Application context

Applicant

Information: Entering names incorrectly may result in denial of permission to board an aircraft to
Australia, or result in delays in border processing on arrival to Australia, even if the applicant has
been granted a visa.

Enter the following details as they appear in the applicant's personal passport.

Australian visa grant number

Place of birth

Relationship status

Citizenship

Other passports or documents for travel

Contact details

Electronic communication

The Department prefers to communicate electronically as this provides a faster method of
communication. All correspondence, including notification of the outcome of the application will be sent to email address.

Note: The holder of this email address may receive a verification email from the Department if the
address has not already been verified. If the address holder receives a verification email, they should
click on the link to verify their address before this application is submitted.
Email address:

Character declarations

If the applicant answers ‘Yes’ to any of the character declarations they must give all relevant details.
If the matter relates to a criminal conviction, provide:
• the date and nature of the offence
• full details of the sentence
• dates of any period of imprisonment or other detention
Has the applicant ever been charged with any offence that is currently awaiting legal action?
Has the applicant ever been convicted of an offence in any country (including any conviction which is
now removed from official records)?
Has the applicant ever been the subject of a domestic violence or family violence order, or any other
order, of a tribunal or court or other similar authority, for the protection of another person?

Declarations

Warning:
Giving false or misleading information is a serious offence.
The applicants declare that they:
Have read and understood the information provided to them in this application.
Have provided complete and correct information in every detail on this form, and on any attachments
to it.
Understand that if any fraudulent documents or false or misleading information has been provided
with this application, or if any of the applicants fail to satisfy the Minister of their identity, the
application may be refused and the applicant(s), and any member of their family unit, may become
unable to be granted a visa for a specified period of time.
Understand that if documents are found to be fraudulent or information to be incorrect after the grant
of a visa, the visa may subsequently be cancelled.
Understand that if this application is approved, any person not included in this application will not
have automatic right of entry to Australia.
Will inform the Department in writing immediately as they become aware of a change in
circumstances (including change of address) or if there is any change relating to information they
have provided in or with this application, while it is being considered.
Have read the information contained in the Privacy Notice(Form 1442i).
Understand that the department may collect, use and disclose the applicant's personal information
(including biometric information and other sensitive information) as outlined in the Privacy
Notice(Form 1442i).