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APPLICANT NAME:
UNIQUE APPLICATION NUMBER: PASSPORT NUMBER:
COUNTRY OF NATIONALITY: DATE OF APPLICATION:
TYPE OF VISA/APPLICATION: REGISTRATION EMAIL: CONTACT EMAIL:
Application type
Were you in the UK before 31 December 2020?
Do you have 5 years 'continuous residence' in the UK?
Since then, have you left the UK for more than 5 years?
Were you in the UK on 31 December 2020?
Since 31 December 2020, have you spent more than 6 months outside the UK in any 12-
month period? Why are you applying after the deadline?
Provide information on your reason for applying after the deadline
Dual nationality
Previous nationality
Permanent residence card
Indefinite Leave to Remain
Are you applying based on being a family member of a person of Northern Ireland?
Residence in the UK
Are you in the UK now?
Address
Town or city
Ionut Ursoiu 3434-5161-2955-6491 059843862
Romania
06 October 2021 13:45 British Summer Time (BST) EU Settlement Scheme
ionutdynacord96@gmail.com ionutdynacord96@gmail.com
Yes Yes
Yes
Yes No
I was unable to apply by the deadline due to my care or support needs
Couse I have long time in England and i like to work hire
No No No No No
Yes, I am in the UK 14
MILL STREET WORCESTER
Ionut Ursoiu
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