EFTA00305977.pdf

Leon Black Meeting Sept. 2, 2015 9:00am 31.Haveyou been refused a visa for any country including the UK in the last 10years? 32. Have you been deported, removed or otherwise required to leave any country including the UK in the last 10years? 33. Have you ever voluntarily elected to depart the UK? 34. Areyou, or haveyou been subject to, an exclusion order from the UK? 35. Have you ever travelled outsideyour country ofresidence, excluding the UK, in the last 10years? Part 1-Passport and Travel Information passport/TravelDocument 1. Family Name/Surname (Ifyou only have one name, please enter it here and in the given name box) 2. Given Names(s)/Forename(s) (Ifyou only have one name, please enter it here and in the family name box) 3. Date ofBirth 4. Place ofBirth 5. Gender 6. Nationality 7. Doyou currently hold, or haveyou ever held, any other nationality or nationalities? 8. Current passport or travel document number 9. Place ofIssue 10. Issuing Authority 11. Date ofIssue 12. Date ofExpiry 13. Current Location 14. Areyou a national of the country in which you are applying? 15. Please enter Details 16. Is thisyour First Passport? 17. Nationality Document Number Issuing Authority Date ofIssue Date ofExpiry Is this Document lost, stolen or inyour possession? 36. Date of Travel -Country Visited -Reason for the Trip EFTA00305977 -Date of Travel -Country Visited -Reason for the trip -Date of Travel -Country Visited -Reason for the Trip -Date of Travel -Country Visited -Reason for the Trip -Date of Travel -Country Visited -Reason for the Trip -Date of Travel -Country Visited -Reason for the Trip -Date of Travel -Country Visited -Reason for the Trip -Date of Travel -Country Visited -Reason for the Trip 18. Are you travelling with Anyone? 19. Date of Planned Arrival in the UK 20. How long do you intend to stay in the UK? 21. What is the main address and contact details of where you will be staying whilst in the UK? Part 2 Personal Details and Treave► History Personal Details 22. What isyour permanent residential address and contact details? 23.How long haveyou lived at this address? 24. Areyou preferred contact details differentform the contact details already provided above? Travel History 25. Have you been issued any visa for the UK, UK overseas territories or commonwealth country in the last 10years? EFTA00305978 26. Type of Visa Issued Date of Issue Date of Expiry Issuing Authority Type of Visa Issued Date of Issue Date of Expiry Issuing Authority 27. Have you ever travelled to the UK in the last 10years? 28. Date of Arrival Departure Date Purpose of the Trip EFTA00305979