Appendix 2 to

Annex H to

BGNSI 12.10

Dated 09 Jan 20

Head of Veteran Services

British Gurkhas Pokhara

BFPO 4

Telephone: 061 567280

Email: BGN-RecordsOfficeGroupMailbox@mod.gov.uk

REQUEST FOR ADOPTION REGISTRATION

Part 1 – To be completed by the Ex-serviceman

I/I, widow of Army No:	ENTER A/NO	Rank:	SELECT RANK

Name:	ENTER FULL NAME HERE	Unit:	SELECT UNIT

wish to adopt and register the following child(ren) on my Kindred Roll:

Name	Age of Child (2-15 years)	Age difference with the Adopter (at least 25 years)	Infertility Checked	Court Paper Obtained	Remarks
FIRST NAME	ENTER AGE	AGE DIFFER	ENTER TEXT
FIRST NAME	ENTER AGE	AGE DIFFER	ENTER TEXT

I have enclosed 1 x passport size photo(s) each of the above named individual(s).

My current address and contact telephone number(s) are as follows:

Village/House No:	ENTER VILLAGE	Ward No/Street:	WARD/STREET
GP/NP/Town:	ENTER GP/NP/TOWN	Post Office/Code:	POST OFFICE
Dist/County:	ENTER DISTRICT	Province/State:	ENTER ANCHAL
Tel:	ENTER TEL NUMBER	Email:	ENTER EMAIL

I declare the above details to be correct and confirm I have read and understood the rules with regards to adopting children in Nepal. I am also fully aware of the restrictions placed by the United Kingdom on child adoption from Nepal and the adverse impact it may cause when applying for UK settlement for the adopted child.

Signature:	Date:	ENTER DATE
Rank:	SELECT RANK	Name:	ENTER FULL NAME HERE

Part 2 – To be completed by SAWO/ A/AWO/ A/HGW/ A/BWO/ EO-RECORDS/ GVAC/ DVAC/ VSO

5.	This is to confirm that I have read out and briefed the contents of the Annex C. The couple has declared and signed the statement in my presence.

Applicant’s	Applicant’s Spouse’s
Photo	Photo

Enter name	Enter name

(This is to confirm that Mr	Enter name.	is a genuine applicant).

Signature of SELECT :	Date:	ENTER DATE

Rank:	SELECT RANK	Name:	Enter OFFICER’S name

Child(ren)’s Photographs

Photo	Photo

Enter name	Enter name

AWC/ GWAC, UK/ GVAC/ DVAC Stamp Note: Affixed Photo(s) is/ are to be signed across by the A/BWO/ A/HGW/ SAWO/A/AWO/ EO-RECORDS/ GVAC/ DVAC/ VSO.

Signature of SELECT :	Date:	ENTER DATE

Rank:	SELECT RANK	Name:	Enter OFFICER’S name