current Supervisor
Forename(s) Surname: Date from:
mm yyyy
Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx):
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 62
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Previous Supervisor
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Previous Supervisor
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 63
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
19/4 Self-Employment
Date on which you established/
Name of company: joined the company: mm yyyy
Your company’s address:
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Forename(s) Surname:
How long have you worked with/for this individual? years months
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 64
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
19/5 Unemployment
Date from which this period of unemployment started
mm yyyy
Building Number:
Building Name:
Street:
District/Area:
Town:
County/Region: Postcode:
Country:
If you have answered ‘No’, please go to Section 21. If you have answered ‘Yes’, please answer the following questions.
Please give details of all previous employment / Service / unemployment in excess of 3 months during this period,
starting with the most recent first. Please use the continuation sheets if necessary.
mm yyyy mm yyyy
Please provide details (including current contact information where known) of each supervisor that you had within the
last 5 years of employment in this organisation. This should be the person who directly supervised you and saw you most
frequently. Details of anyone who supervised you more than 5 years ago are not required.
Page 65
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Supervisor 1
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Supervisor 2
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Page 66
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Supervisor 3
Forename(s) Surname: Tick here if details not fully known
Date from: Date to:
mm yyyy mm yyyy
Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx):
Address Line 1:
Address Line 2:
Address Line 3:
Country:
mm yyyy mm yyyy
Please provide details (including current contact information where known) of each supervisor that you had within the
last 5 years of this period of service. This should be the person who directly supervised you and saw you most frequently.
It must be someone of Petty Officer/SNCO rank (or equivalent grade) or above. Details of anyone who supervised you
more than 5 years ago are not required.
Supervisor 1
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Page 67
OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Address Line 2:
Address Line 3:
Country:
Supervisor 2
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Supervisor 3
Forename(s) Surname: Tick here if details not fully known
Date from: Date to:
mm yyyy mm yyyy
Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx):
Address Line 1:
Address Line 2:
Address Line 3:
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OFFICIAL SENSITIVE PERSONAL (when completed)
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Country:
mm yyyy mm yyyy
Name of employer:
Address Line 2:
Address Line 3:
Country:
Please provide details (including current contact information where known) of each supervisor you had during
employment in this organisation. This should be the person who directly supervised you and saw you most frequently.
Details of anyone who supervised you more than 5 years ago are not required.
Supervisor 1
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
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OFFICIAL SENSITIVE PERSONAL (when completed)
Supervisor 2
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
Supervisor 3
Forename(s) Surname: Tick here if details not fully known
Address Line 1:
Address Line 2:
Address Line 3:
Country:
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mm yyyy mm yyyy
Name of company:
Address Line 2:
Address Line 3:
Country:
Please provide details of someone in a position of authority who knew you well through your work while you were self-
employed. This could be a senior business partner in your company, or a senior representative of a customer by whom
you have been contracted to carry out work (for example, a Government official). Please enter the current information and
contact details for this individual.
Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx):
Forename(s) Surname:
How long did you work with/for this individual? years months
Address Line 1:
Address Line 2:
Address Line 3:
Country:
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mm yyyy mm yyyy
Building Number:
Building Name:
Street:
District/Area:
Town:
County/Region: Postcode:
Country:
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OFFICIAL SENSITIVE PERSONAL (when completed)
Deliberately blank
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OFFICIAL SENSITIVE PERSONAL (when completed)
21. Full Time Education
Have you received full time education during the last 5 years ? Yes No
If you answered ‘No’, please go to Section 22. If you answered ‘Yes’, please answer the following questions:
Name of School/College/University:
mm yyyy
mm yyyy
Please provide details for the Head, Principal or Tutor who knew you best:
Title (Mr/Mrs/Ms/Miss/Dr/Prof/Rev/Mx)
Official address:
Address Line 1:
Address Line 2:
Address Line 3:
Country
Consent Statement
I acknowledge that the vetting authority may ask schools/colleges/universities that I have attended full time in the last 5
years to provide them with my personal data. I understand that they will approach the Head/Principal/member of staff
whom I have identified as having known me best and request them to give an assessment of my character and behaviour
while I was under their supervision. This information will be used solely for the purpose of national security vetting and
will not be disclosed by the vetting authority to anyone who is not authorised to see it. I consent to the academic
institution producing such an assessment for the vetting authority and providing my personal data to them.
Signature Date:
dd mm yyyy
Your full name:
dd mm yyyy
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22. Internet Use
Most people use the internet and social media regularly and routinely for all sorts of reasons, including: recreation, shopping,
education, professional and personal development, and communicating with family, friends and sometimes much wider
communities of interest. The vetting process therefore needs to take proper and appropriate account of online activities to be
assured that:
• There are no implications for an individual’s personal security, i.e. they are not putting themselves or HMG at risk.
• Individuals comply with HMG’s acceptable use policies in respect of social media and online activity generally.
• Individuals are not markedly different in terms of their online personas from how they and their vetting referees would otherwise
describe themselves.
This section seeks some information about your use of the internet and social media for discussion with your Vetting Officer. As
part of your vetting a Vetting Officer may contact you to request a record of your social media activity or other social media usage
and will potentially conduct a search of open source information and images of you on the internet.
c. How many hours do you spend online in an average week or month? (Please only answer one. Choose whichever
period will give a more meaningful answer.)
Per week Hours or Per Month Hours
d. Where do you most commonly access the internet? Select all that apply.
At home At work While out, using Wi-Fi While out, using mobile data
e. Thinking about the sites you access/activities you undertake, which 3 or 4 websites or apps would you say you spend
the greatest time on?
f. Which Internet Service Providers (ISP's) do you use? Please include home and mobile providers. We are aware that you will
not know details of all public Wi-Fi but please provide your standard default providers as used at home and by your phone.
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OFFICIAL SENSITIVE PERSONAL (when completed)
j. Noting that most websites require you to provide some personal details to access their site/services, do you ever
choose not to access a site because of this requirement? Yes No
If you have answered ‘Yes’, what makes this decision for you?
k. When you do enter personal details on a website, do you enter full and accurate personal details and/or contact
information? (For example,when logging into public Wi-Fi or registering on a social networking account.This does not apply to
online shopping or banking, where accurate details must be supplied by default.) Yes No
If you have answered ‘No’, please explain your reasoning.
l. What devices do you use to access the internet? Select all that apply.
PC (Personal Computer) Tablet Phone Other Please specify:
m. Have you created fake profiles, used aliases, handles or monikers associated with your on-line activity, including for
social media and gaming accounts/profiles? Yes No
If you have answered ‘Yes’, please provide details.
n. Do you access, or have you accessed the Deep Web (parts of the web that are not accessible via normal search
engines) or utilised The Onion Router (TOR)? Yes No
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Types of Internet Activity/Services
Please include those accessed through an App on Mobile or Tablet or any other device.
a. Gambling sites:
Daily Frequently (once a week or more) Occasionally (less than once a week)
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
c. Chat rooms:
Daily Frequently (once a week or more) Occasionally (less than once a week)
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
d. Online dating:
Daily Frequently (once a week or more) Occasionally (less than once a week)
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
e. Blogs (personal):
Daily Frequently (once a week or more) Occasionally (less than once a week)
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
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f. On-line gaming, particularly Role Playing Games (RPG) or multi-player online games:
Daily Frequently (once a week or more) Occasionally (less than once a week)
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
g. Pornography:
Daily Frequently (once a week or more) Occasionally (less than once a week)
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
Rarely (less than once a month) Historically (More than 2 years ago) Never
If your answer is anything other than ‘never’, please provide details of the most commonly accessed sites (URLs) or apps
used:
If ‘Yes’:
Daily Frequently (once a week or more) Occasionally (less than once a week)
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If ‘Yes’, please provide an explanation. Is this exclusively to speak to others about the game or do you use these for wider
conversations/socialising?
k. Do you conduct any online transactions using Digital or virtual currencies (for example Bitcoin)? Yes No
If ‘Yes’, why do you use this payment method?
b. Do you have any detailed or specific personal information associated with any social media accounts? For example,
address, contact details, bank details etc. Yes No
If ‘Yes’, do you regularly review your security and privacy settings? Yes No
c. Have you ever disclosed the nature of your work or your security clearance via social media, instant messaging or
other internet chat functions? Yes No
If ‘Yes’, please provide details.
d. Do you use any business networking sites or are you registered with any recruitment agencies? (For example, LinkedIn,
Monster etc.) Yes No
If ‘Yes’:
• Does either your professional profile or on-line CV contain any references to Government departments or
working for Government? Yes No
e. Has your opinion on a political or work issue ever been influenced or altered by someone you have met online?
Yes No
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OFFICIAL SENSITIVE PERSONAL (when completed)
f. Have you ever misrepresented personal details about yourself when communicating with an individual or group online?
For example, your name, age, gender, interests, beliefs etc. Yes No
g. Have you ever been barred from a site or forum, had access to a site removed or been asked by administrators to
withdraw comments or posts? Yes No
h. Have you ever knowingly 'liked', tweeted or in other ways linked with an individual or organisation that could be
considered extremist? For example, terrorist groups, violent political activists or movements etc. Yes No
If ‘yes’, please provide details.
i. Have you ever posted, been identified in or shared any imagery that could be considered obscene or that indicates
involvement in an illegal activity or with any extremist group or individuals, or have you used a webcam to create such
imagery? Yes No
k. Have you ever discussed work or work-related topics online (other than in an official capacity)? (Including over
Skype/Facetime etc., blog posts, comments pages on news websites, etc). Yes No
l. Have you ever shared (including through file sharing sites) information that is illegal or has been obtained illegally?
Yes No If ‘yes’, have you ever done so for profit? Yes No
Security Awareness
a. Do you use public Wi-Fi or Wi-Fi hotspots to access the internet? Yes No
If ‘Yes’, have you exchanged or used bank details or personal information while connected to unsecured Wi-Fi?
Yes No
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b. For each personal device that you use to access the internet, please state:
Type of Device What security measures do you use? Is anti-virus Please specify what software you use
(e.g. phone, (For example, pin lock or passwords on software installed?
tablet, PC) mobile devices)
Yes No
Yes No
Yes No
Yes No
c. Do you have unique passwords for each account or website you access? Yes No
Use a different password every time Use a variation of the same data or information each time
Alternate between a selection of the same passwords Use the same password every time Other
f. Have you concealed your IP address when online or taken steps to reduce the traceability of your IP address and/or
location? Yes No
g. Is there any other information that you wish to provide that will allow us better to understand your internet profile and
activities? Yes No
Between them, referees should cover each specific area in which you have lived during this period. Therefore additional
referees should be named if you have moved frequently during the last 10 years. It is not sufficient to nominate someone
you know officially or professionally, such as a doctor, unless you know them socially as well. Similarly, staff members of
a school, college or university should not be chosen unless they are close personal friends. Referees should include a
person (not a partner), who knows you well in your home environment and ideally someone (other than a supervisor or
employer) who knows you well in the work environment.
YOU SHOULD TELL YOUR REFEREES THAT YOU WISH TO PUT THEIR NAMES FORWARD.
Please ensure that the contact details you provide for your referees are up to date.
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OFFICIAL SENSITIVE PERSONAL (when completed)
First Character Referee
a. Title b. Forename(s) c. Surname
g. Please provide at least one contact telephone number for this referee:
h. Address:
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 1:
Address Line 2:
Address Line 3:
j. How long have you known the Referee (years)? k. When did you last see the Referee?
Month Year
l. Please specify contact methods. Select all that apply.
Once a week Once a month Once a year
Face to face:
Email/letter:
Telephone:
Social networking:
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OFFICIAL SENSITIVE PERSONAL (when completed)
Second Character Referee
g Please provide at least one contact telephone number for this referee:
Preferred contact number: Alternative contact number:
h. Address:
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 1:
Address Line 2:
Address Line 3:
j. How long have you known the Referee (years)? k. When did you last see the Referee?
Month Year
l. Please specify contact methods. Select all that apply.
Once a week Once a month Once a year
Face to face:
Email/letter:
Telephone:
Social networking:
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OFFICIAL SENSITIVE PERSONAL (when completed)
f. Please provide at least one contact telephone number for this referee:
Preferred contact number: Alternative contact number:
h. Address:
Address Line 1:
Address Line 2:
Address Line 3:
Address Line 1:
Address Line 2:
Address Line 3:
j. How long have you known the Referee (years)? k. When did you last see the Referee?
Month Year
l. Please specify contact methods. Select all that apply.
Once a week Once a month Once a year
Face to face:
Email/letter:
Telephone:
Social networking:
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OFFICIAL SENSITIVE PERSONAL (when completed)
24. Health Declaration
Please read the following BEFORE answering the questions below and overleaf about your health.
In some cases it may be necessary to consult your doctor and you may be asked to attend a medical examination. Any
enquiries will be conducted by the vetting authority's medical adviser, an approved Occupational Health Organisation
(OHO) or Medical Officer (MO), such as BMI Health Services, or approved Medical officer (MO). Where appropriate, referral
may also be made to a psychologist or psychiatrist. We have used the term "medical adviser" to denote all of these. In all
but the most exceptional circumstances, these reports will not be made available to Departmental Security Officers,
Personnel Officers or to line management. Exceptionally, a medical report may need to be seen by an appropriate senior
person in your vetting authority in order to help reach a proper assessment of your suitability to hold a security
clearance. This may or may not include access to your full medical records. In such cases, you will be asked to give your
consent for this to be done.
By signing the declaration, you will be giving your consent, under the terms of the Access to Medical Reports Act 1988,
for the medical adviser to obtain a medical report from your doctor or other specialist, if this is considered necessary.
Under the terms of the Act, you have the right to withhold your consent at any stage in the process but you should be
aware that this could mean it is not possible to grant or renew your security clearance.
Once you have given your consent, you have the right to see the medical report before it is supplied to the medical
adviser. The medical adviser will provide you with a copy of the letter that they send to your doctor or specialist asking
them to provide a report. You will have 21 days from the date of that letter in which to ask your doctor/specialist to let you
see the report before they send it to the medical adviser. Your doctor or other specialist will tell you if you cannot see any
part of the report for professional medical reasons. If you are given access to your report, it will not be forwarded to the
medical adviser until you give your consent.
If you think any information in the medical report is incorrect or misleading, you can ask in writing for it to be amended.
You should note that if your doctor or other specialist does not accept the information as incorrect or misleading, they do
not have to make any amendment. They will however invite you to prepare a written statement on the disputed
information, which will be attached to the medical report when it is sent to the medical adviser. Subject to the provisions
of the Act, you have a right to see the medical report for up to six months after it has been sent to the medical adviser. If
your doctor or other specialist gives you a copy of the medical report at your request, they may charge you a reasonable
fee to cover the cost of supplying it.
• If you have answered 'No' to all the above questions, go to Section 25. You need not sign the next page.
• If you have answered 'Yes' to Question 24a only, please give details of your medication below, then go to
Question 25. You need not sign the next page.
• If you have answered 'Yes' to Question 24b, c, d or e, please give full details on the next page of your GP and, if
appropriate, any other medical professionals involved in your treatment. Please sign and date the next page
where indicated.
Details:
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OFFICIAL SENSITIVE PERSONAL (when completed)
GP Details
f. Your Surname:
g. Your Forename(s):
j. Surgery Name:
Address Line 1:
Address Line 2:
Town:
County/Region: Postcode:
Country:
Medical Professionals
If you have a hospital specialist or any other medical professional (e.g. occupational health) who is treating/assisting you
to manage the health matter that you have declared, please give their details below. If necessary, please use the
continuation pages to enter details of further specialists/professionals.
Address Line 1:
Address Line 2:
Town:
County/Region: Postcode:
Country:
Signed: Date:
I wish to exercise my right to see the medical report before it is sent to the vetting authority's medical adviser.
Yes No
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OFFICIAL SENSITIVE PERSONAL (when completed)
25. Criminal Convictions & Related Matters
In line with HM Government's policy on vetting, you must declare any matter which may be relevant. This includes any
criminal convictions which you may have, including those which are 'spent'. You must declare convictions issued by a Scottish
court even if you know that they have been weeded from the Criminal History System in accordance with Police Scotland’s rules on
the retention of information.
You must reveal all convictions, whether or not spent, under the legislation.
In line with the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975, the Rehabilitation of Offenders (Exclusions and
Exceptions)(Scotland) Order 2003 and the Rehabilitation of Offenders (Exceptions) Order (Northern Ireland) 1979, spent
convictions may also be taken into account where protecting public safety or public order is involved.
The relevant department or agency will decide if a criminal conviction affects your security clearance. Although it may be taken into
account, this information will not necessarily prevent you from being awarded a security clearance.
Please answer the three questions on the next page and sign and date the section. You have the option to detach the Criminal
Declaration (Pages 8 and 8) should you wish the Vetting Authorities alone to see your response on these matters. You should
remove the section and place in an envelope, then seal the envelope, sign your name across the flap and attach it to the front of
the questionnaire before sending to your sponsor.
Failure to disclose relevant circumstances or information is likely in itself to be regarded as evidence of unreliability and
will be taken into account when assessing your suitability for security clearance.
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OFFICIAL SENSITIVE PERSONAL (when completed)
You are reminded that your answers will be checked against national criminal records.
a. Have you ever been convicted or found guilty by a Court (including juvenile courts) of ANY offence in ANY country,
excluding parking and speeding convictions but including all other motoring offences even where a spot fine has been
administered by the police? Yes No
If you have answered ‘Yes’, please give full details (including dates):
b. Have you ever been on probation, or received any type of police caution, or been absolutely/conditionally discharged,
or had a fixed penalty notice or penalty notice for disorder issued to you, or accepted a fiscal fine from the Procurator
Fiscal in Scotland, or been bound over after being charged with any offence, or is there any action pending against you?
Yes No
If you have answered ‘Yes’, please give full details (including dates):
c. Have you ever been convicted by a Court Martial, or sentenced to detention or dismissal or fined while serving in the
armed forces of the UK or any Commonwealth or foreign country?
Yes No
If you have answered ‘Yes’, please give full details (including dates):
Please take the time to review all the answers you have given for the criminal convictions & related matters section before
you continue.
I confirm that I have reviewed all the answers I have given for the criminal convictions & related matters section and they
are correct
Please enter your full name and sign and date below.
Surname:
Full forenames:
Signed: Date:
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OFFICIAL SENSITIVE PERSONAL (when completed)
26. Security Information
You are reminded that your answers will be checked against national security records. Failure to make a full declaration
may result in your being denied clearance.
a. Have you ever been involved in Espionage? Yes No
If you have answered ‘Yes’ to any of the above questions, please provide full details (including dates).
a. Do you currently have, or have you ever had, significant financial difficulties? Yes No
If you have answered ‘Yes’, please provide full details, including dates.
b. Are you now, or have you ever been, involved in conduct liable to lead to susceptibility Yes No
to pressure or improper influence?
If you have answered ‘Yes’, please provide full details, including dates.
c. Are you aware of any other circumstances or characteristics not covered by your previous Yes No
answers which might affect your suitability for access to sensitive information or assets?
If you have answered ‘Yes’, please provide full details, including dates.
d. Is there any other information that you wish to provide in support of your clearance Yes No
application?
Please provide full details, including dates (if applicable).
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OFFICIAL SENSITIVE PERSONAL (when completed)
28. Previous Security Clearances
a. Have you completed any previous government security questionnaires, Yes No
or held a security clearance before?
If you have answered ‘Yes’, please provide details of the most recent government security questionnaire completed or
most recent security clearance held:
b. What level of clearance was it? DV SC CTC Not known
d. Vetting Provider (if known - for example, DBS NSV, FCOS etc. ):
e. Date completed:
Month Year
f. Have you ever had a security clearance withdrawn, suspended or refused? Yes No
If you successfully appealed your case then you do not need to answer Yes to this question.
If you have answered ‘Yes’:
Month Year
Financial Information
29. General Circumstances
In the following questions you are being asked to provide a clear, complete and accurate picture of your current and
recent financial situation. This must reflect the situation of anyone who shares financial responsibility with you.
Independent Credit Reference Checks and investigations into your financial circumstances will be carried out.
b. If you have answered ‘Yes’, Does the person you live with share financial Yes No
responsibility with you or make a contribution to your financial situation?
If you have answered ‘Yes’, it will be necessary to explore the impact of this person's contribution on your financial
situation. Please include the requested information in the relevant sections of this form.
c. For whom do you have a financial responsibility, other than yourself? (For example, partner, children, parent etc).
d. What major financial changes to your budget do you anticipate in the next 12 months?
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e. Have you been the victim of 'identity theft' or credit card fraud? Yes No
If you have answered ‘Yes’, please provide details.
Monthly maintenance £ £
received
Has all income been declared for tax purposes? (For example, rental income etc.) Yes No
If a fuller explanation of your income would be helpful to us, please provide details here:
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OFFICIAL SENSITIVE PERSONAL (when completed)
Council tax £
Housekeeping £
For example, food and household necessities
Motoring costs (including tax, insurance, petrol & £
maintenance) / commuting and travel costs
Loan repayments £
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OFFICIAL SENSITIVE PERSONAL (when completed)
32. Financial Circumstances – Properties Owned
a. How many properties do you own, or partly own, in the UK and/or overseas?
This includes those with mortgages outstanding, buy-to-let properties and timeshares.
b. Please provide details of all the properties you own, or partly own. Use the continuation page to add extra properties.
First Property
Address:
Flat number: House number: House
name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Country:
Month Year
Interest only
Flexible Month Year
Buy to let
Other
Mortgage 2
Type of mortgage Mortgage lender Date taken out Term Initial Balance
(months) amount (£) outstanding (£)
Repayment
Interest only
Flexible Month Year
Buy to let
Other
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OFFICIAL SENSITIVE PERSONAL (when completed)
Mortgage 3
Type of mortgage Mortgage lender Date taken out Term Initial Balance
(months) amount (£) outstanding (£)
Repayment
Interest only
Flexible
Month Year
Buy to let
Other
Does this property have any secured loans (other than mortgages) on it? Yes No
If there are any loans secured on the property, please provide details of each loan:
Month Year
Second loan:
Month Year
Third loan:
Month Year
Second Property
Address:
Flat number: House number: House
name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Country:
Month Year
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OFFICIAL SENSITIVE PERSONAL (when completed)
If the property is mortgaged:
How many mortgages do you have on it?
Flexible
Month Year
Buy to let
Other
Mortgage 2
Type of mortgage Mortgage lender Date taken out Term Initial Balance
(months) amount (£) outstanding (£)
Repayment
Interest only
Mortgage 3
Type of mortgage Mortgage lender Date taken out Term Initial Balance
(months) amount (£) outstanding (£)
Repayment
Interest only
Flexible
Month Year
Buy to let
Other
Does this property have any secured loans (other than mortgages) on it? Yes No
If there are any loans secured on the property, please provide details of each loan:
Month Year
Second loan:
Month Year
Third loan:
Month Year
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OFFICIAL SENSITIVE PERSONAL (when completed)
Third Property
Address:
Flat number: House number: House
name:
Address Line 1:
Address Line 2:
Address Line 3:
Town:
Country:
Month Year
Other
Mortgage 2
Type of mortgage Mortgage lender Date taken out Term Initial Balance
(months) amount (£) outstanding (£)
Repayment
Interest only
Buy to let
Other
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OFFICIAL SENSITIVE PERSONAL (when completed)
Mortgage 3
Type of mortgage Mortgage lender Date taken out Term Initial Balance
(months) amount (£) outstanding (£)
Repayment
Interest only
Other
Does this property have any secured loans (other than mortgages) on it? Yes No
If there are any loans secured on the property, please provide details of each loan:
Month Year
Second loan:
Month Year
Third loan:
Month Year
g. Have you ever taken a further mortgage advance(s) for any purpose? Yes No
If ‘Yes’, please provide details:
h. Have you ever adjusted the payment terms of your mortgages? Yes No
(For example, payment holiday)
If ‘Yes’, please provide details:
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OFFICIAL SENSITIVE PERSONAL (when completed)
33. Financial Circumstances – Savings and Other Assets
a. Do you (and your partner) have finances in savings accounts, ISAs, bonds, premium bonds, invested in shares, funds
etc? Yes No
If ‘Yes’, how much? £
If ‘No’, please provide a brief explanation as to why you do not have any savings or investments:
e. Have you ever received a lump sum worth more than £5,000? Yes No
First loan:
dd mm yyyy dd mm yyyy
Second loan:
dd mm yyyy dd mm yyyy
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Third loan:
dd mm yyyy dd mm yyyy
1. Credit card
Store card
Charge card
2. Credit card
Store card
Charge card
3. Credit card
Store card
Charge card
4. Credit card
Store card
Charge card
b. Do you transfer balances between credit cards? (For example, 0% interest deals) Yes No
c. Total of Average Monthly Payments (including any listed on the continuation page): £
d. Total of card balances outstanding (including any listed on the continuation page): £
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
36. Financial Circumstances – Current Accounts: Overdrafts
a. In the last 5 years, how many times have you exceeded your overdraft limit(s)?
b. How many current accounts do you have which were overdrawn in the previous month?
Where applicable, please provide details of all overdrawn current accounts in the previous month. If necessary, please
use the continuation page.
1.
2.
3.
TOTAL OF LIABILITIES
Please add up:
If you have answered ‘No’, please go to Section 38. If you have answered ‘Yes’:
c. What other costs are you liable for (e.g. service charge, agent's fees, etc.)?
d. Do you share rent and utility costs with other tenants? Yes No
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
38. Financial Circumstances – Financial Obligations
a. Do you have any form of financial obligation in excess of Yes No
£1,000 that has not been disclosed elsewhere on this form?
b. Have you ever lent or given anyone (including family members) more than £1,000? Yes No
c. If you stated at Section 29b that you share financial responsibility with another Yes No
person, do they (to your knowledge) have debts in their sole name in excess of £5,000?
If you have answered ‘Yes’, please provide details:
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
vii. Consulted a debt management company or advisory service? Yes No
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
If ‘Yes’: Number of times: Most recent year: Please provide details on the continuation pages
v. Do you have any financial interests that may conflict with your duties as a Civil Servant, member of HM Forces, or as a
Government contractor? (For example, your partner runs a company which tenders for contracts that you are
responsible for placing etc.) Yes No
vi. Are there any details or explanations that would help us to understand Yes No
your financial position better?
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OFFICIAL SENSITIVE PERSONAL (when completed)
40. Financial Circumstances – Self-Employed Contractors: Additional
Information
If you have answered ‘No’, please go to the final declaration. If you have answered ‘Yes’, please answer the following
questions:
b. Are you being employed through an agency for the contracted work? Yes No
c. Are you self-employed and submit invoices in your personal/trading name? Yes No
d. Are your invoices submitted by a company, of which you are the Yes No
primary director or shareholder?
If you have answered ‘No’, please go to the final declaration. If you have answered ‘Yes’, please answer the remaining
questions in Section 40.
Accounting date:
Month Year
g. Are payments of VAT, tax and social security paid up to date, by their due date? Yes No
If you have answered ‘No’, please provide details:
h. Has a late filing penalty been imposed on the company at any time? Yes No
If you have answered ‘Yes’, please provide details:
i. Have the directors been fined for non-filing of documents at any time? Yes No
If you have answered ‘Yes’, please provide details:
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OFFICIAL SENSITIVE PERSONAL (when completed)
j. Has the company been subject to a county court judgement? Yes No
If you have answered ‘Yes’, please provide details:
k. Have you ever been involved with a company that has undertaken Yes No
a voluntary liquidation or creditors' winding up?
If you have answered ‘Yes’, please provide details:
l. Have you ever been disqualified from being a company director? Yes No
If you have answered ‘Yes’, please provide details:
n. Please provide details of your personal (& partner's) income from the company, including the amount of any dividends
received and frequency of payments, for the previous and current accounting periods.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Continuation of Answers
IMPORTANT: When providing additional information please write the Question Number against each answer and provide
all the information requested in the original question.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Continuation of Answers
IMPORTANT: When providing additional information please write the Question Number against each answer and provide
all the information requested in the original question.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Continuation of Answers
IMPORTANT: When providing additional information please write the Question Number against each answer and provide
all the information requested in the original question.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Declaration
I declare that I have read and understood the statement of HM Government's vetting policy accompanying this
questionnaire.
I understand that in accordance with this policy the personal information I have provided on this form about myself, my
partner (if applicable) and my family will be submitted for checking against national criminal and security records.
I understand a check against credit reference agency records and investigations into my financial circumstances will also
be carried out. I understand, too, that the information provided may be subject to ongoing checks where they are
necessary and proportionate.
I declare that the information I have given is true and complete to the best of my knowledge and belief, and I understand
that any false statement or deliberate omission in the information I have given in this questionnaire may disqualify me
from employment (including employment in connection with Crown contracts if applicable) or make me liable to
disciplinary action, which may include dismissal.
I undertake to notify any material changes in the information I have given (e.g. change of partner, address or financial
circumstances), including any future criminal convictions, to the Personnel or Security branch concerned.
Important: Data Protection legislation. This questionnaire asks you to supply "personal" and "sensitive personal" data as
defined by current Data Protection legislation. You will be supplying this data to the appropriate vetting authority where it
will be processed exclusively for the purpose of security vetting, in accordance with HM Government's vetting policy, save that,
in the highly unlikely event that data supplied by you discloses or suggests that:
then the vetting authority may pass on that information alone to the appropriate person(s). Subject to this, the vetting
authority will protect the information you provide and will ensure that it is not passed to anyone who is not authorised to
see it.
By signing the declaration on this page, you are agreeing that you understand that the data you provide in
this questionnaire will be processed in the manner described above.
If you have any concerns about any of the questions we ask, or what we will do with the information you provide, which
are not answered by the guidance notes please contact the person who issued this form for further information.
Note: Please review the form BEFORE SIGNING to ensure that all questions have been fully answered. Please check that
you have signed the Criminal Convictions Declaration on page 88 and (if you answered 'yes' to any question from 24b to
24e inclusive) the Health Declaration on page 86.
When completed, this application form must be returned to your Sponsor. Contractors, please note at page 87/88 that you
may detach and place in a sealed envelope the Criminal Convictions & Related Matters page before returning the form to
the Sponsor.
You are not compelled to undergo national security vetting and you can withdraw from the process at any
time. However, this is likely to mean that you can no longer be employed in the post for which you needed to
be cleared. If you do decide to withdraw, after submitting this form, you must inform your Sponsor
immediately.
Signed: Date:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Developed Vetting (DV) Questionnaire – Sponsor’s Section
To be completed by all Sponsors (Including HM Forces, Government Agencies and Firms)
Please ensure you have completed Section 2 (Security Clearance Required) on page 1, before submitting this request.
Please ensure you only write inside the fields provided. Do not mark or strike through any other areas of the form. If
completing by hand please write in BLACK INK using BLOCK LETTERS. If an answer will not fit in the space provided,
please enter your answer on the continuation sheets (pages 105 to 107). If you make a mistake, please do not correct it
but delete it by striking it through. Please do not use correcting fluid.
Ensure you answer ALL the questions. You can use the abbreviation NA (Not Applicable). NA - If a question does not
apply to you,write NA in the first two boxes only of the relevant question. Not Known - If you do not know the answer, or
you cannot provide the information needed, write NOT KNOWN in the first line only of the relevant question. Please
provide an explanation why the information is unknown to you in the appropriate boxes or on the continuation sheets
(pages 105 to 107). Unanswered questions or Not Known replies may cause delay to the processing of this questionnaire.
Please specify the following employment details for the post which DV clearance is required:
Employment Type: (If the applicant has more than one employment type (for example if they are a civil servant but also a military
reservist), please select the employment type for which you are applying for clearance.)
Contractor Other
Please provide the job title and establishment/location of the post for which the applicant requires this clearance.
Applicant's job title: Establishment location:
Is the applicant an existing employee who has been employed for more than three years? Yes No
Is the post for which clearance is required Reserved or Non-Reserved? Reserved Non-Reserved
Is the vetting subject (a) an employee of, (b) applying for employment with or (c) closely associated with the vetting
service provider? (For example, closely associated may mean they have a relative who works in the organisation that will be
carrying out the vetting etc.) Yes No
Does the vetting subject (a) make security clearance decisions on behalf of your organisation or (b) provide direct
support to the decision maker? Yes No
Checks Completed
I certify that the following checks have been completed:
• Full Baseline Personnel Security Standard (BPSS), comprising verification of the applicant’s (i) Identity, (ii)
Employment/academic history for (as a minimum) the past 12 months, (iii) Nationality/immigration status
(including right to work in the UK), (iv) Criminal record check Yes No
Where the full BPSS has not yet been completed, have the applicant’s identity Yes No
and immigration status been verified?
As the first stage in completing BPSS, it is mandatory to verify identity and immigration status for all new recruits before an
application can be submitted.
• EITHER a Departmental Record Check OR a Company Record Check Yes No
This entails a check of all available records held for the applicant. If the applicant is a new recruit, this includes any
documentation provided as part of the recruitment process.
A Departmental Record Check is carried out when the applicant's employment type is RN, Army, RAF, MOD Civilian,
Other Civil Servant or Police/Civilian Staff.
A Company Record Check is carried out when the applicant's employment type is Civil Nuclear Employee, Civil Nuclear
Contractor, Contractor or Other.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
I certify that the relevant records held for the applicant have been checked for items of security interest and that:
Applicant Details
Applicant's Surname: Applicant's Forenames in full:
Is the Subject an existing employee who has been employed for 3 years or more? Yes No
If you have answered ‘Yes’, only a company records check is required as confirmation of identity:
If the Subject is not an existing employee who has been employed for 3 years or more, how did you confirm their identity?
Please include relevant dates and details. If a full passport is not produced, two other forms of identity must be checked.
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Any Other Information
Is there any other information that you would like to make the vetting service provider aware of? Yes No
If so, please provide details:
Your Details
Your Name:
Sponsor ID:
Signed: Date:
Day Month Year
Notification of Clearance
The outcome of this application will be notified to the Sponsor as an electronic notification. Please ensure a valid email
address is provided. Alternatively, a notification will be sent in writing to the address provided below.
Sponsor's Reference:
Notification address:
Address Line 1:
Address Line 2:
Town:
County/Region: Postcode:
Country:
Email:
If your address as a Sponsor is not the same as the notification address, please give it below:
Address Line 1:
Address Line 2:
Town:
County/Region: Postcode:
Country:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Contractor Details
Please complete this section if you have given the applicant’s employment type as ‘Contractor’ or ‘Civil Nuclear
Contractor’.
Contract number:
Please identify the applicant’s status: Please identify the applicant’s status:
Years Months
Please provide details of the company by which the subject is DIRECTLY employed. For a consultant or locally-employed
contractor, this may be their own business details.
Are the details of the company the same as those provided for the notification address? Yes No
If you have answered ‘Yes’, you do not need to enter them again. If your answer is ‘No’, please enter the details below:
Address Line 1:
Address Line 2:
Town:
County/Region: Postcode:
Country:
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OFFICIAL SENSITIVE PERSONAL (when completed)
OFFICIAL SENSITIVE PERSONAL (when completed)
Subcontractor Details
Please complete this section if you have identified the applicant’s status as ‘List X Subcontractor’, ‘Non-List X
Subcontractor’ or ‘Locally-employed Contractor (under an overarching contract)’.
Please provide details of the prime contractor. (This is the company to which the Subject, or their direct employer, is sub-
contracted. For a locally employed contractor engaged under an overarching contract, it will be the company with which this is
placed.)
If you have answered ‘Yes’, you need not enter the company’s details again. If you have answered ‘No’, please enter the
prime contractor’s details below.
Address Line 1:
Address Line 2:
Town:
County/Region: Postcode:
Country:
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OFFICIAL SENSITIVE PERSONAL (when completed)
Privacy notice for processing personal data during National Security Vetting (NSV)
This privacy notice applies when the vetting provider is United Kingdom Security Vetting (UKSV). UKSV is part of
the Ministry of Defence. If you are unsure as to the identity of your vetting provider, please ask your sponsor, which
is normally the employer. This notice explains how we intend to store and handle your personal data and that of
third parties in the course of conducting NSV. This notice may be updated from time to time – the latest version will
be available on .gov.uk.
This notice applies in relation to all previous and current NSV applications processed by UKSV or its predecessors
(Defence Business Services and FCO Services) and should be read in conjunction with the NSV forms and the
document ‘Personnel Security Controls’, also available on .gov.uk.
When UKSV carries out NSV, but the decision on whether to grant security clearance is taken by the sponsor (which
is normally the public authority employer), the sponsor organisation is a joint data controller with UKSV. In these
circumstances, if you wish to exercise your rights under data protection legislation, you can contact either UKSV’s
Data Protection Officer (DPO) or their counterpart in the sponsor organisation that decides whether you will be
granted security clearance. It is the sponsor’s responsibility to advise you of their DPO’s contact details.
In addition to UKSV and the sponsor organisation, the Security Service is a data controller for NSV in respect of the
check of Security Service records. The Security Service publishes advice on access to information at
https://www.mi5.gov.uk/access-to-information. It can be contacted via:
Should you be granted clearance and subsequently move to another post requiring NSV at a different organisation,
the relevant personnel security risk owner for the new organisation may review your clearance against the particular
security risks that organisation faces. In such circumstances, the new organisation replaces the initial sponsor
organisation as a joint data controller for NSV.
The processing of your personal data and that of third parties is necessary for the purpose of NSV, which is carried
out for reasons of substantial public interest and in the exercise of official authority vested in the data controllers.
Conducting NSV is a function of UKSV, which is part of the Ministry of Defence, a government department.
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the document ‘Personnel Security Controls’ available on .gov.uk. The categories of personal data which we process
are described in those documents.
Conducting NSV
To conduct the various checks that form part of NSV, it may be necessary to share some of your personal data with
the relevant check provider so that they may provide further personal data to us. We only share the minimum
amount of personal data necessary to enable the provider to perform the check. In most cases this is limited to basic
identifying information (such as your name or date of birth) to ensure that the provider performs the check on the
correct individual.
To perform the component NSV checks and reach a security clearance decision, UKSV may share some of your data
with:
• Your employing department or company (to request access to relevant personnel records)
• Public authorities which maintain criminal records databases
• The Security Service
• Credit reference agencies
• Referees (e.g. supervisors, character and academic referees)
• The personnel security risk owner (to enable them to make a decision on your suitability to hold security
clearance or so that they can specify any risk mitigation measures conditional for your clearance).
Third party personal data may be processed as a result of these checks. For example, this might be provided to UKSV
by a referee.
We may also notify your sponsor or employer whether your clearance has been granted, refused or withdrawn.
Risk mitigation
On rare occasions where a security risk has been identified, UKSV or the sponsor department may consider that it is
possible to mitigate that risk to an acceptable level by sharing relevant information with someone within your line
management chain. Should this apply to you, we will not share your personal data without discussing this with you
first and obtaining your explicit consent. If we seek to do this we will give you further explanation of the reasons why
and purpose and also explain your rights with regard to providing and withdrawing consent.
If you are worried about the confidentiality of the NSV process, please contact your sponsor for advice.
Appeal
If your clearance is refused or withdrawn and you decide to appeal to the Security Vetting Appeals Panel, we will
provide the Panel with relevant personal data to enable them to consider your appeal.
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retained by UKSV and the sponsor organisation for six years from the date that your security clearance expires,
lapses or is withdrawn. However, it may be necessary to retain some personal data beyond this period in the
interests of national security or to defend legal proceedings which have already commenced.
Where the sponsor organisation is an international organisation, for example NATO, or where your clearance is to
work for a contractor overseas, we will inform the organisation or contractor whether your clearance is granted,
refused or withdrawn.
11. Complaints
If you are not satisfied with the way in which your personal data is being processed by UKSV:
You can make a complaint to the Ministry of Defence Information Rights Team:
The team will acknowledge your complaint within 5 working days and endeavour to send you a full response within
20 working days. If the team is unable to respond fully in this time, the team will explain why and let you know when
you should get a full response.
If you are not satisfied with the response, you have the right to take your complaint to the Information
Commissioner’s Office: https://ico.org.uk/concerns/ ; telephone: 0303 123 1113.
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