Appendix A: Residency Form
Please complete this form if you answered NO to either of the two questions in Section 4.
What is your Nationality?
Have you been ‘ordinarily resident’ in the UK for
less than 3 years prior to 1 August 2017?
Yes
No
If the answer to the above question is NO, please state your previous addresses in Section 10 on
page 5. Please include the dates you were there, and the reasons why you were resident there.
Residency questionnaire
Q1. Do you have ‘Settled Status’ in the UK?
By ‘Settled Status’ we mean:
• you have a right of permanent
residence’ in the UK; or
• you have been granted indefinite leave
to remain; or
• you have a right of abode in the UK
Q2. Have you or a family member been granted
‘Leave to Enter or Remain for Humanitarian
Protection’ or ‘Discretionary Leave’?
Your family member must be your husband, wife,
civil partner, parent, step parent, child or step-child.
Yes
No
Yes
Q3. Do you or a family member have ‘Refugee status in the UK’
or ‘EU temporary protection status’ in the UK?
Your family member must be your husband, wife,
civil partner, parent, step parent, child or stepchild.
Yes
No
Q5. Are you the child of a Turkish national
who is working or has worked in the UK?
Yes
No
Q7. Are you or a family member an
EEA or Swiss national who is
working/has worked or is looking for
work in the UK?
Your family member must be your husband, wife,
civil partner, parent, step parent, child or
step-child.
Yes
No
No
Q4. Are you an EU national?
Yes
No
Q6. Are you the child of a Swiss national?
Yes
No
If you have answered NO to all questions,
you are not eligible for an EMA.
If you answered YES to one of these
questions, you must provide proof of your
residency status.
Please check below for what to send us.
What to send:
UK Nationals who have been ordinarily
resident in the UK for less than 3 years:
If you answered YES to:
Question 1, 2 or 3:
Question 4, 5, 6 or 7:
Question 5, 6 or 7:
Question 5 or 7:
Question 6 only:
Question 7 only:
Copy of your birth certificate or valid UK passport
Send us the following proof:
Your Biometric Residence Permit or letter from the Home Office AND your immigration
status document. If the status applies to your family member, you also need to provide
proof of your relationship dated the same time as their application to the Home Office.
Your valid passport or National Identity card.
Your parent’s valid passport or National Identity card, AND proof of your relationship.
Proof that your parent/s is/are working/have worked or are seeking employment in the
UK.
Signed letter to confirm your parent is/was living in the UK on 1 August 2017 AND one
of the following: latest bank statement; or payslip showing home address; or tenancy
agreement/mortgage statement; or utility bill dated within 3 months; or local authority
letter on headed paper; or government department letter
If this status applies to you; proof that you are working/are seeking employment in the
UK.
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