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Application for a Temporary Graduate visa

Form

1409

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.

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 www.immi.gov.au

Who should use this form?


You should use this form if you are eligible to apply for a Temporary Graduate visa (subclass 485) and can be assessed against one of the following streams: Graduate Work stream (18 months visa validity) Post-Study Work stream (2, 3 and 4 years visa validity) OR You are a dependant of a person who holds a Temporary Graduate visa (subclass 485), including a subsequent entrant. A summary of the streams has been provided on pages 3 and 4 of this form. Further information about the Temporary Graduate visa is available on the Department of Immigration and Border Protection (the department) website www.immi.gov.au/visas/students/485

Applying online
The department encourages applicants to apply online. Applications lodged online have quicker processing times. For information on how to apply online go to the departments website www.immi.gov.au/e_visa/

Students and the skilled migration program


Australia has a well-deserved reputation for high-quality education and training. We continue to welcome overseas students, and appreciate the contribution they make to both academic life and the communities in which they live. People who wish to study in Australia may be granted a student visa that entitles them to come to Australia on a temporary basis for a specified period to undertake study at an Australian educational institution. While many overseas students make a decision to apply for a permanent visa upon completing their studies, this is an entirely separate process and there is no guarantee that, on the basis of having held a student visa, a person will meet the requirements to be granted a permanent visa at the end of their studies.

Before completing this form


Please read carefully the information below, and the information on the Temporary Graduate visa available on the departments website www.immi.gov.au/visas/students/485

Integrity of application
The department is committed to maintaining the integrity of the visa and citizenship programs. In relation to this application, if: you; a member of your family unit included in your application; or a third party acting on your behalf; provide, or have provided in a previous application relating to yourself or a member of your family unit included in this application, false or misleading information or documents (either knowingly or otherwise), this visa application is likely to be refused and you and any members of your family unit included in this application will be subject to a 3 year bar in relation to visas to which the fraud criterion applies. If information or documents are found to be fraudulent or misleading after the grant of a visa, it may subsequently be cancelled.

Visa Application Charge


A Temporary Graduate visa application is subject to a charge. To check the Visa Application Charge, refer to the departments website www.immi.gov.au/fees-charges 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. Payment must accompany your application. If you intend to pay by credit card, please provide details in Questions 82 and 83.

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Method of payment
To make a payment, please pay by credit card, debit card, bank cheque or money order made payable to the Department of Immigration and Border Protection. Debit card and credit card are the preferred methods of payment. An alternate option is to make a payment at the nearest office of the department, if you are in Australia, or the nearest overseas Australian mission, if you are outside Australia. If you choose to pay in this way you must attach the departmental copy of the receipt to your application form as evidence of payment.

Lodging your application


All applications for a Temporary Graduate visa from both outside Australia and in Australia must be lodged online or sent to the address specified at www.immi.gov.au/visas/ students/_pdf/485-document-checklist.pdf You must lodge your application with the appropriate office, but you can make a payment at the nearest office of the department in Australia or the nearest overseas Australian mission. Important note: Any application made on this form and not lodged at the address specified at www.immi.gov.au/visas/ students/_pdf/485-document-checklist.pdf cannot be accepted. It will not be a valid application and will not be processed. Please note that your nearest office of the department in Australia may not be the specified address.

For further information


For more details on the Temporary Graduate visa, visit the departments website www.immi.gov.au/visas/students/485 or call 131 881. If you are outside Australia, please contact your nearest Australian mission.

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Temporary Graduate visa (subclass 485)


PURPOSE Graduate Work stream This stream is for overseas students who have met the Australian study requirement in the last 6 months and have skills and qualifications in certain skilled occupations. The visa is valid for 18 months and has unrestricted work and study conditions. APPLICATION REQUIREMENTS Graduate Work stream At the time you apply for this visa you must: be in Australia; be under 50 years of age; hold a valid visa; hold or have held an eligible Student visa in the last 6 months; have met the Australian study requirement in the last 6 months; have applied for a skills assessment in your nominated occupation from the Skilled Occupation List (SOL); have evidence that you, and all persons included in this application who require an assessment, have booked or undergone a medical examination for the purpose of this visa application; have evidence that you, and all persons included in this application, have adequate health insurance; have evidence you have applied for a check of criminal records with the Australian Federal Police for you and all persons included in this application who are aged 16 years or over; and have evidence of the required level of English at the time you apply for your visa. Information regarding these requirements is available on the departments website www.immi.gov.au/visas/students/485 Post-Study Work stream This stream is for overseas students who have completed an eligible qualification in Australia and have met the Australian study requirement in the last 6 months. For example, the visa is valid for: 2 years for students who complete a Bachelor degree (including honours) or Masters by Coursework degree or Masters (extended) degree; 3 years for students who complete a Masters by Research degree; 4 years for students who complete a Doctoral degree. This visa has unrestricted work and study conditions. Post-Study Work stream At the time you apply for this visa you must: be in Australia; be under 50 years of age; hold a valid visa; hold or have held an eligible Student visa in the last 6 months; have met the Australian study requirement in the last 6 months; have applied for and subsequently been granted your first Student visa on or after 5 November 2011; have completed an eligible qualification at an eligible institution in the last 6 months; have evidence that you, and all persons included in this application who require an assessment, have booked or undergone a medical examination for the purpose of this visa application; have evidence that you, and all persons included in this application, have adequate health insurance; have evidence you have applied for a check of criminal records with the Australian Federal Police for you and all persons included in this application who are aged 16 years or over; and have evidence of the required level of English at the time you apply for your visa. Information regarding these requirements is available on the departments website www.immi.gov.au/visas/students/485

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PURPOSE Subsequent entrant This form may be filled in for members of the family unit of current Temporary Graduate (subclass 485) visa holders who wish to join the main applicant in Australia. A subsequent entrant is: the main applicants partner; a dependent child of the main applicant or their partner; a dependent relative of the main applicant or their partner. The main applicant must already have been granted a subclass 485 visa before the subsequent entrant can apply for this visa. The subsequent entrants visa is valid for the same duration as specified for the main applicant. Subsequent entrant

APPLICATION REQUIREMENTS At the time you apply for this visa you must: have evidence that you, and all persons included in this application, who require an assessment, have booked or undergone a medical examination for the purpose of this visa application; have evidence that you, and all persons included in this application, have adequate health insurance; and have evidence you have applied for a check of criminal records with the Australian Federal Police for you and all persons included in this application who are aged 16 years or over. Note: Subsequent entrants may be in or outside Australia at the time they apply to be added to a subclass 485 visa, and in or outside Australia when their visa is granted. Information regarding these requirements is available on the departments website www.immi.gov.au/visas/students/485

Further information about this visa


You must not have previously held a subclass 476 or a subclass 485 visa that was granted on the basis that you satisfied the primary criteria for the grant of the visa. The visa is valid only between the date it is granted and the date of expiry. Once granted, the timing of the visa may not be altered or deferred.

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Making a valid application and supporting documents


To make a valid application you must provide certain supporting documents with your application. The documents required are different for each type of application. If you do not provide the required documents your application may not be valid and may be returned to you. You will find the checklist of the documents you must provide in support of your application on the departments website www.immi.gov.au/visas/students/_pdf/485-documentchecklist.pdf You must complete the appropriate checklist from this website if you are sending your application by mail or courier. If you are applying online, the electronic form has an in-built checklist. In either case, enclose/attach copies of all documents listed on the relevant checklist with your application. You may be asked to provide other documents during processing. Certified copies of documents means authorised or stamped true copies of originals by a person or agency recognised by law of your country. In Australia, they must be certified by a Justice of the Peace or Commissioner for Declarations or by a person before whom a statutory declaration may be made. The department also accepts documents certified by a registered migration agent. Documents in languages other than English should be accompanied by an English translation. If the applicant is onshore, the translation should be undertaken by a translator accredited by the National Accreditation Authority for Translators and Interpreters (NAATI). Failure to do so may significantly affect the processing of your application. Translations provided by non-accredited translators overseas should be endorsed by the translator with their full name, address, telephone number, and details of their qualifications and experience in the language being translated. Note: You must include both a certified copy of the original language document and a certified copy of the translated document with your application. Do not supply any original documents with your application, unless you have been asked to do so.

Health insurance requirements


You are required to hold adequate private medical and hospital health insurance cover for the entire time you are in Australia on a Temporary Graduate visa. To meet this requirement you should attach to this application evidence of adequate health insurance, which states the level of health care provided by the insurance policy. A copy of the suggested certification letter and further information on the minimum level of coverage is available from www.immi.gov.au/visas/students/485 The above does not apply if you have enrolled with Medicare (Australias national health cover). Information on entitlements to Medicare is available from www.medicareaustralia.gov.au

Who is covered by this form?


The application form covers the main applicant and, if applicable, secondary applicants. Applicants seeking to meet the criteria as a subsequent applicant can also use this form. For information about who can be included in your application as a secondary or subsequent applicant, see the departments website www.immi.gov.au/visas/students/485

Dependent children
A dependent child may be your or your partners child or stepchild. Step-child means a child of your current partner or a child of your former partner when the child is under 18 years of age and you have a legal responsibility to care for that child (for example, when your former partner is deceased and you have legal custody of your former partners child). You will need to provide a certified copy of the overseas or Australian court order in relation to the custody of the child. A child aged 18 years or over is not considered dependent if he or she is married or in a de facto relationship or is engaged to be married. A child aged 18 years or over will not be considered dependent unless you can show that they are wholly or substantially reliant on you for financial support for their basic needs of food, shelter and clothing. You must also show that you have provided that support for a significant period and that the child is more reliant on you than on any other person or source. Unless you can provide evidence of this, they should apply separately. You should also be aware that a child aged 25 years or over will generally not be considered dependent. Children of any age who have a total or partial loss of bodily or mental functions, which stops them earning a living, are regarded as dependent and part of the family unit (whether or not they accompany you). Give details of such children and whether or not they are in your care. In all cases you should attach evidence of your childs dependency on you.

Character requirements Australian Federal Police clearance


You must provide evidence of having applied for an Australian Federal Police (AFP) National Police Check in the 12 months before you apply for the Temporary Graduate (subclass 485) visa. This also applies to all family members listed in your application who are aged 16 years or older. The AFP National Police Check is the only acceptable police certificate. This certificate will have the words Complete Disclosure in the heading. Under the sub-heading Purpose for check, you must select Immigration/Citizenship (Code 33). Fingerprints are not required. The AFP National Police Check Application Form is available from the AFP website www.afp.gov.au/what-we-do/policechecks/national-police-checks.aspx

Custody requirements
The department will seek to ensure that allowing a child to reside temporarily in Australia is not in contravention of Australias international obligations in relation to the prevention of child abduction. If your application includes a child under 18 years of age and the childs other parent is not accompanying you or there is any other person who has the legal right to determine where the child can live, you will need to provide a Statutory Declaration from each of them giving permission for the child to accompany you in Australia. Alternatively, you can provide a certified copy of a valid court order showing that you, or your partner, has the legal right to remove the child from the country.

Health requirements
All applicants must meet Australias health requirements. You and any family members included in this application may be required to undergo a chest x-ray and medical examination. Refer to form 1163i Health requirement for temporary entry to Australia for further details.

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Other dependants
You may include other relatives in your application if they are wholly or substantially reliant on you for financial support for their basic needs of food, shelter and clothing and they have been reliant on you for that support for a substantial period. They must also be more reliant on you for support than on any other person or source. A relative may also be considered dependent on you if they are reliant on you for financial support because they have a mental or physical disability which stops them from earning a living to support themselves. Other relatives dependent on you or your partner may include, for example, an aged, unmarried relative. A form 47A Details of child or other dependent family member aged 18 years or over must be completed for each dependant aged 18 years or over, whether migrating or not. The dependant may need to provide supporting documents. Form 47A is available from the departments 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 countries, including the United Kingdom, the United States of America, Canada and New Zealand. These international information exchanges may involve the sharing of personal identifiers, including facial images 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 biographical data, copies of travel and other identity documents or information from such documents, your immigration status and immigration history (which may include any immigration abuse and offences) and any criminal history information relevant to immigration purposes. The purpose of such disclosure would be to help confirm your identity and determine if you have presented to the department and the other agency under the same identity and with similar claims. For more detailed information you should read information form 1243i Your personal identifying information, which is available from the departments website www.immi.gov.au/allforms/ or from any office of the department or Australian mission overseas.

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 Temporary Graduate visa to travel, enter and/or remain in Australia, to monitor the conduct of migration agents, and for other purposes relating to the administration of the Migration Act. Personal information collected in this form together with other information held by the department relating to you may be disclosed to educational institutions where you have held a valid Confirmation of Enrolment or equivalent (including partner educational institutions of such institutions). If you come from a country where the government has issued you with a unique identity number for the purpose of confirming your identity you need to enter that identity number and the country that issued the identity number. (An identity number is usually issued on an Identity Card which contains other personal details such as your full name, date of birth, photograph, signature etc. An identity card can also be referred to as a National Identity Card, Smart Identity Card, Citizen Card etc.) 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 has information on Australias temporary visa health requirements. Form 1163i is available at offices of the department or from the departments website www.immi.gov.au/allforms/ The information you provide might also be disclosed to agencies who are authorised to receive information relating to adoption, border control, business skills, citizenship, education, employment, health assessment, health insurance, health services, law enforcement, payment of pensions and benefits, taxation, review of decisions and regulation of migration agents. 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 the departments website, gives details of agencies to which your personal information might be disclosed.
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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 Office of the Migration Agents Registration Authority (Office of the 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.

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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. Information on migration agents, including a list of registered migration agents, is available on the Office of the MARA website www.mara.gov.au You can also access information about migration agents on the departments website www.immi.gov.au

To appoint an authorised recipient you should complete: Question 81 Options for receiving written communications; and form 956A Appointment or withdrawal of an authorised recipient. Note: Migration agents/exempt persons do not need to complete form 956A. Form 956A is available from the departments website www.immi.gov.au/allforms/

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. They will not be added to any mailing list. 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. If you authorise another person to receive documents on your behalf and they wish to be contacted electronically, their signature is required on form 956 or 956A to indicate their consent to this form of communication. Note: Electronic communication is the fastest means of communication available and the department prefers to communicate electronically because this results in faster processing.

Exempt persons
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 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.

Appointing a migration agent/exempt person


To appoint a migration agent/exempt person you should complete Question 81 Options for receiving written communications. Your migration agent/exempt person should complete form956 Advice by a migration agent/exempt person of providing immigration assistance. Form 956 is available from the departments website www.immi.gov.au/allforms/

How to fill in this form?


You must: complete the form in English; print clearly using a pen; answer all questions truthfully and completely; and provide supporting documents where necessary. Read the notes for each question. If a question is not applicable, write N/A. Any changes or corrections you make must be initialled and dated by each person who signs the form. If you use any other sheets of paper for providing additional information, each page must also be signed and dated by all persons who sign the form. If there is not enough space on the form to answer any questions in full, please give details at Question 85 Additional information or attach additional sheets of paper with the details. If you provide incorrect information or documents, it may affect whether you are granted a visa or not, or whether your visa may be subsequently cancelled.

Options for receiving written communications


If you do not appoint a migration agent/exempt person you may still authorise another person, in writing, to receive written communications on your behalf. This person is called the authorised recipient.

Authorised recipient information


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. You will be taken to have received any documents sent to that person as if they had been sent to you.

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Home page General enquiry line

www.immi.gov.au
Telephone 131 881 during business hours in Australia to speak to an operator (recorded information available outside these hours). Ifyou are outside Australia, please contact your nearest Australian mission.

Please keep these information pages for your reference


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Application for a Temporary Graduate visa

Form

1409

When lodging your application do NOT place the application in a binder, folder or plastic sleeve. Before you fill in the form, it is very important that you read and understand all the information outlined on pages 1 to 7. Please use a pen, and write neatly in English using BLOCK LETTERS. Tick where applicable

Part A To be completed by all applicants Application overview


1 2
How many people are included in this application? TYPE OF APPLICATION Graduate (main applicant) Subsequent entrant Complete ALL Parts Complete Parts A, C and D

Visa conditions 8534 and 8503


IMPORTANT INFORMATION FOR APPLICANTS WHO HOLD A STUDENT VISA APPLYING FOR A TEMPORARY GRADUATE VISA WHILE IN AUSTRALIA Applicants with conditions 8534 and 8503 on their student visa cannot apply for a Temporary Graduate visa while in Australia without applying for conditions 8534 and 8503 to be waived. Do you have condition 8534 on your student visa? No Yes Would you like to apply to have that condition waived to allow you to apply for a Temporary Graduate visa in Australia? No Yes By ticking this box you are applying for a waiver of this condition.

Are you applying for: (Tick one box only) Note: Before submitting your application, you should assess your eligibility against all of the visa requirements. Check the departments website www.immi.gov.au/visas/students/485 Graduate Work stream (18 months visa validity) OR Post-Study Work stream (2, 3 or 4 years visa validity) OR Temporary Graduate visa as a subsequent entrant (Note: The main applicant must have already been granted their visa) Family name Given names Give details of the main visa holder below Go to Question 4 Go to Question 4

Do you have condition 8503 on your student visa? No Yes Would you like to apply to have that condition waived to allow you to apply for a Temporary Graduate visa in Australia? No Yes By ticking this box you are applying for a waiver of this condition.

Sex Date of birth

Male
DAY MONTH

Female
YEAR

Current visa (Note: Must be a subclass 485) Passport number File number (if known)

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Your details
4
Your full name (as shown in your passport or travel document) Family name Given names

14 Answer only if you are a subsequent entrant applying outside Australia


Country of current residence

15 Do you have a passport?


No Yes Go to Question 17 Give details

Name in your own language or script (if applicable)

Passport number Country of passport


DAY MONTH YEAR

Date of issue

Other ways you spell your name Family name Given names

Date of expiry Passport place of issue/issuing authority Note: Most visa applicants will be required to hold a valid passport before they can be granted a visa. It is strongly 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.

Name in Chinese Commercial Code Numbers (if applicable)

Other names you are, or have been, known by (including name at birth, previous married names, aliases) Family name Given names Reason for change

16 Do you hold more than one passport?


No Yes Give details of all other passports

1. Passport number Country of passport


DAY MONTH YEAR

If more than one other name, give details at Question 85 Additional information

Date of issue Date of expiry Passport place of issue/issuing authority

Sex

Male
DAY MONTH

Female
YEAR

10 Date of birth 11 Place of birth


Town/city Country 2. Passport number Country of passport
DAY MONTH YEAR

Date of issue Date of expiry Passport place of issue/issuing authority

12 Your present country of citizenship

13 Do you hold any other citizenship?


No Yes Which countries?

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17 Details of countries of residence


For persons aged 16 years or older, provide details of all countries in which you have lived for a total of 12 months or more during the last 10 years. Country Dates lived there
MONTH FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO YEAR

Last permanent address in that country (include suburb/town/city and state/province)

/ / / / / / / / / / / / / / / / / / / /

18 Do you hold an identity card or identity number issued to you by your


government (eg. National identity card) (if applicable)? 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 are a permanent resident of, or reside in. No Yes Give details

21 Contact telephone numbers


COUNTRY CODE AREA CODE ) ( ) ( ) ) NUMBER ) NUMBER

Office hours After hours Mobile/cell

( ( COUNTRY CODE (

Identity number Country of issue

22 Do you agree to the department communicating with you by


electronic means? No Yes Fax number Mobile/cell E-mail address Give details
COUNTRY CODE ( AREA CODE ) ( ) NUMBER

19 Your current residential address


Note: A post office box address is not acceptable as a residential address. Failure to give your residential address will result in this application being invalid.

POSTCODE

20 Address for correspondence


(If the same as your residential address, write AS ABOVE) Note: It is your responsibility to advise the department of any change to your address for correspondence during the application process.

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23 Relationship status
DAY MONTH YEAR

Married Engaged De facto Separated Divorced Widowed Never married or been in a de facto relationship

Date of marriage Date of intended marriage Date relationship began

Go to Question 25

24 Is your partner included in this application?


No Yes

25 Do you have any dependants (other than a partner) included in this


visa application? No Yes

26 Health details
Have you, and any other person included in this application who requires assessment, booked or undergone a medical examination? No Yes Important If you, or any other person included in this application, require an assessment and have not booked or undergone a medical examination, you cannot meet the criteria for the grant of this visa. Give details List the main applicant details first. Full name
DAY

Date of medical examination


MONTH YEAR

City of examination

Booking reference number

/ / / / /

/ / / / /

27 Do you and all applicants included in this application hold health


insurance? No Important You will need to hold health insurance before this visa application is lodged. This visa application may not be approved without adequate health insurance arrangements for all applicants. Attach evidence of health insurance for all applicants. This may include: copy of health insurance policy; copy of Medicare card(s).

Yes

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28 Australian Federal Police check


Have you, and any other person included in this application who is aged 16 years or over, applied for an Australian Federal Police National Police Check? For more information see Character requirements Australian Federal Police clearance on page 5. No Important If you, and any other person included in this application who is aged 16 years or over, have not requested an Australian Federal Police National Police Check, you cannot meet the criteria for the grant of this visa. Give details List the main applicant details first.

Part B To be completed by the main applicant


If you are applying as a Subsequent entrant, Go to Part C

29 Language requirements
Do you hold a current passport from the USA, UK, Canada, New Zealand or the Republic of Ireland (to demonstrate you have competent English) No Yes Go to Question 30 Go to Question 31

Yes

30 Have you undertaken an English test within the last 36 months that
demonstrates that you have at least competent English? For information on the standard required to meet at least competent English go to the departments website www.immi.gov.au/visas/students/485 No Important If you have not answered Yes to either Question 29 or 30, you cannot meet the criteria for the grant of this visa. Give details of your English test

1. Full name
DAY MONTH YEAR

Date of request Reference number 2. Full name


DAY MONTH YEAR

Yes

Name of test Date of request Reference number 3. Full name


DAY MONTH YEAR DAY MONTH YEAR

Date of test Test reference number

Date of request Reference number 4. Full name


DAY MONTH YEAR

Date of request Reference number 5. Full name


DAY MONTH YEAR

Date of request Reference number Attach a certified copy of the Australian Federal Police National Police Check for each person listed above if held at the time of lodgement of this application.

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31 Educational qualification details


Provide details of your Australian and/or overseas post-secondary qualifications. List the most recent first. Qualification Course name Institution name City/Country Postcode of campus Dates of enrolment
MONTH FROM TO FROM TO FROM TO FROM TO FROM TO YEAR

/ / / / / / / / / /

Attach certified copies of your academic transcripts with your application.

Applicant skills
32 Are you applying for the Graduate Work stream (18 months visa validity)?
No Yes Go to Part C

36 Have you obtained a skills assessment from the relevant assessing


authority for your nominated occupation which confirms that your skills have been assessed as suitable for your nominated occupation? No Yes Give details Name of assessing authority
DAY MONTH YEAR

33 What is your nominated occupation?


(Your occupation must be on the Skilled Occupations List which is available from the departments website www.immi.gov.au/skilled/sol)

Date of assessment

34 What is the Australian and New Zealand Standard Classification of


Occupations (ANZSCO) code for your nominated occupation?

Reference or receipt number

35 Skills assessment
Have you applied for a skills assessment from the relevant assessing authority for your nominated occupation? No Important If you have not applied for a skills assessment, you cannot meet the criteria for the grant of this visa. Give details of your skills assessment

Yes

Name of assessing authority


DAY MONTH YEAR

Date of assessment Reference or receipt number

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COMMONWEALTH OF AUSTRALIA, 2013

Part C To be completed by all applicants Details of family members


Give details of all members of your family unit whether or not they intend to accompany you to Australia. Members of your family unit are your partner and any dependent children of you or your partner who are unmarried, not in a de facto relationship and who have not turned 18 years of age. Please attach evidence of your relationship to each family member (eg. certified copies of birth certificates or marriage certificate). If you are in a de facto relationship, please attach evidence that you have been in cohabitation with your partner for at least 12 months (eg. joint account statements and utility billing accounts). Complete all applicable questions.

44 Place of birth
Town/city Country

45 Give details of the passport that your partner will use to enter
Australia (Enter these details exactly how they appear in their passport) Note: It is strongly recommended that the passport be valid for at least 6 months. Passport number Country of passport
DAY MONTH YEAR

Date of issue Date of expiry Passport place of issue/issuing authority

About your partner


37 Partners full name
(as shown in passport or travel document) Family name Given names

46 Does your partner have other passports?


No Yes Give details of all other passports

38 Name in his/her own language or script (if applicable)

1. Passport number Country of passport


DAY MONTH YEAR

Date of issue

39 Other ways your partner spells his/her name


Family name Given names

Date of expiry Passport place of issue/issuing authority

40 Name in Chinese Commercial Code Numbers (if applicable)

2. Passport number Country of passport

41 Other names your partner is, or has been, known by


(including name at birth, previous married names, aliases) Family name Given names Reason for change

DAY

MONTH

YEAR

Date of issue Date of expiry Passport place of issue/issuing authority

42 Sex 43 Date of birth

Male
DAY MONTH

Female
YEAR

COMMONWEALTH OF AUSTRALIA, 2013

1409 (Design date 11/13) - Page 15

47 Details of your partners countries of residence


For persons aged 16 years or older, provide details of all countries in which your partner has lived for a total of 12 months or more during the last 10 years. Country Dates lived there
MONTH FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO YEAR

Last permanent address in that country (include suburb/town/city and state/province)

/ / / / / / / / / / / / / / / / / /

48 Does your partner hold an identity card or identity number issued to


them by their government (eg. National identity card) (if applicable)? Note: If your partner is the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Give details

Details of accompanying family members


52 Give details of ALL your and/or your partners children aged under
18 years who are INCLUDED in this application 1. Family name Given names
DAY MONTH YEAR

Identity number Country of issue

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

49 Partners country of current residence

50 Partners residential address

Date of issue
POSTCODE

Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue

51 Partners telephone numbers (if different from main applicant)


COUNTRY CODE AREA CODE ) ( ) ( ) ) NUMBER ) NUMBER

Office hours After hours Mobile/cell

( ( COUNTRY CODE (

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COMMONWEALTH OF AUSTRALIA, 2013

2. Family name Given names


DAY MONTH YEAR

4. Family name Given names


DAY MONTH YEAR

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue 3. Family name Given names
DAY MONTH YEAR

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue 5. Family name Given names
DAY MONTH YEAR

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue
COMMONWEALTH OF AUSTRALIA, 2013

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue
1409 (Design date 11/13) - Page 17

6. Family name Given names


DAY MONTH YEAR

55 Are there any legal impediments to the removal of any of these


children from their home country? No Male Female Yes Give details

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

56 Give details of ALL your and/or your partners children aged 18 years
or over who are INCLUDED in this application 1. Family name Given names
DAY MONTH YEAR

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue If you have more than 6 children aged under 18 years who are included in this application, give details at Question 85 Additional information

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue

53 Are all the children aged under 18 years in your care and legal custody?
No Yes Give details

54 Does any other person have custodial, access or guardianship rights


to any of these children? No Yes Give details

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COMMONWEALTH OF AUSTRALIA, 2013

2. Family name Given names


DAY MONTH YEAR

4. Family name Given names


DAY MONTH YEAR

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue 3. Family name Given names
DAY MONTH YEAR

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue 5. Family name Given names
DAY MONTH YEAR

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue
COMMONWEALTH OF AUSTRALIA, 2013

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue
1409 (Design date 11/13) - Page 19

6. Family name Given names


DAY MONTH YEAR

Date of birth Relationship to you Country of birth Country of residence Citizenship Passport number Country of passport
DAY MONTH YEAR

Male

Female

Date of issue Date of expiry Passport place of issue/issuing authority Does this person hold an identity card or identity number issued to them by their government (eg. National identity card) (if applicable)? Note: If they are the holder of multiple identity numbers because they are a citizen of more than one country they need to enter the identity number on the card from the country that they are a permanent resident of, or reside in. No Yes Identity number Country of issue If you have more than 6 dependants aged 18 years or over who are included in this application, give details at Question 85 Additional information

57 Give details of all your and/or your partners other family members who are to be INCLUDED in this application
(Include any dependent children of a dependant) Full name
DAY

Select
Date of birth
MONTH YEAR

(use codes below)

Relationship status

Relationship to you

Country of current residence

/ / / / / / /
Relationship status codes M = Married D = Divorced E = Engaged W = Widowed F = De facto N = Never married or been in S = Separated a de facto relationship

/ / / / / / /

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COMMONWEALTH OF AUSTRALIA, 2013

58 Are any of your and/or your partners children married, engaged to be


married or in a de facto relationship? No Yes Give details

59 For accompanying dependants aged 16 years or over, provide details of all countries in which they have lived for a total of 12 months or more
during the last 10 years. Country Dates lived there
MONTH FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO FROM TO YEAR

Last permanent address in that country (include suburb/town/city and state/province)

Who lived there? (Provide full name)

/ / / / / / / / / / / / / / / / / / / /

Details of non-accompanying family members


60 Give details of ALL your and your partners other family members, not accompanying you to Australia
(If not living, write DECEASED in Country of current residence column) Full name Sex
M/F DAY

Date of birth
MONTH YEAR

(use codes below)

Select Relationship status

Country of current residence

/ / / / / /
Relationship status codes M = Married D = Divorced E = Engaged W = Widowed F = De facto N = Never married or been in S = Separated a de facto relationship
COMMONWEALTH OF AUSTRALIA, 2013

/ / / / / /

1409 (Design date 11/13) - Page 21

Part D To be completed by all applicants Health requirements


61 In the last 5 years, have you, or any other person included in this
application, visited or lived outside your country of passport for more than 3 consecutive months? No Yes Give details

64 Do you, or any other person included in this application, intend to work,


or be a trainee, at a child care centre (including preschools and creches) while in Australia? No Yes Give details

1. Full name Country(s)


DAY MONTH YEAR DAY MONTH YEAR

65 Do you, or any other person included in this application, intend to be


in a classroom situation for more than 3 months (eg. as either a student, teacher, lecturer or observer)? No Yes Give details to

Date

from

2. Full name Country(s)


DAY MONTH YEAR DAY MONTH YEAR

Date

from

to

66 Have you, or any other person included in this application:


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? No

3. Full name Country(s)


DAY MONTH YEAR DAY MONTH YEAR

Date

from

to

Yes

Give details

62 Do you, or any other person included in this application, intend to


enter a hospital or a health care facility (including nursing homes) while in Australia? No Yes Give details

67 During your proposed visit to Australia, do you, or any other person


included in this application, 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? No Yes Give details

63 Do you, or any other person included in this application, intend to


work as, or study to be, a doctor, dentist, nurse or paramedic during your stay in Australia? No Yes Give details

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COMMONWEALTH OF AUSTRALIA, 2013

68 Do you, or any other person included in this application, require


assistance with mobility or care due to a medical condition? No Yes Give details

Character requirements
70 Character declarations
Note: All relevant information must be disclosed regardless of age, minor nature of offence and whether or not the offences are considered to have expired in home country. Have you, or any person included in this application, ever: been convicted of a crime or offence in any country (including any conviction which is now removed from official records)?

No No

Yes Yes

69 Have you, or any other person included in this application, undertaken


a health examination for an Australian visa in the last 12 months? No Yes Give details (including HAP ID if available)

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 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? 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)?

No No No No

Yes Yes Yes Yes

No

Yes

No

Yes

No

Yes

No

Yes

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.

COMMONWEALTH OF AUSTRALIA, 2013

1409 (Design date 11/13) - Page 23

71 Have you, or any other person included in


this application, ever been refused an entry permit or visa to Australia? Have you, or any other person included in this application, ever had an entry permit or visa cancelled in Australia? Are you, or any other person included in this application, waiting on a decision on any other visa application? No Yes

72 Have you/your partner or any dependent family members


(accompanying you or not) ever served in the armed forces? No Yes No Yes Give full names, and enclose evidence of service, discharge and rank on discharge

No

Yes

If you answered Yes to any of the above questions, you must state who it applies to and give ALL relevant details.

1409 (Design date 11/13) - Page 24

COMMONWEALTH OF AUSTRALIA, 2013

Details of previous visa(s)


Warning: In general, a person can only hold one visa at a time. If you are granted a visa while you already have another, the first visa will cease automatically when the new visa is granted.

73 Give details of any Australian visa applications that you, or any person accompanying you, are awaiting a decision on (not including this one)
Full name Type of visa Date applied
DAY MONTH YEAR

Office applied at

/ / / / /

/ / / / /

74 Have you, or any person accompanying you, previously been to Australia, held or currently hold a visa for travel to Australia?
No Yes Give details of any previous visits to Australia by you or any person accompanying you Full name Type of visa Visa number Purpose and details of previous stay in Australia Date of arrival and departure
DAY FROM TO FROM TO FROM TO FROM TO FROM TO MONTH YEAR

/ / / / / / / / / /

/ / / / / / / / / /

75 Give details of any Australian entry permit or visa that you, or any other person accompanying you, have had refused
Full name Type of visa refused Date refused
DAY MONTH YEAR

Office applied at

/ / / / /

/ / / / /

76 Give details of any Australian entry permit or visa that you, or any other person accompanying you, had cancelled
Full name Type of visa cancelled Date cancelled
DAY MONTH YEAR

Office applied at

/ / / / /

/ / / / /

COMMONWEALTH OF AUSTRALIA, 2013

1409 (Design date 11/13) - Page 25

Assistance with this form


77 Did you receive assistance in completing this form?
No Yes Title: Mr Go to Question 81 Please give details of the person who assisted you Mrs Miss Ms Other

Options for receiving written communications


81 All written communications about this application should be sent to:
(Tick one box only) Myself OR Authorised recipient OR Migration agent OR Your migration agent/exempt person should complete form 956 Advice by a migration agent/exempt person of providing immigration assistance You should complete form 956A Appointment or withdrawal of an authorised recipient

Family name Given names Address

POSTCODE

Exempt person

Telephone number or daytime contact


COUNTRY CODE AREA CODE ) ( ) NUMBER

Office hours Mobile/cell

78 Is the person an agent registered with the Office of the Migration


Agents Registration Authority (Office of the MARA)? No Yes Go to Question 81

79 Is the person/agent in Australia?


No Yes Go to Question 81

80 Did you pay the person/agent and/or give a gift for this assistance?
No Yes

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COMMONWEALTH OF AUSTRALIA, 2013

Payment details
82 IMPORTANT: You must refer to the departments website at www.immi.gov.au/fees-charges to complete this part of your application.
The website shows reference tables with the Visa Application Charges applicable to each visa subclass. Visa subclass you are applying for Base Application Charge Write the amount shown on the reference table for your visa subclass AUD (1)

+
Non-internet Application Charge (if applicable) Additional Applicant Charge aged 18 years or over at the time your application is lodged Write the amount shown on the reference table for your visa subclass AUD Number of additional applicants aged 18 years or over X (multiplied by) = AUD AUD (2)

+
(3)

Additional Applicant Charge under 18 years of age at the time your application is lodged Write the amount shown on the reference table for your visa subclass AUD Number of additional applicants under 18 years of age X (multiplied by) = AUD

+
(4)

Subsequent Temporary Application Charge (if applicable) Write the amount shown on the reference table for your visa subclass AUD Number of applicants X (multiplied by) = AUD

+
(5)

=
Total Total (1) + (2) + (3) + (4) + (5) You must pay the total amount or your visa application will not be valid. Note: A second instalment of the Visa Application Charge must also be paid before we can grant some visas. AUD

83 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 Border Protection. 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. Bank cheque Money order Debit card Credit card Cannot be used for applications lodged by mail Give details below Australian Dollars Diners Club JCB AUD Telephone number Address
COUNTRY CODE ( AREA CODE ) ( ) NUMBER

Payment by (tick one box) MasterCard American Express Visa Credit card number : : : : : : : : :
YEAR

POSTCODE

: Signature of cardholder

MONTH

Expiry date Cardholders name

1409 (Design date 11/13) - Page 27

Credit card information will be used for charge paying purposes only.
COMMONWEALTH OF AUSTRALIA, 2013

Declaration and consent


84 DECLARATION FOR ALL APPLICANTS
WARNING: Giving false or misleading information is a serious offence. I declare that: I declare that the information I have supplied in this application is complete, correct and up-to-date in every detail. I understand that if I, a member of my family unit included in my application, or third parties acting on my behalf, provide (or have provided in another application) false or misleading information or bogus documents either knowingly or otherwise, my visa application will be refused. If my application is refused on this basis, I will likely be subject to a 3 year bar in relation to visas to which the fraud criterion applies. Any visa granted may be cancelled. I have made adequate health insurance arrangements for the period of my stay in Australia and I acknowledge that I am required to maintain these arrangements while in Australia as the holder of a Temporary Graduate visa. I understand that if this application is approved, any person not included in this application will not have automatic right of entry to Australia by way of this application. I will inform the department of any changes to my personal circumstances (including change of address) while my application is being considered. I authorise the Australian Government to make any enquiries necessary to determine my eligibility for temporary stay in Australia, and to use any information supplied in this application for that purpose. The agencies/ organisations to which information may be disclosed include: federal, state or territory government agencies; federal, state or territory law enforcement agencies; state or territory housing authorities (including private landlords); local government authorities; financial institutions; educational institutions; and private businesses (including telecommunication and internet service providers, insurance companies). I have read and understood the information supplied to me in this application. I understand that a Temporary Graduate visa is a temporary visa, and that being granted a Temporary Graduate visa will not guarantee that I will be eligible for the grant of a further visa to remain in Australia, including a skilled migration visa. I understand that if I cannot obtain a further visa that I must depart Australia on or before the cease date of the Temporary Graduate visa. I will respect Australian values during my stay in Australia and will obey the laws of Australia. Have you completed the visa specific checklist from the departments website www.immi.gov.au/visas/students/_pdf/485-documentchecklist.pdf No Yes Please complete the checklist Include it with your application Family name Given names
DAY MONTH YEAR

Signature Family name Given names

DAY

MONTH

YEAR

Date

Signature Family name Given names

DAY

MONTH

YEAR

Date

Signature Family name Given names

DAY

MONTH

YEAR

Date

Signature Family name Given names

DAY

MONTH

YEAR

Date

Signature Family name Given names

DAY

MONTH

YEAR

Date

Signature

The declaration and consent must be signed and dated by all people aged 18 years or older included in this application. Both parents or any person who has legal custody must complete the declaration and consent on behalf of any children aged under 18years or any person who lacks the legal capacity to sign on their own behalf. Signature of primary applicant Date
1409 (Design date 11/13) - Page 28

Date When lodging your application do NOT place the application in any binder, folder or plastic sleeve.

DAY MONTH YEAR

We strongly advise that you keep a copy of your application and all attachments for your records.

COMMONWEALTH OF AUSTRALIA, 2013

Additional information
85
Question number Additional information

If insufficient space, attach additional details.


COMMONWEALTH OF AUSTRALIA, 2013 1409 (Design date 11/13) - Page 29

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