Life in Australia – Australian values
The Australian Government encourages people to gain an understanding of Australia, its people and their way of life, before applying for a visa to live in Australia. As part of this application every person aged 18 years or over must declare that they will respect Australian values, as outlined below and obey the laws of Australia.
Australian values include respect for the freedom and dignity of the individual, freedom of religion,
commitment to the rule of law, Parliamentary
democracy, equality of men and women and a spirit of egalitarianism that embraces mutual respect, tolerance, fair play and compassion for those in need and pursuit of the public good.
Australian society also values equality of opportunity for individuals, regardless of their race, religion or ethnic background.
It is also important to understand that English is the national language.
Further information is contained in the Life in Australia booklet, however, you are not required to read the booklet.
The booklet is available in a wide range of languages. If you would like a copy of the booklet it can be obtained from the Department of Immigration and Citizenship (the department) website www.immi.gov.au
About this form
Important – Please read this information carefully before you complete your application. Once you have completed your application we strongly advise that you keep a copy for your records.
Note: Any reference in this form to ‘country’ refers to ‘foreign country’ which is defined in paragraph 22(1)(f) of the Acts Interpretation Act 1901 as any country (whether or not an independent sovereign state) outside Australia and the external Territories.
Who should use this application?
Applicants for a first or second Working Holiday (subclass 417) visa.
Each applicant must apply individually and cannot include family members in their application.
Online applications
Applicants from the arrangement countries listed below under
‘Arrangement Countries and Regions’ may apply on the department’s website. Payment must be made by credit card for online applications. Further information is available from the department’s website www.immi.gov.au/visitors/
If you wish to apply online do not use this application.
Integrity of application
The department is committed to maintaining the integrity of the visa and citizenship programs. Please be aware that if you provide us with fraudulent documents or claims, this may result in processing delays and possibly your application being refused.
Visa overview
The Working Holiday program encourages cultural exchange and closer ties between arrangement countries by allowing young people to have an extended holiday supplemented by short-term employment.
A Working Holiday visa allows the visa holder to:
• enter Australia within 12 months of the date of visa grant;
• stay in Australia for up to 12 months;
• leave and re-enter Australia any number of times while the visa is valid;
• work in Australia for up to 6 months with each employer;
and
• study for up to 4 months.
Arrangement countries and regions
Australia currently has reciprocal Working Holiday arrangements with:
• Belgium;
• Canada;
• Republic of Cyprus;
• Denmark;
• Estonia;
• Finland;
• France;
• Germany;
• Hong Kong Special Administrative Region (HKSAR) of the People’s Republic of China;
• Republic of Ireland;
• Italy;
• Japan;
• Republic of Korea;
• Malta;
• Netherlands;
• Norway;
• Sweden;
• Taiwan; and
• United Kingdom.
Australia continues to negotiate Working Holiday arrangements with additional countries. Information on whether any arrangements have been established with additional countries, is available from www.immi.gov.au/visitors/
Form
Application for a Working Holiday visa 1150
Continued on the next page
Eligibility requirements
To be granted a Working Holiday visa, there are a number of eligibility requirements that applicants must meet.
All applicants must:
• be aged between 18 years and 30 years inclusive (at the time you apply);
• hold a passport from an eligible country, preferably valid for at least 6 months;
• not be accompanied by dependent children;
• be outside Australia when you apply and when the visa is granted (except applicants for a second Working Holiday visa, who can apply while in Australia – see ‘Second Working Holiday visa’ below);
• not have entered Australia on a Working Holiday visa previously (except applicants for a second Working Holiday visa – see ‘Second Working Holiday visa’ below);
• have sufficient funds (generally AUD5,000);
• have funds for a return or onward ticket to depart Australia (or an actual ticket);
• have health insurance (recommended) to cover your stay in Australia. This can be obtained in your home country or in Australia. More information is available from
www.immi.gov.au/visitors/;
• meet Australia’s health requirement – depending on the country you are from and your intentions in Australia (such as entering a hospital, health care area, childcare centre or classroom), you may need to undertake a medical
examination. More information is available from www.immi.gov.au/visitors/working-holiday/417/
eligibility.htm; and
• meet Australia’s character requirement. More information is available from www.immi.gov.au/allforms/.
Second Working Holiday visa
The second Working Holiday visa is available to people who have undertaken work for a minimum of 3 months (88 days in total) in a specified field or industry* in a designated area of regional Australia** on a first Working Holiday visa.
Specified work is any type of work in the list below:
• plant and animal cultivation:
– cultivating or propagating plants, fungi or their products or parts;
– general maintenance crop work;
– harvesting and/or packing fruit and vegetable crops;
– immediate processing of animal products including shearing, butchery in an abattoir, packing and tanning;
Note: Secondary processing of animal products, such as small goods processing and retail butchery is not eligible.
– immediate processing of plant products;
– maintaining animals for the purpose of selling them or their bodily produce, including natural increase;
– manufacturing dairy produce from raw material;
– pruning and trimming vines and trees.
* For further information please see ‘Specified work’
www.immi.gov.au/visitors/working-holiday/417/
eligibility-second.htm
**‘Regional Australia’ is restricted to areas within the postcodes listed in the following table:
2311 to 2312 2328 to 2411 2420 to 2490 2536 to 2551 2575 to 2594 2618 to 2739 2787 to 2898 Northern Territory Entire Territory
4124 to 4125 4133 4211 4270 to 4272 4275 4280 4285 4287 4307 to 4499 4510 4512 4515 to 4519 4522 to 4899 South Australia Entire State
Tasmania Entire State
3139 3211 to 3334 3340 to 3424 3430 to 3649 3658 to 3749
3753, 3756, 3758, 3762, 3764 3778 to 3781
3783, 3797, 3799 3810 to 3909 3921 to 3925 3945 to 3974 3979 3981 to 3996 6041 to 6044 6083 to 6084 6121 to 6126 6200 to 6799
Information about harvest work opportunities in regional Australia is available from the Harvest Trail website www.jobsearch.gov.au/harvesttrail
Note: Some vacancies on the Harvest Trail website may not be in the above eligible postcodes.
Regional areas Postcodes
New South Wales
(most areas except the greater Sydney area, Newcastle, the Central Coast and Wollongong)
Queensland
(most areas except the greater Brisbane area and the Gold Coast)
Victoria
(most areas except the greater Melbourne area)
Western Australia (most areas except Perth and surrounding areas)
• fishing and pearling:
– conducting operations relating directly to taking or catching fish and other aquatic species;
– conducting operations relating directly to taking or culturing pearls or pearl shell.
• tree farming and felling:
– felling trees in a plantation or forest;
– planting or tending trees in a plantation or forest that are intended to be felled;
– transporting trees or parts of trees that were felled in a plantation or forest to the place where they are first to be milled or processed or from which they are to be transported to the place where they are to be milled or processed.
• mining:
– coal mining;
– construction material engineering;
– exploration;
– metal ore mining;
– mining support services;
– oil and gas extraction;
– other non-metallic mineral mining and quarrying.
• construction:
– building completion services;
– building installation services;
– building structure services;
– heavy and civil engineering construction;
– land development and site preparation services;
– non-residential building construction;
– residential building construction;
– other construction services.
Specified work:
• does not need to be paid work.
Example: Work undertaken as a volunteer or through the Willing Workers on Organic Farms (WWOOF) scheme may also qualify if the work you undertook falls with the specified work definition above.
• does not need to be undertaken as a direct employee.
Example: Work in the list above as a contractor is eligible.
• must be listed above.
Example: Working as a nanny for a farmer would not be eligible.
In addition to the eligibility requirements for a first Working Holiday visa (see ‘Eligibility requirements’ above), applicants for a second Working Holiday must also have:
• entered Australia on no more than one Working Holiday visa previously; and
• done specified workin regional Australia for a minimum of 3 months (88 days in total) while holding a Working Holiday visa.
You can apply while you hold a first Working Holiday visa, or at a later date.
Applications can be made either in Australia or outside Australia.
If you apply in Australia, you should lodge your application before your current visa ceases, and must be in Australia for the visa to be granted. If you apply outside Australia, you must be outside Australia for the visa to be granted.
If you apply for a second Working Holiday visa, you will need to provide evidence that you have worked for a minimum of 3 months doing specified work in regional Australia (see table of postcodes for regional Australia).
Acceptable evidence includes:
• a completed form 1263 Working Holiday visa: Employment verification, signed by your employer(s), which you can obtain from the nearest office of the department or from www.immi.gov.au/allforms/; and/or
• an original or certified copies of payslips, group certificates, payment summaries, tax returns and/or employer references.
Note: Providing form 1263 and additional evidence will allow your application to be assessed more quickly.
How much does the visa cost?
Payment must accompany your application and is generally not refunded if the application is unsuccessful.
To check the Visa Application Charge, see form 990i Charges, available from the department’s website
www.immi.gov.au/allforms/990i.htm or check with the nearest office of the department.
Fees may be subject to adjustment at any time. Visa Application Charges may be subject to adjustment on 1 July each year.
This may increase the cost of a visa.
Method of payment
In Australia
To make a payment, please pay by credit card, debit card, bank cheque or money order made payable to the Department of Immigration and Citizenship. Debit card and credit card are the preferred methods of payment.
Outside Australia
Before making a payment outside Australia, please check with the Australian Government office where you intend to lodge your application as to what methods of payment and currencies they can accept and to whom the payment should be made payable.
Continued on the next page
How to apply
Step 1
Complete this application form.
Please use a pen, and write neatly in English using BLOCK LETTERS.
You must provide the address where you intend to live while your application is being dealt with. Failure to give a residential address in your application will result in your application being invalid. A post office box address will not be accepted as your residential address.
Step 2
Lodge your completed application, and required attachments (see Application checklist on page 6 of this form) as outlined below.
All applicants for a first Working Holiday visa can lodge their application by posting, faxing or hand delivering this form to any Australian Immigration office overseas. See
www.immi.gov.au/contacts/overseas.
Applicants for a second Working Holiday visa can lodge their application by posting to:
2nd Working Holiday Centre PO Box 1269
CAIRNS QLD 4870 AUSTRALIA
Do not send cash or your passport with your application.
What happens next?
Your application will be assessed. You may be asked to provide additional information to enable a decision to be made. You will be advised in writing whether your application has been approved. If your application is refused, you will be given reasons for the decision.
You should not make any irreversible travel arrangements until you receive written advice of the department’s decision on your application.
Activating your Working Holiday visa
If you applied for your Working Holiday visa outside Australia, your 12 month stay period starts when you enter Australia. Your 12 month stay period will start if you pass through immigration clearance in Australia (the counter where you present your passenger card and passport), even if you are in transit or hold an Electronic Travel Authority or Maritime Crew visa.
If you are intending to transit or travel to Australia, and you do not want to start your Working Holiday visa, you should delay applying for this visa until you wish to commence your working holiday.
Important – change of personal/passport details
If you wish to change any details after you lodge your application, including your passport details, or if you wish to withdraw the application, please contact the department as follows:
• First Working Holiday visa applicants – Contact the Australian Government office where you lodged your application. Contact details for offices of the department are available on the department’s website
www.immi.gov.au/contacts/overseas/ or if you lodged your application online email
evisa.whm.helpdesk@immi.gov.au
• Second Working Holiday visa applicants – e-mail 2ndWHM.Helpdesk@immi.gov.au
Your Working Holiday visa application is linked to the passport number provided in your application. If you are granted a Working Holiday visa, but do not provide the
department with the details of any new passport you use to travel to Australia, you will experience significant delays at the airport and could be denied permission to board your plane.
Options for receiving written communications
An applicant may authorise another person to receive all communications, both written and electronic, about this application with the department. The applicant will be taken to have received any documents sent to that other person as if they had been sent to the applicant.
To do this please complete Part F Options for receiving written communications and form 956 Appointment of a migration agent or exempt agent or other authorised recipient. For an explanation of what a migration agent or exempt agent or authorised recipient can do please read the sections below.
To change or end the appointment of a migration agent or exempt agent or authorised recipient the department must be promptly advised in writing. This can also be done by using form 956 Appointment of a migration agent or exempt agent or other authorised recipient.
Authorised recipient information
An authorised recipient is someone you appoint to receive written communications about your application with the department.
All written communication about your application will be sent to your authorised recipient, unless you indicate that you wish to have health and/or character information sent directly to you.
The department will communicate with the most recently appointed authorised recipient as you may only appoint one authorised recipient at any time for a particular application.
Migration agent information
A migration agent is someone who can:
• advise you on the visa that may best suit you;
• tell you the documents you need to submit with your application;
• help you fill in the application and submit it; and
• communicate with the department on your behalf.
If you appoint a migration agent, the department will assume that your migration agent will be your authorised recipient, unless you indicate otherwise.
Your migration agent will be the person with whom the department will discuss your application and from whom it will seek further information when required.
You are not required to use a migration agent. However, if you use a migration agent, the department encourages you to use a registered migration agent. Registered agents are bound by the Migration Agents Code of Conduct, which requires them to act professionally in their clients’ lawful best interests.
Immigration assistance
A person gives immigration assistance to you if he or she uses, or claims to use, his or her knowledge or experience in migration procedure to assist you with your visa application, request for ministerial intervention, cancellation review application, sponsorship or nomination.
In Australia a person may only lawfully give immigration assistance if he or she is a registered migration agent or is exempt from being registered. Only registered migration agents may receive a fee or reward for providing immigration
assistance.
If an unregistered person in Australia, who is not exempt from registration, gives you immigration assistance they are committing a criminal offence and may be prosecuted.
Migration agents in Australia
Migration agents in Australia must be registered with the Migration Agents Registration Authority (MARA) unless they are exempt from registration.
Migration agents outside Australia
Migration agents who operate outside Australia do not have to be registered. The department may give some overseas agents an ID number. This number does not mean that they are registered.
Note: Some Australian registered migration agents operate overseas.
Continued on the next page Exempt agents
The following people do not have to be a registered migration agent in order to provide immigration assistance, but they must not charge a fee for their service:
• a close family member (spouse, de facto partner, child, parent, brother or sister);
• a sponsor or nominator for this visa application;
• a member of parliament or their staff;
• an official whose duties include providing immigration assistance (eg. a Legal Aid provider);
• a member of a diplomatic mission, consular post or international organisation.
Further information on migration agents
Information on migration agents, including a list of registered migration agents, is available on the Migration Agents Registration Authority (MARA) website www.themara.com.au You can also access information about migration agents on the department’s website www.immi.gov.au
Consent to communicate electronically
The department may use a range of means to communicate with you. However, electronic means such as fax or e-mail will only be used if you indicate your agreement to receiving communication in this way.
To process your application the department may need to communicate with you about sensitive information, for example, health, police checks, financial viability and personal
relationships. Electronic communications, unless adequately encrypted, are not secure and may be viewed by others or interfered with. If you agree to the department communicating with you by electronic means, the details you provide will only be used by the department for the purpose for which you have provided them, unless there is a legal obligation or necessity to use them for another purpose, or you have consented to use for another purpose.
The Australian Government accepts no responsibility for the security or integrity of any information sent to the department over the internet or by other electronic means.
Telephone 131 881 during business hours in Australia to speak to an operator (recorded information available outside these hours).
If you are outside Australia, please contact your nearest Australian mission.
General enquiry line
Home page www.immi.gov.au
Please keep these information pages for your reference Application checklist
This checklist is provided for your assistance and lists the required documents to include with your application. It is not a requirement of your application and does not apply to online applications.
Note: Processing of your application will be delayed if you do not provide all the required information and documents at the time of lodgement.
Note: Certified copies are copies authorised, or stamped as being true copies or originals, by a person or agency recognised by the law of the country in which you currently reside eg. police or notary.
Note: If your documents are in a language other than English, translations into English must be provided.
A certified copy of the pages of your passport containing your photo and personal details (Note: Your passport should preferably be valid for at least 6 months).
The Visa Application Charge (for the current Working Holiday Visa Application Charge, see form 990i Charges, available from
www.immi.gov.au/allforms/pdf/990i.pdf ) For payment options, see Method of payment on page 3 of this application.
TICK when completed.
If you are applying for a second Working Holiday visa:
Evidence of your specified work in regional Australia, which may include a completed and signed form 1263 Working Holiday visa:
Employment verification, and/or original or certified copies of payslips, group
certificates, payment summaries, tax returns, and employer references.
A list of offices of the department in Australia is available from www.immi.gov.au/contacts/offices.htm Further information about the Working Holiday visa is available from www.immi.gov.au/visitors/
If you are authorising another person to act and receive communications on your behalf, complete Part F Options for receiving written communications on page 10 and form 956 Appointment of a migration agent or exempt agent or other authorised recipient.
About the information you give
The department is authorised to collect information provided on this form under Part 2 of the Migration Act 1958 ‘Control of Arrival and Presence of Non-Citizens’. The information provided will be used for assessing your eligibility for a visa to visit to Australia.
The information provided might also be disclosed to agencies who are authorised to receive information relating to adoption, border control, business skills, citizenship, education, health assessment, health insurance, health services, law enforcement, payment of pensions and benefits, taxation, superannuation, review of decisions and registration of migration agents.
Relevant information about you will be disclosed to federal, state and territory police to assist in your location and possible detention in the event that you become an unlawful non-citizen.
You will become an unlawful non-citizen if your visa ceases (by cancellation for breach of visa condition for example) or expires and you do not hold another visa authorising you to remain in Australia.
The collection, access, storage, use and disclosure by the department of the information you provide in this form is governed by the Privacy Act 1988 and, in particular, by the 11 Information Privacy Principles. The information form 993i Safeguarding your personal information, available from offices of the department, gives details of agencies to which your personal information might be disclosed.
The information provided on this form, including any information on your health, will be used to assess your health for an Australian visa and may be disclosed to the relevant Commonwealth, state and territory health agencies and examining doctor(s).
Form 1163i Health Requirement for temporary entry to Australia provides additional information on Australia’s visa health requirements. Form 1163i is available at offices of the department or from the department’s website
www.immi.gov.au/allforms/
The department is authorised under the Migration Act 1958, in certain circumstances, to collect a range of personal identifiers including a facial image, fingerprints and a signature from non- citizens, including from visa applicants. The department requires personal identifiers to assist in assessing your identity. The department is authorised to disclose your personal identifiers and information relating to your name and other relevant biographical data to a number of agencies including law enforcement and health agencies and to other agencies who may need to check your identity with this department. Where the department obtains personal identifiers they will become part of your official record with the department.
The department is involved in international information exchanges with a number of other countries. These exchanges include the sharing of personal identifiers, including a facial image and fingerprint data collected by immigration agencies such as this department. If, as a result of this sharing between countries, there is a match with your personal identifiers, the department will disclose your biographic data and immigration history to the other agency. The purpose of such disclosure would be to determine if you are presenting to the department and the other agency under the same identity and making similar claims.
For more detailed information you should read information form 1243i Your personal identifying information, which is available from the department’s website
www.immi.gov.au/allforms/ or from any office of the department or Australian mission overseas.
1
Yes No
Part A – Your details
Your full name exactly as it appears on the passport on which you will be travelling to Australia
2
Family name Given names
Have you been known by any other names?
(including name at birth, previous married names, aliases)
Give details
3 Sex Male Female
Date of birth 4
Place of birth 5
Town/city Country
Form
Application for a Working Holiday visa 1150
Details from your passport
DAY MONTH YEAR
Passport number Country of passport Date of issue
Issuing authority/
Place of issue as shown in your passport
DAY MONTH YEAR
Date of expiry Note: Any reference in this form to ‘country’ refers to ‘foreign country’ which
is defined in paragraph 22(1)(f) of the Acts Interpretation Act 1901 as any country (whether or not an independent sovereign state) outside Australia and the external territories.
Note: Visa applicants must hold a valid passport to be granted a visa. It is recommended that the passport be valid for at least 6 months.
If you change your passport after you have been granted the visa you must notify the nearest Australian mission or office of the department.
If you do not provide the department with the details of any new or additional passport you use to travel to Australia, you will experience significant delays at the airport and could be denied permission to board your plane.
Do you hold any citizenship other than that shown as your country of passport above?
Yes
No Give details
7
9
If you hold more than one passport please provide details of those passports
Passport number Country of passport Date of issue Date of expiry
DAY MONTH YEAR
Details of identity card or identity number issued to you by your government (if applicable) eg. National identity card.
Note: If you are the holder of multiple identity numbers because you are a citizen of more than one country, you need to enter the identity number on the card from the country that you live in.
Identity number Country of issue Issuing authority/
Place of issue as shown in your passport
Your full name as it appears in the passport Family name
Given names
8 Relationship status
6
Married Never married or
been in a de facto relationship Separated
De facto Engaged
Widowed Divorced Tick where applicable
Please use a pen, and write neatly in English using BLOCK LETTERS.
Part B – Previous applications
11 What type of employment do you intend to seek during your stay?
If you are applying for a second Working Holiday visa, have you undertaken 3 months of specified work in regional Australia on a Working Holiday (subclass 417) visa? (See postcode table on page 2 for areas defined as regional Australia)
23
Please attach evidence of 3 months of specified work in regional Australia.
Yes
No You are not eligible to apply for a second Working Holiday visa.
Note: Acceptable evidence of 3 months of specified work in regional Australia may be any of the following(providing evidence will allow your application to be assessed more quickly):
• completed form 1263 Working Holiday visa: Employment verification;
and/or
• certified copies of payslips, tax returns, group certificates, and employer references.
Qualifications 12
Usual occupation 10
Have you previously been to Australia, applied for a visa, held or currently hold a visa for travel to Australia (including a Working Holiday visa)?
21
Yes No Current residential address
(If applying in Australia, please give your current address in Australia) Note: A post office box address is not acceptable as a residential address. Failure to give a residential address will result in your application being invalid.
13
POSTCODE
Address for correspondence
(This may be required by the department to communicate with you about your application. If the same as your residential address, write
‘AS ABOVE’) 14
POSTCODE
16 Do you agree to the department communicating with you by fax, e-mail, or other electronic means? (Providing an e-mail address will allow for more efficient processing of your application)
Give details
E-mail address
Fax number ( )
COUNTRY CODE AREA CODE ( )
NUMBER
Your telephone numbers 15
Office hours After hours
( )
COUNTRY CODE AREA CODE ( )
NUMBER
( ) ( )
If you are outside Australia, date of proposed travel to Australia
17 DAY MONTH YEAR
Yes No Mobile/cell
Do you have sufficient funds for the initial period of your stay in Australia?
Note: You may be asked to provide evidence (eg. bank statement).
18 No
Please ensure you have access to this e-mail while your application is being processed
Give full details including type of visa(s), place(s) of application and date(s) of entry to Australia (if applicable)
Have you previously had an Australian visa cancelled, been detained in Australia, removed or deported from Australia, or refused entry into Australia?
22
Yes No
Give full details
Yes
Do you have a return or onward ticket or the funds for a fare to depart Australia?
WARNING: You may be asked to provide evidence.
19
No
Do you have any dependent children that will accompany you to Australia?
20 No Yes Yes
Note: You cannot be accompanied by dependent children on this visa.
Part C – Health details
Do you hold health insurance to cover your stay in Australia?
Note: See page 2 of this form for further information about health insurance.
32
Yes No
Continued on the next page In the last 5 years, have you visited, or lived, outside your country of
passport for more than 3 consecutive months?
24
Yes No
Give details Country(s) Date
DAY MONTH YEAR DAY MONTH YEAR
to from
1.
2.
3.
Date
DAY MONTH YEAR DAY MONTH YEAR
to from
Date
DAY MONTH YEAR DAY MONTH YEAR
to from
Country(s)
Country(s)
Do you intend to enter a hospital or a health care facility (including nursing homes) while in Australia?
25
Yes No
Give details
Do you intend to work as, or study to be, a doctor, dentist, nurse or paramedic during your stay in Australia?
26
Yes No
Give details
Do you intend to work, or be a trainee, at a child care centre (including preschools and creches) while in Australia?
27
Yes No
Give details
Do you intend to be in a classroom situation for more than 3 months (eg. as either a student, teacher, lecturer, or observer)?
28
Yes No
Give details
Have you:
• ever had, or currently have, tuberculosis?
• been in close contact with a family member that has active tuberculosis?
• ever had a chest x-ray which showed an abnormality?
29
Yes No
Give full details
Do you require assistance with mobility or care due to a medical condition?
31
Yes No
Give details
30 During your proposed visit to Australia, do you expect to incur medical costs, or require treatment or medical follow up for:
• blood disorder;
• cancer;
• heart disease;
• hepatitis B or C and/or liver disease;
• HIV infection, including AIDS;
• kidney disease, including dialysis;
• mental illness;
• pregnancy;
• respiratory disease that has required hospital admission or oxygen therapy;
• other?
Yes No
Give details
33 Have you ever:
If you answered ‘Yes’ to any of the above questions you must give all relevant details in the space provided below.
If the matter relates to a criminal conviction, please give the nature of the offence, full details of sentence, dates of any period of imprisonment or other detention and a personal account of the events leading up to and including the offence(s).
Part D – Character details
• been convicted of a crime or offence in any country (including any conviction which is now removed from official records)?
• been charged with any offence that is currently awaiting legal action?
• been acquitted of any criminal offence or other offence on the grounds of mental illness, insanity or unsoundness of mind?
• been removed or deported from any country (including Australia)?
• left any country to avoid being removed or deported?
• been refused a visa for Australia or another country?
• been excluded from or asked to leave any country (including Australia)?
• committed, or been involved in the commission of war crimes or crimes against humanity or human rights abuses?
• been involved in any activities that would represent a risk to Australian national security?
• had any outstanding debts to the Australian Government or any public authority in Australia?
• been involved in any activity, or been convicted of any offence, relating to the illegal movement of people to any country (including Australia)?
• served in a military force or state sponsored/private militia, undergone any military/paramilitary training, or been trained in weapons/explosives use (however described) other than in the course of compulsory national military service?
No Yes
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
No Yes
Yes No
No
Yes No
No
Yes
Yes
Part F – Options for receiving written communications
Part E – Assistance with this form
Is the person an agent registered with the Migration Agents Registration Authority (MARA)?
35
Yes No
Go to Part F
Did you receive assistance in completing this form?
34
Yes No
Please give details of the person who assisted you
Did you pay the person/agent and/or give a gift for this assistance?
37
Yes No
Go to Part F
Mr Mrs Miss Ms
Title: Other
Family name Given names Address
Telephone number or daytime contact Office hours
Mobile/cell E-mail address
( )
COUNTRY CODE AREA CODE ( )
NUMBER
Is the person/agent in Australia?
36
Yes
No Go to Part F
POSTCODE
Myself All written communications will be sent to the address for communications that you have provided in this form.
Migration agent Authorised recipient
38 All written communications about this application should be sent to:
(Tick one box only)
Agent exempt from registration
You must complete form 956 Appointment of a migration agent or exempt agent or other authorised recipient and attach it to this application form. Form 956 is available from the department’s website
www.immi.gov.au OR
OR
OR
WARNING: Giving false or misleading information is a serious offence.
I declare that:
• the information on this form is correct;
• I have read the notes at the front of this application, and am aware that I am required to abide by the conditions that are placed on my visa;
• after applying, I will notify the department of any change in my circumstances, including my address details; and
• I will respect Australian values as listed on this form, during my stay in Australia and will obey the laws of Australia.
41
Date Signature of applicant
DAY MONTH YEAR
Part H – Declaration
Do you have the application charge to include with your application?
(Refer to the latest form 990i Charges available from the department’s website www.immi.gov.au/allforms/pdf/990i.pdf)
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Yes
No This application will be returned to you as a valid application will not have been made
Part G – Payment details
Please check all questions are answered. If your form is incomplete, there may be delays in processing your application.
We strongly advise that you keep a copy of your application and all attachments for your records.
How will you pay your application charge?
If applying in Australia, debit card or credit card are the preferred methods of payment. Debit cards cannot be used for applications lodged by mail. If paying by bank cheque or money order please make payable to the Department of Immigration and Citizenship.
If applying outside Australia, please check with the Australian Government office where you intend to lodge your application as to what methods of payment and currencies they can accept and to whom the payment should be made payable.
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Payment by (tick one box) MasterCard
Visa
Diners Club JCB
Australian Dollars
AUD
Expiry date
Credit card information will be used for charge paying purposes only.
Signature of cardholder Address Telephone number
Cardholder’s name Credit card number
Bank cheque Money order
Credit card Give details below
American Express
: : : : : : : : : : : : : : : : : :
Debit card
:
MONTH YEAR
:
( )
COUNTRY CODE AREA CODE ( )
NUMBER
POSTCODE
Cannot be used for applications lodged by mail
