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Form
956
Exempt persons
The following people do not have to be registered as
migration agents in order to provide immigration assistance:
a close family member (spouse, child, adopted child,
parent, brother or sister of a visa applicant);
a sponsor or nominator for a visa applicant;
Authorised recipient
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.
Form
Please use a pen, and write neatly in English using BLOCK LETTERS.
Tick where applicable
Are you notifying the department that you have been appointed to
provide immigration assistance, or that your appointment has ended?
New appointment
Yes
Give details
COUNTRY CODE
Fax number
AREA CODE
) (
Mrs
Family name
Iimori
Given names
Jennifer
Miss
Ms
Other
DAY
YEAR
Fragomen Global
Non-registered migration
agent outside Australia
Go to Question 11
Exempt person
Go to Question 12
7 DIGITS
1: 1
7 : 5: 2: 3 : 1
Go to Question 13
Yes
Family name
Jusufspahic
Given names
Ines
Telephone numbers
COUNTRY CODE
Office hours
Sydney NSW
POSTCODE
Go to Question 9
IAAAS
MONTH
8224 8500
NUMBER
02
956
NUMBER
02
) (
8224 8555
Mobile/cell
2000
GPO Box 53
AREA CODE
7 DIGITS
1 : 2
7 : 6 : 6 :8 : 8
Go to Question 13
Sydney NSW
POSTCODE
2001
Telephone numbers
COUNTRY CODE
Office hours
AREA CODE
02
) (
NUMBER
)
8224 8532
Mobile/cell
Sponsor
Nominator
Member of a diplomatic mission, consular
post or international organisation
Member of parliament or their staff
An official whose duties include providing
immigration assistance
COMMONWEALTH OF AUSTRALIA, 2014
Clients details
Type of assistance
visa applicant
sponsor or sponsor applicant
Application process
Type of application
457 visa
DAY
MONTH
YEAR
Date lodged
14 Client 1
Subclass of visa
Full name (If the client is an organisation, provide the name of the
contact person)
DAY
Family name
MONTH
YEAR
Given names
DAY
MONTH
YEAR
Date of birth
Organisation name (if applicable)
POSTCODE
Telephone numbers
COUNTRY CODE
Office hours
AREA CODE
) (
NUMBER
)
Mobile/cell
DIBP Client ID number (if known)
Authorised recipient
18 Have you been authorised to receive written communication on behalf
of your client(s) in relation to the matter indicated in Question 16?
No
Go to Part C
Yes
Go to Part C
Part C Declarations
Declaration by migration agent/exempt
person
Given names
Organisation name (if applicable)
Telephone numbers
COUNTRY CODE
Office hours
AREA CODE
) (
NUMBER
)
Mobile/cell
If applicable:
Migration Agent Registration
Number (MARN)
7 DIGITS
DAY
21 Clients details
Full name (If the client is an organisation, provide the name of the
contact person)
Family name
Given names
DAY
MONTH
MONTH
YEAR
Date
YEAR
Date of birth
Declaration by client
24 Tick one only
Appointment I declare that I have appointed the migration
agent/exempt person named in Part A of this form to provide
assistance with matters as indicated on this form.
Ending appointment I declare that the migration agent/exempt
person named in Part B is no longer acting on my behalf.
Signature of
client
DAY
MONTH
YEAR
Date