Form EEA4 - UK Border Agency - the Home Office

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Section 8 – Time Spent Outside The UKTo qualify for permanent residence you need to have resided in the UK continuously for 5 yearsunless you are applying on the grounds that your EEA national family member stopped working orbeing self-employed due to early retirement, reaching state pension age or permanent incapacity,or has died.. Time spent outside the UK which does not exceed 6 months in total in any year andabsences due to special circumstances will not affect your period of residence.8.1 Please give the date and place of your first arrival in the UK for yourself, your EEA nationalfamily member and any family members mentioned in section 2. Continue on a separate sheet ifnecessary and enclose it with this form.NameDate of first arrivaldd/mm/yyyyPlace of first arrival8.2 Please complete the table below for yourself, your EEA national family member and anyfamily members mentioned in section 2 to show any time you have spent outside the UK duringthe 5 years continuous residence. If your EEA national family member has a document certifyingpermanent residence you only need to mention any absences they have had of more than 2consecutive years since they received the document. When counting the number of days absent donot include the day of departure or the day of return. Continue on a separate sheet if necessary andenclose it with this formName of person(s) absent fromthe UKCountry or countriesvisitedDate ofdeparturefrom UKDate ofreturn toUKNumber ofdays8.3 If any of the absences mentioned above exceed 6 months in any year please explain below thereasons why you were absent from the UK. Continue on a separate sheet if necessary and encloseit with this form.EEA4 Permanent Residence Card Version 06/2014 - page 28 of 38
Section 9 - Personal History (criminal convictions, war crimes, etc.)You must provide details as requested below of any criminal convictions you may have both in theUK and overseas. Please note that it is an offence under Section 26(1)(c) of the Immigration Act1971 to make a statement or representation which you know to be false or do not believe to be true.Information given will be checked with other agencies.9.1. Have you or any family members who are applying with you been convicted of any criminaloffence in the UK or any other country?Yes - go to question 9.2 No - go to question 9.39.2. Please give details below for each criminal conviction, starting with the most recent one. If youor any family members who are applying with you have received more than two convictions, pleasephotocopy this page and enclose it with this form.Note: We will carry out criminal record checks on all applicants and family members. You must givedetails of all unspent and spent criminal convictions. This includes road traffic offences but not fixedpenalty notices (such as speeding or parking tickets) unless they were part of a sentence of the court.This includes all drink-driving offences.Criminal conviction 1Country where convictedNature of the offenceSentence givenDate sentenced D D M M Y Y Y YIf you or any family members who are applying with you weresentenced to a period of imprisonment, what was the length of theprison sentence imposed (in months)?Criminal conviction 2Country where convictedmonthsNature of the offenceSentence givenEEA4 Permanent Residence Card Version 06/2014 - page 29 of 38
Page 4: Page left deliberately blankEEA4 Pe
Page 7 and 8: Please note that we always use the
Page 9 and 10: The following nationals may exercis
Page 12 and 13: 1.9 Place of birth - town or city a
Page 14 and 15: 2.13 Family member’s full name2.1
Page 16: Section 4 - Retained Right Of Resid
Page 19 and 20: Section 5 - Permanent Residence Due
Page 21 and 22: About you6.6 How are you related to
Page 23 and 24: Rented by you/the BritishcitizenPro
Page 26 and 27: Section 7 - Details Of The Exercise
Page 30 and 31: Date sentenced D D M M Y Y Y YIf yo
Page 32 and 33: Section 10 - PhotographsYou must pr
Page 34 and 35: For time spent seeking work: this c
Page 36 and 37: Section 12 - DeclarationPlease read
Page 38: Final ChecklistTo ensure that your

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