Section 4 bail application form - UK Border Agency

Application for a bail address and support under Section 4(1)(C) Of TheImmigration and Asylum Act 1999This form should only be used by applicants who are currently in immigrationdetention and who require a bail address or who have already been grantedbail from immigration detention.Please fill in this form in block capitals using black inkPlease read the accompanying guidance notes before filling out this formPersonal Details1 Full name:Including anynamespreviously usedand aliasesMr Mrs Ms Miss Other (please specify)…………………………Surname/Family Name:First name:Other names used/Alias:2 Are you: Male Female3 Date of birth: / / (day/month/year)4 Nationality:5 ReferenceNumbers:Home Office ReferencePort ReferenceSupport ReferenceARC Card (IFB) Reference………………………………………………………………………………………………………………………………………………………5aHave youapplied forSection 4 BailSupport before?YesNoS4 Bail Application Form. V5 Page 1

Please return the completed form to the Home Office by the following method:Post: Home OfficeSection 4 Bail Team14 th Floor (long corridor),Lunar House, 40 Wellesley RoadCroydon CR9 2BYFax: 0870 336 9368S4 Bail Application Form. V5 Page 4