Asylum Support Application Form ASF1

Asylum Support Application Form (ASF1)
Destitution Message
As set out in the Immigration and Asylum Act 1999, the Secretary of State may
provide, or arrange for the provision of, support for asylum seekers, dependants of
asylum seekers, failed asylum seekers or inadmissible asylum seekers who appear
to be destitute or are likely to become destitute within a 14-day period.
An applicant is deemed destitute if:
“They and their dependants do not have adequate accommodation or any

means of obtaining it, even if other essential living needs are met, or they and
their dependants have adequate accommodation or the means of obtaining it
but cannot meet essential living needs.”
As an applicant, you should note that:
1. You must complete all fields that are relevant to your application;
2. Failure to disclose all necessary information or to knowingly provide false

information about yourself or any dependant may lead to information being
passed to the police or other agencies for investigation and possible further
action by them;
3. Failure to supply the required information may result in your application for
support being refused.
☐ I have read and understood the destitution message
Page 1 of 37 ASF1_ V4.0

Section 1. Tell us any reference numbers which may help us to identify
Reference you.
numbers
Give details of any Home Office Reference

current Home
Office reference
numbers Port Reference
Asylum Support Reference
Any other relevant

reference numbers
(i.e. NHS)
Type of support
Section 95 ☐ (you must complete parts 1 – 18)
What type of
Section 4 ☐ (you must complete parts 1 – 26)
support are you
applying for?
What type of section Accommodation and subsistence ☐

95 support are you
applying for? Accommodation only ☐
Subsistence only ☐
Section 2. Personal Tell us details about yourself.

details
Name
Title: Mr ☐ Mrs ☐ Miss ☐ Ms. ☐ Dr ☐
About other Family Name:

names you use
now Given Names;
Do you currently
use any other
name?
Yes ☐ No ☐

Details of other name Title: Mr ☐ Mrs ☐ Miss ☐ Ms. ☐ Dr ☐
Family
Name:
Given
Names:
Gender Male ☐ Female ☐
Date of birth
(dd-mm-yyyy) Day Month Year
Nationality
What is your first

language?
Do you speak English? Yes ☐ No ☐
Can you read English? Yes ☐ No ☐
Relationship status ☐ Married ☐ Single

☐ divorced ☐ Civil Partnership
☐ Separated ☐ Widowed
☐ Partner ☐ Same Sex Partner
☐ Dissolved partnership ☐ Surviving Civil Partner
How many
dependants, in the UK,
are to be included in
this application for
support
Do you have any

dependants that are
not on your asylum
application that you Yes ☐ No ☐
wish to claim support
for?

Why are you
requesting support for
this person?
Section 3.
Passport details
Do you have a
current passport or Yes ☐ No ☐
travel document?
Where is this
document?
Do you have any other

passports or travel
documents? Yes ☐ No ☐
Your Passport
details
Document number
Country of Issue
Date of Issue
and expiry
Issuing Authority
Section 4. Other Tell us if you hold another nationality

nationalities you
hold now
Do you have any
other nationality? Yes ☐ No ☐
Other nationality
Other nationalities
you have held in the
past:
Have you had any Yes ☐ No ☐

other nationalities
in the past?

Previous nationality.
When did you have
this nationality?
Section 5. Your
current
circumstances
Are you, or will you be,
without Yes ☐ No ☐
accommodation or the
means to meet your
essential living needs
within 14 days?
Day Month Year
If “Yes” when will this
be from?
Section 6. Address
and contact details
in the UK
Do you have a
current address? Yes ☐ No ☐ (If no, provide a phone number where we can contact you)
Address House Number or Name
Street Name
Town or City
County
Postcode
Home
telephone
number
Mobile
telephone
number
E- mail address.
Your address:
Tell us where we can write to you:
Is your current
address also your
Yes ☐ No ☐ (if No fill in the correspondence address)
correspondence
address?

House number or name
Address
Street
Name Town
or City
County
Who currently Postcode ☐ Friend

provides you with ☐ Rented
accommodation? ☐ Home Office ☐ Charity
☐ Relative Other?
☐ Partner
☐ Street Homeless
Tell us who you
currently live with?
(please include their
name and any contact
details you have for
them)
Do you pay towards

the cost of your
accommodation?
Yes ☐ No ☐
Amount per month
How are these

payments made and
how is this funded?
Evidence of the rent amount, and how

If you are claiming for much you pay towards it.
subsistence only Entitlement to reside in the property
support, you must Council tax bill
provide the following Utility bill (Gas, Water, Electric)
evidence. Bank statements for partner / other
dependants
Proof of who is paying the rent
Have you been asked

to leave this
accommodation?
If yes, state when you
Yes ☐ No ☐
are expected to leave

and explain why you
can no longer be
accommodated there.
From To
When did you live at
this address?
Any previous address Yes ☐ No ☐

history?
Provide the address

and dates you lived at
each place.
Section 7. Legal Provide us with the details of your legal representative

representative
Do you have a legal
representative? Yes ☐ No ☐
Who pays for your

representative?
Name of the
representative’s
organisation
Title: Mr ☐ Mrs ☐ Miss ☐ Ms ☐ Dr ☐

Name of
representative Family Name:
Given Names:
Contact telephone
number
E mail address

Address of your House Number or Name
representative
Street Name
Town or City
County
Postcode
Section 8. Support Tell us more about all the support you or your dependants have
received from your friends and or relatives.
Have you or your

dependants received Yes ☐ No ☐
any support from
friends or relatives
since arriving in the
UK?
If yes, you must

provide details of the
support and why it
stopped or cannot
continue.
Title: ☐ Mr ☐ Mrs ☐ ☐ Miss ☐ Ms ☐
Who provided the

support? Dr Family Name:
Given Names:
Relationship to you:
House Number
or Name:
Address Street Name:
Town or City:
County:
Postcode:

Contact
telephone
number
E- mail address
Have you or your Yes ☐ No ☐

dependants received
any support from any
other friend or relative
since arriving in the
UK?
If yes, you must

provide details of the
support provided and
why it stopped or
cannot continue.
Title: ☐ Mr ☐ Mrs ☐ ☐ Miss ☐ Ms ☐
Who provided the Dr Family Name

support?
Given Names
Relationship
to you
House Number or Name
Street Name
Town or City
County
Postcode
Contact
telephone
number
E- mail address

Any further information
about the support you
have been receiving?
Section 9. Tell us about any employment you have had whilst in the UK
Employment history
Name of your
current employer or
business
Street Name
Town or City
County
Postcode
Start date Day Month Year
Your previous Tell us about any previous employment you have had:
employment (use additional information section if needed)
details:
Name of previous
employer or House Number or Name
business
Street Name
Address
Town or City
County
Postcode
Start date (dd-mm-yyyy)
End date (dd-mm-yyyy)

Have you ever had
a National
Insurance Number
Yes ☐ No ☐
(NINO)?
If “Yes” please
provide your
National Insurance
number. Also,
provide P45 and
P60 forms.
Section 10. Visa Tell us about any visa applications you have made to enter the
applications UK in the last 3 years.
Have you ever applied

for a visa to enter the Yes ☐ No ☐
UK?
Tell us about your visa Was the visa granted?
application
If not granted why not?
Date visa issued

Valid from
Valid until
Visa reference number
What financial information and

or assets did you declare to
support your application?
Do you still have access to the
assets you declared to obtain a
visa?
If not, why not?
Section 11A. Tell us about any monetary assets you have access to in the
Monetary assets in UK.
the UK
Do you have any cash Yes ☐ No ☐ Provide details here
funds?
Do you have any bank
and or saving
accounts? Yes ☐ No ☐ Provide details here

Do you have any Yes ☐ No ☐
credit cards and or
loans? Provide details here
Do you have a PayPal Yes ☐ No ☐
account?
Provide details here
Do you have a private Yes ☐ No ☐
and or state pension?
Yes ☐ No ☐ Provide details here
Do you have any

Investments?
Currency Value
Currency Value
You must provide Name of bank Account Sort Code Balance of

details of any or organisation Number Account
accounts held
using the table,
and indicate that
you have included,
at least, statements
for the last six
months.
Section 11B. Tell us about any monetary assets you have access to abroad.
Monetary assets
abroad
Do you have any cash Yes ☐ No ☐ Provide details here

funds?
Currency Value
Currency Value
Do you have any bank Yes ☐ No ☐

and or saving
accounts? Provide details here
Yes ☐ No ☐
Do you have any
credit cards and or Yes ☐ No ☐
Loans? Provide details here
Do you have a PayPal

account?

Do you have a private Yes ☐ No ☐ Provide details here
pension?
Do you have any
Investments? Yes ☐ No ☐
You must provide details

Name of Account Sort Code Balance of Currency
of any accounts held
bank or Number Account
using the table and
organisation
indicate that you have
included, at least,
statements for the last 6
months.
Section 12A. Tell us about the material assets you have in the UK.
Material assets in the
UK
Do you own any land
in the UK? Yes ☐ No ☐
Provide details of the
land that you own Where is it? Estimated value? Can you liquidate or rent it? You must
provide supporting evidence
Do you own any Yes ☐ No ☐

property in the UK?
What is it? Where is it? Estimated value? Can you liquidate or rent it? You
Provide details of the must provide supporting evidence.
property that you own

Do you have a car or Yes ☐ No ☐
other vehicle?
car or other vehicle Yes ☐ No ☐
Registration number
Value
If you have not yet
sold this vehicle,
please provide an
explanation why.
Section 12B. Tell us about the material assets you have outside the UK
Material assets held
abroad
Do you own any land
abroad? Yes ☐ No ☐
Provide details of the Where is it? Estimated value? Can you liquidate or rent it? You must provide
land that you own supporting evidence.
Do you own any

property abroad? Yes ☐ No ☐
Provide details of the Y What is it? Where is it? Estimated value? Can you liquidate or rent it? You
must provide supporting evidence.
property that you own

Section 13. Tell us about any Welfare you receive.
Welfare and
Benefits
Are you in receipt
of any UK welfare Yes ☐ No ☐ Provide details here
or benefits or
support now or
have you been in
the previous 6
months?
Are you (or

someone else) in Provide details here
Yes ☐ No ☐
receipt of any
welfare or benefit
support in relation
to any dependants
on this claim? Or
have been in the
previous 6
months?
Section 14. Tell us about any individual circumstances for you or your
Individual dependants that we should be aware of.
circumstances
Provide details of your ☐ Pregnant
individual ☐ Learning disabilities
circumstances ☐ Physical health problems (including any mobility issues)
☐ Chronic disease
☐ Mental health problems (including high risk of suicide, serious self-
harm or risk to others)
☐ Victim of domestic violence
☐ Victim of modern slavery (If yes, have you already been referred
into the National Referral Mechanism? Have you received a decision?)
☐ Other
☐ No additional reasons

Yes ☐ No ☐
Brief Description
Do you hold
any supporting
documents?
Are you currently
registered with a Yes ☐ No ☐
doctor in the UK?
Doctor’s Name
Doctor’s Address
House Number or Name
Street Name
Town or city
County
Postcode

Telephone
Email

Section 15. Tell us about any accommodation requirements specific to
Individual you or your dependants’ individual needs we should be aware
of.
accommodation
requirements
Provide details, with
evidence, about any
specific
accommodation
requirements you or
your dependants
have.
In making decisions
about the allocation of
asylum
accommodation, the
Home Office has
regard to the specific
situation of vulnerable
persons such as
minors,
unaccompanied
minors, disabled
people, elderly people,
pregnant women,
single parents with
minor children and
persons who have
been subjected to
torture, rape or other
serious forms of
psychological, physical
or sexual violence. Do
any of these apply to
you? If so, which?
Asylum
accommodation is
allocated on a no
choice basis, so it
could be in any
location in the UK.
Accommodation
types vary across
the UK depending
on availability.
Initially, you will be
allocated
accommodation in
any of the following
(although this list is
not exhaustive):
 hotels, Houses of
Multiple
Occupancy,
hostels, refurbished
accommodation
that previously
housed military
personnel, large
sites with
communal living
and communal
sleeping quarters,
or moored
 vessels.
You may also be

required to room
share in any of the
above
accommodation.
Are there any

factors we need to
be aware of when
allocating your
accommodation?
Section 16. You must complete this section for your 1st dependant. Complete
Dependants a separate Section 16 for each of your dependants. Attach the
completed copies to your application.
Dependants’ details Title: Mr ☐ Mrs ☐ Miss ☐ Ms ☐ Dr ☐
Name
Family
Do they currently use

any other name? Name Given
Names
Yes ☐ No ☐
Title: Mr ☐ Mrs ☐ Miss ☐ Ms ☐ Dr ☐

Other names used
Family Name
Given Names
Day Month Year
Date of birth
Male ☐ Female ☐
Nationality ☐ Spouse
☐ Child under 18
Gender ☐ Unmarried partner
☐ Other
Relationship to you
If other, please
explain why you are
requesting support for
this person and
provide evidence.
If applicable please
provide the other
parent’s details
(Name, DOB, and
Nationality) and an
explanation as to why
they are unable to
support them. (If the
child’s parent is not Yes ☐ No ☐
part of the claim) If yes, you must provide an explanation for this.
Is the child’s other

parent (not included
on this form) claiming
any support for the
child?
Does this dependant Yes ☐ No ☐

live with you?
Address

Why does this
dependant not live at
your address?
Section 16A. Tell us about your dependant’s visa applications.

Visa applications
Has your dependant

ever applied for a visa Yes ☐ No ☐
to enter the UK?
Tell us about your
Was the visa granted?
dependants’ visa
application If the visa was not granted why
not?
Date visa issued
Valid from
Valid until
Visa reference
What financial information or

assets did they declare to
support their application, or in
support of your application?
Do they still have access to

these assets?
If you do not have access to
the assets they declared in the
visa application, why not?
Part 16B. Tell us about your dependant’s UK employment history.

Employment of
dependants
Have they ever had a
National Insurance Yes ☐ No ☐
Number (NINO)?
If “Yes” please provide

their National
Insurance number.
Is this dependant
currently in
employment (working) Yes ☐ No ☐
in the UK?

Name of their
employer or business
Street Name
Town or City
County
Start date Postcode
Their previous Day Month Year

employment details:
Name of previous
employer or business
Address
House number or name
Street name
Town or city
County
Start Date
Postcode
End date
(dd-mm-yyyy)
(dd-mm-yyyy)
Section 16C. Tell us about your dependant’s education in the UK.

Education
Does your dependant
attend School, College Yes ☐ No ☐
or University?
Name of School
College or University
How long have they

been attending? From To

Section 16D. Tell us about any monetary assets your dependants have
Dependant monetary access to in the UK.
assets in the UK
Does your dependant
have any cash funds? Yes ☐ No ☐
Currency Value
Does your dependant Yes ☐ No ☐ Provide details here

have any bank and or
saving accounts?
Do you have any Yes ☐ No ☐ Provide details here

credit cards and or
Loans?
Does your dependant Yes ☐ No ☐ Provide details here
have a PayPal
account?
Yes ☐ No ☐ Provide details
Does your dependant
have a private
pension? here
Balance of
Does your dependant
Account
have any
investments? Yes ☐ No ☐ Provide details here
You must provide

Name of bank Account Sort Code
details of any accounts
or organisation Number
held using the table
below, and indicate
that you have
included, at least,
statements for the last
6 months.

Section 16E. Tell us about any monetary assets your dependants have
Dependant monetary access to abroad.
assets abroad
Does your dependant Yes ☐ No ☐

have any cash funds
outside of the UK? Currency Value
Currency Value
Do they have any

bank and or saving Yes ☐ No ☐
accounts?
Yes ☐ No ☐
Do you have any
credit cards and or
Loans? Yes ☐ No ☐
Do they have a PayPal
account? Yes ☐ No ☐
Do they have a private Balance of Currency
pension? Yes ☐ No ☐
Sort Code Account
Do they have any
Name of Account
investments?
bank or Number
You must provide organisation
details of any accounts
held using the table
below, and indicate
that you have
included, at least,
statements for the last
6 months.
Section 16F. Tell us about the material assets your dependant has in the UK.
Dependant material
assets in UK
Do they own any land Yes ☐ No ☐
in the UK?
land that they own supporting evidence.
Yes ☐ No ☐
Do they own any
property in the UK? Where is it? Estimated value? Can you liquidate or rent it? You must provide
supporting evidence.
property they own

Do they have a car or Yes ☐ No ☐
other vehicle?
Provide details of the Registration number

car or other vehicle
Value
If they have not yet
sold this vehicle,
please provide an
explanation why.
Section 16G. Tell us about the material assets your dependant has abroad.
Dependants material
assets abroad
Do they own any land
abroad? Yes ☐ No ☐
land that they own supporting evidence.
Do they own any Yes ☐ No ☐

property abroad?
Where is it? Estimated value? Can you liquidate or rent it? You must provide
Provide details of the supporting evidence.
property that they own
Section 16H. Tell us about the Welfare or Benefits your dependant is

Dependant Welfare receiving.
and Benefits
Are they in receipt of
any UK welfare or If yes, you must give details and provide evidence
Yes ☐ No ☐
benefit payments or
support or have they
been in the previous 6
months?
Section 17. Tell us who helped you to complete this form

Additional
details
Who helped you ☐ Legal representative
complete this form ☐ Voluntary Sector
☐ Relative
☐Other
☐Nobody

Name of person or Title: Mr ☐ Mrs ☐ Miss ☐ Ms ☐ Dr ☐
organisation who
assisted you. Family Name
Given Names
Organisation name
Address of person or House Number or Name

organisation who
assisted you. Street name
Town or City
County
Postcode
Telephone number
and email address of
the person who
assisted you
Section 18. Section 95 declaration
If you are applying for section 4 support, do not sign here.

You must also complete sections 19 to 25 and sign the
declaration at Section 26

Once you submit this application you have agreed to accept the
following terms:
 I confirm that the information I have given on this form is
correct and complete.
 I understand that if I give false information, you may take
action against me and I could be prosecuted.
 I confirm that I will tell you if my or my dependants’
circumstances change or there is new information that is
relevant to this application.
 I agree that you can pass the information on this form to
the prescription pricing authority so they can give me and
my family help toward health costs.
 You can use this information to check that my family and I are
entitled to help, and to prevent and detect fraud and money
laundering. I also understand that such agencies may provide
the Home Office with information about me..
 You may undertake a search with Experian for the purposes of
verifying my identity. To do so Experian may check the details I
supply against information held on any database (public or
otherwise) to which they have access. They may also use my
details in the future to assist other companies for verification
purposes. A record of the search will be retained.
The Home Office will use the personal information you provide to
consider your application. We may also share your information with
other public and private sector organisations in the UK and
overseas. For more detail please see the Privacy Notice for the
Border, Immigration and Citizenship system at:
www.gov.uk/government/publications/personal-information-use-in-
borders-immigration-and-citizenship. This also sets out your rights
under the Data Protection Act 2018 and explains how you can
access your personal information and complain if you have
concerns about how we are using it.
I agree to the use of the data provided in this application in

accordance with the Home Office’s Information Charter: I confirm
that I agree to all the above statements
Name:
Signature:
Date:

If you are applying for section 95 support and you do not have
any additional details that you wish to add on page 31, you do
not need to complete and print the remaining pages of this
form.
Section 19. APPLICATION for SECTION 4 SUPPORT
I Consider that I am eligible for support under section 4

because:
Part 1 - I am destitute, (Note: You should demonstrate, in your

answers to questions below, that you are without adequate
accommodation or the means of obtaining it now, or within 14
days, or, if you have adequate accommodation, that you cannot
meet your other essential living needs now, or within 14 days. If
you have been without support from the Home Office or a local
authority for some time, you will be expected to explain how you
have supported yourself during this period and provide evidence
where necessary).
Part 2 – and I satisfy at least one of the criteria listed below

(please tick all that apply) as set out under 3(2) of the
Immigration and Asylum (Provision for Accommodation to
Failed Asylum-Seekers) Regulations 2005.
☐ I am taking all reasonable steps to leave the UK or place

myself in a position in which I am able to leave the UK. This
could include complying with attempts to obtain a travel
document to facilitate departure.
☐ I am unable to leave the UK by reason of a physical

impediment to travel or for some other medical reason.
☐ I am unable to leave the UK because in the opinion of the

Secretary of State there is currently no viable route of return
available.
☐ I have made an application in Scotland for judicial review of a

decision in relation to my asylum claim or, in England and Wales
or Northern Ireland, I have applied for such a judicial review and
been granted permission or leave to proceed.
☐ The provision of accommodation is necessary for the purpose of

avoiding a breach of a person’s Convention rights, within the
meaning of the Human Rights Act 1998.

Section 20. About Tell us what steps you have taken, are taking, to leave the UK
your steps to leave voluntarily, if any.
the UK voluntarily
Have you tried to
obtain documentation Yes ☐ No ☐
to be able to return
home?
Tell us the steps you

are taking to obtain a
travel document.
Have you applied for Yes ☐ No ☐

the Voluntary Return
Service (VRS)?
What date did you Day Month Year

apply?
Have you been offered No ☐

Yes ☐
a flight that you have
failed to take up?
Details
Section 21. About

your impediment to
travel
Give a brief
explanation as to why
you cannot leave the
UK
Have you submitted a

section 4 medical Yes ☐ No ☐
declaration form or a
maternity declaration
(MATB1)?
Please submit if you
have not done so
already.
Section 22. No
viable route to return

Please say why you
think you have no
viable route home.
Section 23. About
your Judicial Review
Has your case been
given permission to
proceed or granted
leave to proceed to Yes ☐ No ☐
Judicial Review?
Section 24.
Avoiding a breach of
ECHR
Have you submitted
further submissions
following the refusal of a Yes ☐ No ☐
protection or human
rights claim, or where a
protection or human
rights has been
withdrawn or treated as
withdrawn, that you
wish to be considered
by the Home Office as
a fresh human rights
or protection claim?
State the reason,

attaching evidence as
appropriate, why you
think a failure to
provide section 4
support would breach
your ECHR rights.
Section 25.
Previous section 4
applications
Have you previously
applied for section 4 Yes ☐ No ☐
support, had an
application for section
Name of applicant, date of application and Home Office reference number if
4 support refused or
known etc.
discontinued or ever
been the dependant of
another asylum
seeker?

If “Yes” to any part of
the question above,
please provide details
Section 26

Section 4 Declaration
The information you have provided in the section 4 application form
will be treated in confidence. However, it may be disclosed to other
UK government departments or agencies, local authorities, law
enforcement agencies, foreign governments and other bodies for
immigration or research purposes to carry out their functions. The
Home Office may also obtain information about you from other
organisations (including credit reference agencies) to assess
whether you are eligible for section 4 support.
Declaration
In submitting this application for support under section 4 of the
Immigration and Asylum Act 1999, I understand that I am also
accepting the conditions under which this support is provided.
Conditions may include specific standards of behaviour, reporting,
residence or complying with steps to facilitate departure from the
UK. These conditions will be set out in a notice in writing.
Additionally:
☐ I understand the criteria for eligibility for support under

section 4, and that I must continue to satisfy all relevant
criteria to remain eligible for and be provided with support.
☐ I understand that should a decision be taken to provide me

with support under section 4, I will be notified of the
conditions under which support is provided. I also understand
that should I fail to comply with any of these conditions the
support provided to me may be discontinued.
☐ I understand that should a decision be taken to provide

me with support under section 4, it may be necessary for
me to relocate to another area to access this support on a
no choice basis.
☐ I understand that any failure on my part to conform to the

Home Office’s reporting imposed in a notice in writing
may result in discontinuation of support.
☐ I understand that failure to disclose all necessary information

regarding myself or my dependants may lead to the withdrawal
of section 4 support.
☐ I understand that failure to disclose all necessary financial

information regarding myself or any dependants may lead
to the withdrawal of section 4 support.
☐ I understand that my dependants, if I have any, may also be

provided with support under section 4 subject to the same

conditions as myself. If any of the conditions on the continued
provision of support to my dependants vary from my own,
those conditions shall be set out separately to them in writing.
☐ I understand that you can use the information in my

application to check that my family and I are entitled to
support, and to prevent and detect fraud and money
laundering. I also understand that such agencies may
provide the Home Office with information about me.
☐ I understand that you may undertake a search with Experian for

the purposes of verifying my identity. To do so Experian may
check the details I supply against information on any database
(public or otherwise) to which they have access. They may also
use my details in the future to assist other companies for
verification purposes. A record of the search will be retained.
☐ I agree to the use of the data provided in this application in

accordance with the Home Office’s Information Charter.
The Home Office will use the personal information you provide to
consider your application. We may also share your information with
other public and private sector organisations in the UK and
overseas. For more detail please see the Privacy Notice for the
Border, Immigration and Citizenship system at:
www.gov.uk/government/publications/personal-information-use-in-
borders-immigration-and-citizenship. This also sets out your rights
under the Data Protection Act 2018 and explains how you can
access your personal information and complain if you have concerns
about how we are using it.
I confirm that I agree to all the above statements

Signature:
Name: (print)
Date:

Section 27. Additional Information
Is there any other

information you would
like us to consider?

Section 28. Documents Checklist
Use the table below as a checklist of all the supporting documents you
are providing with your application. Tell us how many of each of the
documents listed that you have included. Ensure that all supporting
documents and evidence is listed. Add extra lines if necessary. All
documents must be originals.
Document Number
of pages

Section 29. Next Steps for Your Application
1. Ensure the application is complete and that you have

provided answers to all questions relevant to your claim for
support. Ensure that you have provided evidence to support
the answers in your application form where required.
See the guidance document to ensure you have included all

the necessary supporting documents and evidence which are
being enclosed with the application form. Failure to supply
documents and or evidence will lead to delays in reaching a
decision and may lead to the rejection of your claim.
2. Ensure you have read and signed the declaration for section
95 or section 4 support depending on which you are claiming
for.
3. Once you are satisfied that your application is complete,

collate your form and documents together and send to: PO
Box 471, Dover, CT16 9FN. If no original documents are
required then you can e-mail the application to
[email protected] if you are
applying for section 95 support or [email protected]
if you are applying for section 4 support.
If you use recorded or special delivery, this will help us to

record the receipt of your application. Make sure you keep
the recorded delivery or special delivery number.
Consideration will be given to the information you have

provided.
You will be notified in writing of our decision.
4. If you need to contact us after you have applied please

contact: PO Box 471, Dover,
CT16 9FN. Telephone: 0808 8010 503
You must keep us informed of any changes to the

information that you have provided.

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Asylum Support Application Form (ASF1)

An applicant is deemed destitute if:

“They and their dependants do not have adequate accommodation or any

As an applicant, you should note that:

2. Failure to disclose all necessary information or to knowingly provide false

☐ I have read and understood the destitution message

Page 1 of 37 ASF1_ V4.0

Give details of any Home Office Reference

Asylum Support Reference

Any other relevant

What type of section Accommodation and subsistence ☐

Section 2. Personal Tell us details about yourself.

About other Family Name:

Page 2 of 37 ASF1_ V4.0

Gender Male ☐ Female ☐

What is your first

Do you speak English? Yes ☐ No ☐

Can you read English? Yes ☐ No ☐

Relationship status ☐ Married ☐ Single

Do you have any

Page 3 of 37 ASF1_ V4.0

Do you have any other

Section 4. Other Tell us if you hold another nationality

Have you had any Yes ☐ No ☐

Page 4 of 37 ASF1_ V4.0

Address House Number or Name

Page 5 of 37 ASF1_ V4.0

Who currently Postcode ☐ Friend

Do you pay towards

How are these

Evidence of the rent amount, and how

Have you been asked

Page 6 of 37 ASF1_ V4.0

Any previous address Yes ☐ No ☐

Provide the address

Section 7. Legal Provide us with the details of your legal representative

Who pays for your

Title: Mr ☐ Mrs ☐ Miss ☐ Ms ☐ Dr ☐

Page 7 of 37 ASF1_ V4.0

Have you or your

If yes, you must

Title: ☐ Mr ☐ Mrs ☐ ☐ Miss ☐ Ms ☐

Who provided the

Address Street Name:

Page 8 of 37 ASF1_ V4.0

Have you or your Yes ☐ No ☐

If yes, you must

Title: ☐ Mr ☐ Mrs ☐ ☐ Miss ☐ Ms ☐

Who provided the Dr Family Name

House Number or Name

Page 9 of 37 ASF1_ V4.0

Address House Number or Name

Start date Day Month Year

Start date (dd-mm-yyyy)

End date (dd-mm-yyyy)

Page 10 of 37 ASF1_ V4.0

Have you ever applied

Date visa issued