IHS Refund Application Form

Please note that you must only apply for your refund once you have received your visa.
This requirement also applies to any dependants included in the refund.

Whether you are applying for a refund for yourself (the main MTI participant) or separately for a dependant, all individuals listed on the refund application must have received their visa before the IHS fee can be reimbursed.

If a refund of the IHS is requested or processed before the visa has been granted, UKVI will apply an additional charge.

Before proceeding, please confirm the following:

I, the MTI doctor, have received my visa*

Yes.No (If No is selected, you cannot proceed with a refund application until your visa has been received, as UKVI will charge an additional fee.)

All dependants included in this refund application have received their visa (please select N/A if you are not applying for a refund for any dependants)*

Yes.No (If No is selected, you cannot proceed with a refund application until all relevant visas have been received, as UKVI will charge an additional fee.)N/A

You cannot proceed with a refund request until all pending visa applications for yourself and any dependants have been granted.

Submitting an IHS refund request before a visa has been issued may result in UKVI requesting an additional payment.

Please return to this form once all visas have been granted to avoid delays or additional charges. If you have any queries, please contact ihsrefund@aomrc.org.uk.

Please note that this form can only be used by those who entered the UK on a Temporary Work – Government Authorised Exchange (TW GAE, formerly known as Tier-5) visa sponsored by the Academy of Medical Royal Colleges (AoMRC)

If you were not sponsored by the AoMRC, please contact the organisation listed under "Sponsor name" on your CoS.

Further information can be found on gov.uk.

Sponsor Licence Number (Found on your Certificate of Sponsorship (CoS), below "Certificate of sponsorship status")*

Please ensure that you are entering the Sponsor License Number found at the top of your CoS to continue this form. Please note that this is not the same as your Certificate of Sponsorship number.

Given name*

Family name*

Date of birth of main MTI applicant*

Date

Email address *

Please confirm you authorise the Academy to contact you at the email address provided should we require more information*

I confirm

Certificate of Sponsorship number. PLEASE NOTE: [this number will start with C5 and be followed by a 9-digit format with numbers and letters]*

Immigration Health Surcharge number [this will start with IHS or IHSC followed by nine numbers] PLEASE NOTE: Do not include PA01 in the IHS reference number*

Please ensure you enter the correct reference number above.

If your reference starts with "IHS", it should be 12 characters long

If your reference starts with "IHSC", it should be 13 characters long

If your reference number is longer than 13 characters, this is not the correct reference number.

Unique Response Number (please make a note of this as it will help you track your application)

Admin field - payment before March 2020 (needs to stay hidden)

Do you have any dependents?*

YesNo

You have previously indicated that you are not applying for refunds for any dependants.

Submitting an IHS refund request before a visa has been issued may result in UKVI requesting an additional payment.

Please return to this form once all visas have been granted to avoid delays or additional charges and please contact mti@aomrc.org.uk if you have any queries.

Given name of first dependent*

Family name of first dependent*

Date of birth of first dependent*

Date

First dependent's Certificate of Sponsorship number [this number will start with C5 and be a 9-digit format with numbers and letters]*

First dependent's Immigration Health Surcharge number [this will start with IHS or IHSC followed by nine numbers]*

Would you like to add a second dependent?*

YesNo

Given name of second dependent*

Family name of second dependent*

Date of birth of second dependent*

Date

Second dependent's Certificate of Sponsorship number [this number will start with C5 and be a 9-digit format with numbers and letters]*

Second dependent's Immigration Health Surcharge number [this will start with IHS or IHSC followed by nine numbers]*

Would you like to add a third dependent?*

YesNo

Given name of third dependent*

Family name of third dependent*

Date of birth of third dependent*

Date

Third dependent's Certificate of Sponsorship number [this number will start with C5 and be a 9-digit format with numbers and letters]*

Third dependent's Immigration Health Surcharge number [this will start with IHS or IHSC followed by nine numbers]*

Would you like to add a fourth dependent?*

YesNo

Given name of fourth dependent*

Family name of fourth dependent*

Date of birth of fourth dependent*

Date

Fourth dependent's Certificate of Sponsorship number [this number will start with C5 and be a 9-digit format with numbers and letters]*

Fourth dependent's Immigration Health Surcharge number [this will start with IHS or IHSC followed by nine numbers]*

Would you like to add a fifth dependent?*

YesNo

Given name of fifth dependent*

Family name of fifth dependent*

Date of birth of fifth dependent*

Date

Fifth dependent's Certificate of Sponsorship number [this number will start with C5 and be a 9-digit format with numbers and letters]*

Fifth dependent's Immigration Health Surcharge number [this will start with IHS or IHSC followed by nine numbers]*

Would you like to add a sixth dependent?*

YesNo

Given name of sixth dependent*

Family name of sixth dependent*

Date of birth of sixth dependent*

Date

Sixth dependent's Certificate of Sponsorship number [this number will start with C5 and be a 9-digit format with numbers and letters]*

Sixth dependent's Immigration Health Surcharge number [this will start with IHS or IHSC followed by nine numbers]*

Please note that it may take a few seconds for the Unique Response Number (URN) to generate. Please do not submit this form until a URN is displayed in the relevant box.

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Immigration Health Surcharge Application

First dependent

Second dependent

Third dependent

Fourth dependent

Fifth dependent

Sixth dependent