Form T619

Notice of appeal/

Notice of application for review to The Special Immigration

AppealsCommission (SIAC)

THESPECIALIMMIGRATIONAPPEALSCOMMISSIONACT1997

Pleaseattach acopyofthecertificate,notice ofdecision, notice of direction and/orletter from theHomeOffice which youareappealing against or applying to have reviewed.

Youwill have had aletter ornotice tellingyou about thedecision or direction. Thatletterornotice explainsyour rights ofappeal or review. Pleasecompletetheinformationbelowand tickthesection(s)oftheSpecialImmigration Appeals CommissionAct1997 and/orNationalityImmigrationandAsylumAct 2002under whichyouare appealing or applying for review.

Section1Decision(s) or direction(s)youareappealing against or applying to have reviewed

AHomeOfficereference

BDate of service of Home Office

decision/direction//

CDeadline to appeal/apply for review//

DMethod of service of Home Office decision/ direction

(ie. how did you receive it)

PostFax or Personal

Service

Appeal being made under:

SpecialImmigrationAppealsCommissionAct1997:Section 2Section 2B

Nationality, Immigration and Asylum Act 2002: Section 97A(3)

Application for review being made under:

SpecialImmigrationAppealsCommissionAct1997:Section 2C Section 2D Section 2E

Nationality, Immigration and Asylum Act 2002: Section 97A(2F)

Section2About You

ASurname or family name. (CAPITALS)

BOther names

CAddress where you can be contacted

Notice: If you change your address, you mustnotifySIAC immediately, in writing.

D

E

F

G

Telephonenumber

(Give a number where SIAC may contact youduring the day)

Date of birth

(Please give as Day/Month/Year)

Nationality (or nationalities) or citizenship

Do you havea representative?

//

NoYesYour representative should complete Section6: Representative’s Details

HHave you previously made an asylum and/or a human rights claim or appealed against, or applied for a review of, any immigration decision or direction made in the United Kingdom?

NoYes
What type of decision did you appeal/review?

Date of appeal/review//

What is the appeal/ review number, if you know it?

Who did you make the appeal/application for review to?

AIT/First-tier Tribunal (IAC)/

Upper Tribunal (IAC)

High Court/Court of Session

SIAC

I

Whowill be present at the hearing?

YourselfYour representative

Witness/es

If this information is not yetknown, please leaveblank and provide it to SIAC when the hearing date is set.

Please list details of all witnesses you wish to attend anyhearing

J

If you,your representativeor a witness are attending the hearing, will aninterpreter beneeded?

Yourself

Your representative

Witness/es

If this information is not yetknown, please leaveblank and provide it to SIAC when the hearing date is set.

KIf you,your representativeor a witness has a disability, please

explain any special arrangements needed for the hearing.

If this information is not yetknown, please leaveblank and provide it to SIAC when the hearing date is set.

Which language will be needed?

Language:

Dialect(if applicable):

Section3Grounds of Appeal or Application for Review

In this section you mustsetout thegrounds for your appeal or application for review and give the reasons in support of these grounds – that is, why you disagree with the decision or direction.

If you are applying for a review, please note that in determining your application SIAC will apply judicial review principles.

Pleaserefer to the paragraphs of the letter or notice containing the decision/swhen possible.

You should include in this section any parts of your claim that you think have not been addressed in the refusalletter.You must say if you have raised these issues before.

Give as muchdetail as possible; use additional sheets of paper if you need to.

Please note that if you want to varyyour grounds at a later date, you will only be able to do so if youobtain permission from SIAC.

Section4Late Appeal or Application for Review

The time limits setting out when your appeal/application must be received at the Special Immigration Appeals Commission are set out in Rule 8 of The Special Immigration Appeals Commission (Procedure) Rules 2003)

If you know your appeal is late, or you are not sure if it will be received in time, you must apply for an extension of time.

Explain why your appeal is late in the box below. Attach any evidence / additional sheets if necessary.

Section5

Additional Documents

Youmustsendtheletter ornotice tellingyouabout thedecision,oracopyofit,withthis form,together withanyotherdocumentwhich wasservedonyouwhich providedreasons forthe decision or direction.

Ifyouaresendingadditionaldocumentswiththisformpleaselistthemallhere, including the HO letter/notice:

Section6

Declaration

DeclarationI declare that the information I have given is true and complete to the best of my knowledge andbelief.

Appellant/applicantsignatureanddate

Nameofappellant/applicant

PleaseuseCAPITALLETTERS

Representativesignatureand date

Nameofrepresentative

PleaseuseCAPITAL LETTERS

Section7Representative’s Details

Thissection isforcompletionbyyourrepresentative.

NameofRepresentative

NameofRepresentativeOrganisation

PostalAddress ofOrganisation

TelephoneandFaxNumber

EmailAddress

Istherepresentativeregulatedby

theOfficeoftheImmigrationServices

Commissioner(OISC)?

NoYes

P...