Form FLR(S) - UK Border Agency - the Home Office

10.3. Do you or any dependants who are applying with you have any civil judgmentsagainst you or any civil penalty under the UK Immigration Acts?Yes go to 10.4 No go to 10.510.4. Give details for each civil judgment or any civil penalty under UK Immigration Acts,starting with the most recent one.If you or any dependants who are applying with you have received more than two civiljudgments and/or civil penalties under the UK Immigration Acts, please photocopy this pageand enclose it with this form.Details of judgment or civil penalty 1Date of judgment or civil penaltyD D M M Y Y Y YCountry where judgment madeDetails of judgment or civil penalty 2Date of judgment or civil penalty 2D D M M Y Y Y YCountry where judgment madeYou must answer questions 10.5 to 10.10 below even if you have answered no toquestion 10.1For help in answering these questions, please see the definitions at the end of thissection.*10.5 Have you or any dependants who are applying with you ever been chargedin any country with a criminal offence for which you have not yet been tried in acourt of law?10.6 In times of either peace or war, have you or any dependants who areapplying with you ever been involved, or suspected of involvement, in warcrimes, crimes against humanity or genocide?YesYesNoNoSTATELESS LEAVE APPLICATION FORM Version 03/2013 – page 15 of 33