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New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
New editable   form 80
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New editable form 80

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  • 1. Form Personal particulars for assessment including character assessment 80Important – Please read this information carefully before you Please use a pen, and write neatly in English using BLOCK LETTERS.complete this form. Once you have completed this form we ✓strongly advise that you keep a copy for your records. Tick where applicableThis form is to be completed in English by applicants for visasfor Australia who are 16 years of age or over, as requested by the I am applying for a visa to travel to Australia as a: migrantoffice processing the application. temporary resident visitorIntegrity of application studentThe Department of Immigration and Citizenship (thedepartment) is committed to maintaining the integrity of the refugee/ humanitarian entrantvisa and citizenship programs. Please be aware that if you ORprovide us with fraudulent documents or claims, this may I am applying in Australia for: a further temporary stay or visitresult in processing delays and possibly your application beingrefused. permanent residence protectionAbout the information you giveThe department is authorised to collect information providedon this form under Part 2 of the Migration Act 1958 ‘Control of Part A – Your detailsArrival and Presence of Non-Citizens’. The information providedwill be used for assessing your eligibility for a visa to travel to, 1 Give details as they appear on your current passport or the travelenter and remain in Australia and for other purposes relating to document that you will use to enter Australiathe administration of the Migration Act, for example, to assist Passportmigrants with settling in Australia or for ensuring compliancewith the Migration Act. Other Type of documentThe information provided might also be disclosed to agencieswho are authorised to receive information relating to adoption, Note: If your passport/travel document only shows one name,border control, business skills, citizenship, education, healthassessment, health insurance, health services, law enforcement, write that name in the Family name box.payment of pensions and benefits, taxation, superannuation, Family namereview of decisions and registration of migration agents.The information form 993i Safeguarding your personal All giveninformation, available from offices of the department, gives namesdetails of agencies to which your information might bedisclosed. Sex Male Female DAY MONTH YEAR Date of birth Place of birth Town/city Country Passport/travel document number Country of passport/travel document DAY MONTH YEAR Date of issue Date of expiry Nationality Place of issue/issuing authority © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 1
  • 2. 2 Does the passport/travel document at Question 1 show your 7 Have you ever been known by other names or spellings of your name? full name? Examples of the types of other names: No What is your full name? • name at birth • cultural or tribal name or Family name • name before or after marriage clan/subclan name • adoptive or foster name • preferred name • alias or pseudonym • patronymic name Given names (including patronymic name in English) • other spellings of names No Yes Give details in English Yes 1. Type of name 3 Are you currently in Australia? Family name No Go to Question 5 Yes Given names 4 Did you use the passport/travel document at Question 1 to enter Australia? No Write the number of the document you used to 2. Type of name enter Australia Family name Given names Yes 5 Do you ever use a Chinese Commercial Code Number for your names shown in the passport/travel document at Question 1 If more than 2, give details at Part J No 8 Have you ever had an alternative date of birth? Yes Chinese Commercial Code Number No DAY MONTH YEAR Yes Alternative date of birth 6 Are you of Arabic descent? 9 Are you a citizen of the country of passport/travel document at No Question 1? Yes In English, write the full name of your father’s father No (ie. your paternal grandfather) Yes How did you gain this citizenship (eg. birth, descent, naturalisation)? DAY MONTH YEAR Date you gained this citizenship80 (Design date 04/12) - Page 2 © COMMONWEALTH OF AUSTRALIA, 2012
  • 3. 10 Do you currently have, or have you ever had, other passports/travel 11 Are you currently, or have you ever been, a citizen of any other documents? country not already shown at Question 1 or Question 10? No No Yes Give details as they appear on the other passports/travel Yes Give details documents (If more than one, give details at Part J) 1. Country Note: If the passport/travel document only shows one name, write that name in the Family name box. How did you gain this citizenship (eg. birth, descent, naturalisation)? Family name All given When did you have this citizenship? DAY MONTH YEAR names From To (If you still have the citizenship, Passport/travel document number write ‘Current’) 2. Country Country of passport/travel document How did you gain this citizenship (eg. birth, descent, naturalisation)? DAY MONTH YEAR Date of issue When did you have this citizenship? DAY MONTH YEAR Date of expiry From Nationality To (If you still have the citizenship, Place of issue/issuing authority write ‘Current’) If more than 2, give details at Part J 12 Do you currently have permanent residence rights in any country Are you, or have you ever been, a citizen of the country of passport/ not already shown at Question 1, Question 10 or Question 11? travel document shown above? No No Yes Give details Yes How did you gain this citizenship (eg. birth, descent, naturalisation)? 1. Country 2. Country When did you have this citizenship? DAY MONTH YEAR 13 Have you ever been refused citizenship of any country? From No To (If you still have the Yes Give details citizenship, write ‘Current’) 1. Country Reason for refusal DAY MONTH YEAR Date 2. Country Reason for refusal DAY MONTH YEAR Date If more than 2, give details at Part J © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 3
  • 4. 14 Do you currently have, or have you ever had, any national identity documents or numbers (including birth registration numbers, social security cards etc)? No Yes Give details Type of identification document Country of issue Identification number shown Name shown on document (if applicable) Attach certified copies of original documents and English translations 15 Details of your place of birth 18 Your current contact numbers (include country code if outside Australia) Country COUNTRY CODE AREA CODE NUMBER State/ Work ( ) ( ) Province/ Region Home ( ) ( ) Town/city Mobile/cell Suburb (if Fax ( ) ( ) applicable) Other contact numbers you have 16 Your current residential address (this is the place where you ( ) ( ) currently live) Note: A post office box or mailbox address is not acceptable as a ( ) ( ) residential address. Unit/Apartment number 19 Address in Australia where you can be contacted or will be staying Address Note: A post office box or mailbox address is not acceptable. Suburb/Town/City POSTCODE State/Province/Region 20 Contact telephone numbers in Australia (if known) AREA CODE NUMBER Work ( ) Country Home ( ) Postal code Mobile/cell Other contact numbers Attach certified copies of original documents and English ( ) translations that give evidence of your address ( ) 17 Do you have an e-mail address? Note: Do not provide the email address of a migration agent. No Yes E-mail address80 (Design date 04/12) - Page 4 © COMMONWEALTH OF AUSTRALIA, 2012
  • 5. 21 Do you have personal contacts in Australia (including business Part B – Your partner’s details contacts/sponsor)? Note: If you are widowed, you must give details for your deceased partner. No Yes Give details 23 Your partner’s full name 1. Family name Family name Given names All given names Sex Male Female DAY MONTH YEAR Date of birth 24 Sex Male Female Relationship to you (eg. partner, sister, aunt, friend, DAY MONTH YEAR business contact/sponsor) 25 Date of birth Date of death AREA CODE NUMBER (if deceased) Telephone number ( ) 26 Your partner’s place of birth 2. Family name Country State/ Given names Province/ Region Town/city Sex Male Female Suburb (if DAY MONTH YEAR applicable) Date of birth Relationship to you (eg. partner, sister, aunt, friend, 27 Is your partner currently, or have they ever been, a citizen of any business contact/sponsor) country? No Yes Give details AREA CODE NUMBER Telephone number ( ) 1. Country When did your partner have this citizenship? If more than 2, give details at Part J DAY MONTH YEAR From22 Relationship status DAY MONTH YEAR To (If they still have the citizenship, Married Date of marriage write ‘Current’) Engaged Date of intended marriage 2. Country De facto Date relationship began When did your partner have this citizenship? DAY MONTH YEAR Separated From Divorced To (If they still have the citizenship, Widowed write ‘Current’) Never married or Go to Part C If more than 2, give details at Part J been in a de facto relationship 28 Does your partner ever use a Chinese Commercial Code Number for names shown at Question 23 No Yes Chinese Commercial Code Number © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 5
  • 6. 29 Is your partner of Arabic descent? No Yes In English, write the full name of your partner’s father’s father (ie. paternal grandfather) 30 Is your partner currently, or have they ever been, known by other names or spellings of their name? Examples of the types of other names: • name at birth • cultural or tribal name or • name before or after marriage clan/subclan name • adoptive or foster name • preferred name • alias or pseudonym • patronymic name • other spellings of names No Yes Give details in English 1. Type of name Family name Given names 2. Type of name Family name Given names If more than 2, give details at Part J 31 Does your partner currently have, or have they ever had, any national identity documents or numbers (including birth registration numbers, social security cards etc)? No Yes Give details Type of identification document Country of issue Identification number shown Name shown on document (if applicable) Attach certified copies of original documents and English translations80 (Design date 04/12) - Page 6 © COMMONWEALTH OF AUSTRALIA, 2012
  • 7. Part C – Travel to Australia32 Are you travelling, or did you travel to Australia with any other 33 Are you currently in Australia? person(s)? No No Yes Go to Part D Yes Give details 34 Proposed arrival details 1. Family name DAY MONTH YEAR Arrival date Given names Flight number or vessel details (if known) Place of arrival DAY MONTH YEAR City Date of birth State Citizenship 35 Are you applying for a temporary visa? Relationship to you (eg. partner, sister, friend, business contact) No Yes Proposed final departure details DAY MONTH YEAR 2. Family name Departure date Flight number or vessel details (if known) Given names Place of departure City DAY MONTH YEAR Date of birth State Citizenship 36 What is the main reason for going to Australia? Include details of any dates that are of special significance to Relationship to you (eg. partner, sister, friend, business contact) your time in Australia If more than 2, give details at Part J Go to Part E © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 7
  • 8. Part D – Current visa details NOTE: Only complete this Part if you are currently in Australia 37 Do you currently hold an Australian visa? No Go to Part E Yes 38 Visa details Type of visa Visa number V < DAY MONTH YEAR Date of issue Visa conditions (if applicable) 39 Country where you lived when you were issued this visa 40 Details of your arrival in Australia DAY MONTH YEAR Arrival date Place of arrival City State 41 Final date you must leave Australia DAY MONTH YEAR on this visa 42 Have you been given an additional period of stay in Australia with this visa? No Yes Give details80 (Design date 04/12) - Page 8 © COMMONWEALTH OF AUSTRALIA, 2012
  • 9. Part E – Other information43 Have you travelled to Australia before? No Yes Give details in chronological order (If insufficient space, give details at Part J) Date from Date to Type of visa Country where you lived when (eg. visitor, student, business) visa was issued Your names shown on visa Reason for visit DAY MONTH YEAR DAY MONTH YEAR44 Have you travelled to any countries other than Australia (including short stays) during the last 10 years? No Yes Give details in chronological order (If insufficient space, give details at Part J) Date from Date to Country or countries Reason for visit DAY MONTH YEAR DAY MONTH YEAR45 List, in chronological order, the addresses of the places where you have lived during the last 10 years (including Australia). You must account for every year. If you are unable to provide an address for any period of time please provide an explanation. (If insufficient space, give details at Part J) Date from Date to Country Full address (number, street name, suburb, state/province, country) MONTH YEAR MONTH YEAR © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 9
  • 10. 46 Give details of your employment history for the entire time since leaving school, including periods of unemployment. (If insufficient space, give details at Part J) Date from Date to Name and address of employer/business Employer’s contact number Type of business Your position/title/duties MONTH YEAR MONTH YEAR 47 Are you currently unemployed? No Yes Give details of how you financially support yourself, including how long you have received this support for and how much you receive on a monthly basis 48 Have you had any military service? No Yes Give details in chronological order (If insufficient space, give details at Part J) Date from Date to Country Full name of Unit/Battalian/Brigade Rank Duties DAY MONTH YEAR DAY MONTH YEAR80 (Design date 04/12) - Page 10 © COMMONWEALTH OF AUSTRALIA, 2012
  • 11. 49 Have you undertaken any qualifications since secondary school (including courses completed, withdrawn or continuing)? (If insufficient space, give details at Part J) Date from Date to Did you complete the course, Country Name and address of institution Course of study withdraw or currently enrolled? MONTH YEAR MONTH YEAR Completed course Withdrew Currently enrolled Completed course Withdrew Currently enrolled Completed course Withdrew Currently enrolled Completed course Withdrew Currently enrolled Completed course Withdrew Currently enrolled50 Have you undertaken an academic thesis, dissertation or publication (including completed, withdrawn or continuing theses, dissertations or publications)? No Yes Give details Full name of your supervisor Family name Given names © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 11
  • 12. Part F – About your parents Note: You must give details for any person (living or deceased) who h. Does this parent ever use a Chinese Commercial Code Number, is or was your parent or with whom you have had a parent-like National Identity Number and/or Birth Registry Number? relationship. This should include, but is not limited to, natural parents, No adoptive parents, surrogate parents, step-parents, foster parents, and/ or guardians. Yes Give details Provide details of one parent at Question 51 and the other parent at 1. Number Question 52. If more than 2, give details at Part J. Type of number (eg. birth registry number) 51 Parent a. Relationship to you (eg. natural parent, step-parent etc) 2. Number Type of number (eg. birth registry number) b. Your parent’s full name Family name i. Is this parent of Arabic descent? All given names including, if applicable, patronymic name No (in English), clan and sub-clan names, and middle names Yes In English, write the full name of your parent’s father’s father (ie. paternal grandfather) c. Sex Male Female DAY MONTH YEAR d. Date of birth j. Is this parent currently, or have they ever been, known by other names or spellings of their name? e. Date of death (if deceased) Examples of the types of other names: f. Parent’s place of birth • name at birth • cultural or tribal name or Country • name before or after marriage clan/subclan name State/ • adoptive or foster name • preferred name Province/ • alias or pseudonym • patronymic name Region • other spellings of names Town/city No Suburb (if Yes Give details in English applicable) 1. Type of name g. Is this parent currently, or have they ever been, a citizen of any country? Family name No Yes Give details Given names 1. Country When did this parent have this citizenship? DAY MONTH YEAR From 2. Type of name To (If they still have the citizenship, Family name write ‘Current’) 2. Country Given names When did this parent have this citizenship? DAY MONTH YEAR From k. Country where this parent lives now To (If they still have the citizenship, If in Australia, write the full address, if not living, write ‘DECEASED’ write ‘Current’)80 (Design date 04/12) - Page 12 © COMMONWEALTH OF AUSTRALIA, 2012
  • 13. 52 Parenta. Relationship to you (eg. natural parent, step-parent etc) h. Does this parent ever use a Chinese Commercial Code Number, National Identity Number and/or Birth Registry Number?b. Your parent’s full name No Family name Yes Give details All given names including, if applicable, patronymic name 1. Number (in English), clan and sub-clan names, and middle names Type of number (eg. birth registry number) 2. Numberc. Sex Male Female Type of number (eg. birth registry number) DAY MONTH YEARd. Date of birth i. Is this parent of Arabic descent?e. Date of death (if deceased) Nof. Parent’s place of birth Yes In English, write the full name of your parent’s father’s father (ie. paternal grandfather) Country State/ Province/ Region Town/city Suburb (if applicable) j. Is this parent currently, or have they ever been, known by other names or spellings of their name?g. Is this parent currently, or have they ever been, a citizen of any Examples of the types of other names: country? • name at birth • cultural or tribal name or No clan/subclan name • name before or after marriage Yes Give details • adoptive or foster name • preferred name • alias or pseudonym • patronymic name 1. Country • other spellings of names When did this parent have this citizenship? DAY MONTH YEAR No From Yes Give details in English To (If they still have the citizenship, 1. Type of name write ‘Current’) Family name 2. Country When did this parent have this citizenship? Given names DAY MONTH YEAR From To (If they still have the citizenship, write ‘Current’) 2. Type of name Family name Given names k. Country where this parent lives now If in Australia, write the full address, if not living, write ‘DECEASED’ © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 13
  • 14. Part G – About your brothers and sisters Note: You must give details for any person (living or deceased) who is or was your brother or sister. This should include, but is not limited to, natural brothers and sisters, adoptive brothers and sisters, step- brothers and sisters. Provide details of one brother or sister at Question 53 and the others at Questions 54 – 56. If more than 4, give details at Part J. 53 Brother or sister i. Is this person of Arabic descent? a. Relationship to you (eg. brother, sister, step-brother, step-sister) No Yes In English, write the full name of this person’s father’s father (ie. paternal grandfather) b. Family name All given names including, if applicable, patronymic name (in English), clan and sub-clan names, and middle names j. Is this person currently, or have they ever been, known by other names or spellings of their name? Examples of the types of other names: c. Sex Male Female • name at birth • cultural or tribal name or DAY MONTH YEAR • name before or after marriage clan/subclan name d. Date of birth • preferred name • adoptive or foster name e. Date of death (if deceased) • alias or pseudonym • patronymic name • other spellings of names f. Place of birth No Country Yes Give details in English State/ Province/ 1. Type of name Region Family name Town/city Suburb (if applicable) Given names g. Is this person currently, or have they ever been, a citizen of any country? No Yes Give details 2. Type of name Family name 1. Country When did this person have this citizenship? DAY MONTH YEAR Given names From To (If they still have the citizenship, write ‘Current’) k. Country where this person lives now If in Australia, write the full address, if not living, write ‘DECEASED’ 2. Country When did this person have this citizenship? DAY MONTH YEAR From To (If they still have the citizenship, write ‘Current’) h. Does this person ever use a Chinese Commercial Code Number? No Yes Chinese Commercial Code Number80 (Design date 04/12) - Page 14 © COMMONWEALTH OF AUSTRALIA, 2012
  • 15. 54 Brother or sistera. Relationship to you (eg. brother, sister, step-brother, step-sister) i. Is this person of Arabic descent? Nob. Family name Yes In English, write the full name of this person’s father’s father (ie. paternal grandfather) All given names including, if applicable, patronymic name (in English), clan and sub-clan names, and middle names j. Is this person currently, or have they ever been, known by other names or spellings of their name?c. Sex Male Female Examples of the types of other names: DAY MONTH YEAR • name at birth • cultural or tribal name ord. Date of birth • name before or after marriage clan/subclan namee. Date of death (if deceased) • adoptive or foster name • preferred name • alias or pseudonym • patronymic namef. Place of birth • other spellings of names Country No State/ Province/ Yes Give details in English Region 1. Type of name Town/city Family name Suburb (if applicable) Given namesg. Is this person currently, or have they ever been, a citizen of any country? No Yes Give details 2. Type of name 1. Country Family name When did this person have this citizenship? DAY MONTH YEAR From Given names To (If they still have the citizenship, write ‘Current’) 2. Country k. Country where this person lives now If in Australia, write the full address, if not living, write ‘DECEASED’ When did this person have this citizenship? DAY MONTH YEAR From To (If they still have the citizenship, write ‘Current’)h. Does this person ever use a Chinese Commercial Code Number? No Yes Chinese Commercial Code Number © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 15
  • 16. 55 Brother or sister a. Relationship to you (eg. brother, sister, step-brother, step-sister) i. Is this person of Arabic descent? No b. Family name Yes In English, write the full name of this person’s father’s father (ie. paternal grandfather) All given names including, if applicable, patronymic name (in English), clan and sub-clan names, and middle names j. Is this person currently, or have they ever been, known by other names or spellings of their name? c. Sex Male Female Examples of the types of other names: DAY MONTH YEAR • name at birth • cultural or tribal name or d. Date of birth • name before or after marriage clan/subclan name e. Date of death (if deceased) • adoptive or foster name • preferred name • alias or pseudonym • patronymic name f. Place of birth • other spellings of names Country No State/ Province/ Yes Give details in English Region 1. Type of name Town/city Family name Suburb (if applicable) Given names g. Is this person currently, or have they ever been, a citizen of any country? No Yes Give details 2. Type of name 1. Country Family name When did this person have this citizenship? DAY MONTH YEAR From Given names To (If they still have the citizenship, write ‘Current’) 2. Country k. Country where this person lives now If in Australia, write the full address, if not living, write ‘DECEASED’ When did this person have this citizenship? DAY MONTH YEAR From To (If they still have the citizenship, write ‘Current’) h. Does this person ever use a Chinese Commercial Code Number? No Yes Chinese Commercial Code Number80 (Design date 04/12) - Page 16 © COMMONWEALTH OF AUSTRALIA, 2012
  • 17. 56 Brother or sistera. Relationship to you (eg. brother, sister, step-brother, step-sister) i. Is this person of Arabic descent? Nob. Family name Yes In English, write the full name of this person’s father’s father (ie. paternal grandfather) All given names including, if applicable, patronymic name (in English), clan and sub-clan names, and middle names j. Is this person currently, or have they ever been, known by other names or spellings of their name?c. Sex Male Female Examples of the types of other names: DAY MONTH YEAR • name at birth • cultural or tribal name ord. Date of birth • name before or after marriage clan/subclan namee. Date of death (if deceased) • adoptive or foster name • preferred name • alias or pseudonym • patronymic namef. Place of birth • other spellings of names Country No State/ Province/ Yes Give details in English Region 1. Type of name Town/city Family name Suburb (if applicable) Given namesg. Is this person currently, or have they ever been, a citizen of any country? No Yes Give details 2. Type of name 1. Country Family name When did this person have this citizenship? DAY MONTH YEAR From Given names To (If they still have the citizenship, write ‘Current’) 2. Country k. Country where this person lives now If in Australia, write the full address, if not living, write ‘DECEASED’ When did this person have this citizenship? DAY MONTH YEAR From To (If they still have the citizenship, write ‘Current’)h. Does this person ever use a Chinese Commercial Code Number? No Yes Chinese Commercial Code Number © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 17
  • 18. Part H – Character details 58 Are you currently, or have you been employed as an intelligence officer or an agent of an intelligence or security agency? 57 Have you, or any other person included in this application, ever: No • been convicted of a crime or offence in any Yes Give details of organisation, role and dates you served country (including any conviction which is now removed from official records)? No Yes • been charged with any offence that is currently awaiting legal action? No Yes • been acquitted of any criminal offence or other offence on the grounds of mental illness, insanity or unsoundness of mind? No Yes • been removed or deported from any country 59 Have you ever been denied or refused a visa or entry to another (including Australia)? No Yes country? • left any country to avoid being removed or No deported (including Australia)? No Yes Yes Give details • been refused a visa for Australia or any other country? No Yes • been excluded from or asked to leave any country (including Australia)? No Yes • committed, or been involved in the commission of war crimes or crimes against humanity or human rights? No Yes • been involved in any activities that would represent a risk to Australian national Part I – Declaration security? No Yes • had any outstanding debts to the Australian WARNING: Giving false or misleading information is a serious offence. Government or any public authority in 60 I declare that: Australia? No Yes • the information I have supplied in or with this form is complete, • been involved in any activity, or been correct and up-to-date in every detail. convicted of any offence, relating to the • I have read and understand the information supplied to me. illegal movement of people to any country (including Australia)? No Yes Signature of • been associated with or involved in a applicant program related to the development of DAY MONTH YEAR weapons of mass destruction? No Yes Date • been associated with or received training from an organisation engaged in violence, or been involved in an act of violence (including We strongly advise that you keep a copy of your application war, insurgency, freedom fighting, terrorism, and all attachments for your records. protest) overseas or in Australia? No Yes • Are you, or any other person included in this application, presently under a probation order, good behaviour bond, on parole, released on licence or subject to a periodic detention overseas or in Australia? No Yes If you answered ‘Yes’ to any of the above questions, you must state who it applies to and give ALL relevant details. If the matter relates to a criminal conviction, please give the nature of the offence, full details of sentence and dates of any period of imprisonment or other detention. If insufficient space, give details at Part J80 (Design date 04/12) - Page 18 © COMMONWEALTH OF AUSTRALIA, 2012
  • 19. Part J – Additional details61 Question number Additional information (If insufficient space, attach additional details) © COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 19

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