Annex K 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

WITNESS DECLARATION

(Service/Welfare/GCSPF Pensioner/Non Pensioner)

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

Unit:	SELECT UNIT	Name:	ENTER FULL NAME HERE

solemnly and at my own will declare that I know the pensioner below and his family very well and confirm the details:

No:	ENTER A/NO	Rank:	SELECT RANK
Name:	ENTER FULL NAME HERE

listed at Annex	SELECT	/	Appendix	SELECT	(and Court Affidavit dated select date
for Gurkhas domiciled in India if applicable) as genuine and correct.

I am fully aware that, for any falsification of the declared details/aiding or abetting fraudulent claims may lead to:

None grant of/withdrawal of visa already granted to me and my family under the provision of Settlement Rights granted to Ex-Gurkhas.

Loss of my visa application fee for Settlement Application(s) or any other form of visa to United Kingdom.

Lengthy ban on my application for visa of all kind to United Kingdom in the future.

Be placed on the BGN blacklist for 1 year which will prevent me from getting any service from the Records Office and Pension Payment Office.

I have enclosed copies of relevant pages of my AF B108, NPP and passport.

I give my full consent to Records Office to hold, process and share my personal information to other partner organisations (GWT(N) / GWAC / UKVI / Hong Kong Immigration / Pension Office Nepal & UK / Gurkha Settlement Office / RAN / Nepal Government Authorities / Other Government Departments* with regards to the attached application.

Please fill in the contact details you want us to use when communicating with you:

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

Signature:	Date:	select date

* delete as appropriate