Personal particulars for character assessment

Transcription

1 Personal particulars for character assessment Form 80 This form is to be completed in English by applicants for visas for Australia who are 16 years of age or over, as requested by the office processing the application. All questions must be completed. 4 (a) Write your name in your own language or script. For Russian citizens, include Patronymic name The Department of Immigration and (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 n-citizens. The information provided will be used for assessing your eligibility for a visa to travel, enter and remain in Australia and for other purposes relating to the administration of the Migration Act, for example, to assist migrants with settling in Australia or for ensuring compliance with the Migration Act. The information provided might also be disclosed to agencies who are authorised to receive information relating to adoption, border control, business skills, citizenship, education, health assessment, health insurance, health services, law enforcement, payment of pensions and benefits, taxation, review of decisions and registration of migration agents. The information form 993i Safeguarding your personal information, available from offices of the department, gives details of agencies to which your information might be disclosed. For officer This form is designed for completion by applicants and requires attachment of form 80H, internally completed, before despatch for checking purposes. I am applying for a visa to travel to Australia as a: OR I am applying in Australia for: refugee/ humanitarian entrant temporary resident a further temporary stay migrant visitor student permanent residence protection Write your name and birth details as shown on official documents such as birth certificate, family book, passport or identification document. 5 6 Place of birth wn/city State/ Province (b) Your name in Chinese commercial code numbers (if applicable) (c) If you are of Arabic descent, write the full names of your paternal grandfather (ie. your father s father) Date of birth What is your current marital status? (Tick more than one if appropriate) Never married Divorced Married Temporarily separated Engaged to be married Permanently and legally separated Widowed Living in a de facto marriage What is your current citizenship? How was your citizenship acquired? (eg. birth, descent, naturalisation) 1 10 When was your citizenship granted? 2 3 Other names you are, or have been, known by (if insufficient space, please provide details on a separate sheet of paper) 11 Are you a dual citizen, or have you held any other citizenship? Provide detail including date of citizenship 80 (Design date 10/07a) - Page 1

2 12 Have you ever been refused citizenship of another country? 17 Your current residential address (t a post office box address ) Date Provide details below of residence POSTAL CODE Reason for refusal Date 18 About your SPOUSE For the purposes of this form, the term spouse means a legally married husband or wife, or a partner in a de facto marriage, or an intended spouse. If you do not have a spouse, write N/A and go to Question 19. Reason for refusal (If insufficient space, give details on an attachment) 13 Details of all passports ever issued to you Passport number of issue 14 Details of any identity documents, social security cards, or any alien registration numbers you currently use or have used in the past Type of document Number Write your spouse s name in his/her own language or script. Please also write Chinese names in Chinese commercial code numbers. For Russian citizens, include Patronymic name. If your spouse is of Arabic descent, write the full names of his/her paternal grandfather (ie. his/her father s father) 15 Your addresses What is your spouse s current citizenship? 16 Your telephone numbers Work COUNTRY CODE AREA CODE Home Is your spouse a dual citizen, or has she/he held any other citizenship? Provide detail including date of citizenship Mobile Fax Other Contact telephone if in Australia 80 (Design date 10/07a) - Page 2

3 19 About your FATHER 20 About your MOTHER Write your father s name in his own language or script. Please also write citizens, include Patronymic name. If your father is of Arabic descent, write the full names of his paternal grandfather (ie. his father s father) Write your mother s name in her own language or script. Please also write citizens, include Patronymic name. If your mother is of Arabic descent, write the full names of her paternal grandfather (ie. her father s father) or nationality (Give details of all held) or nationality (Give details of all held) Continued on the next page 80 (Design date 10/07a) - Page 3

4 21 About your BROTHERS and/or SISTERS or nationality (Give details of all held) or nationality (Give details of all held) or nationality (Give details of all held) or nationality (Give details of all held) If you have more than four brothers and/or sisters, please provide details on a separate sheet of paper 80 (Design date 10/07a) - Page 4

5 22 Previous addresses of the places where you have lived for 12 months or more, either continuously or cumulatively, during the last 10 years (including Australia). You must account for every year. (If insufficient space, give details on an attachment) Address (number, street name, suburb, state/province, country) 23 What is your present occupation 24 Give details of your employment history for the entire period since leaving school until now, including periods of unemployment (If insufficient space, give details on an attachment) Name and address of employer Type of business Your occupation/ position 25 Give details of your education history for the entire period since leaving (high) school Name and address of institution (include country) Course studied Course completed or withdrawn 26 Give details of all your previous visits to Australia (If none, write N/A. If insufficient space, give details on an attachment) Type of entry (visitor, student, temporary resident) Place where visa was issued Name used on entry Purpose of visit 27 Give details of all visits (including short stays) to countries outside Australia for the last 10 years (If insufficient space, give details on an attachment) or countries Reason for visit 80 (Design date 10/07a) - Page 5

6 28 Your current travel document details (eg. passport, travel authority, documentary visa) Type of travel document 31 Details of intended visit to Australia Date of arrival or proposed arrival (DAY//) Number Place of issue Place of proposed arrival Period of time permitted to remain in Australia as authorised on arrival Date of issue (DAY//) Purpose of journey Date of expiry (DAY//) Name on passport Additional periods of stay authorised after arrival (if applicable) Proposed address in Australia (number, street name, suburb, state) 29 Details of contacts in Australia Go to Question Visa details (of initial arrival) Relationship to applicant (eg. family friend, mother) Telephone number AREA CODE Type of visa Visa number V < Place of issue of visa Date of issue of visa (DAY//) Special conditions (if applicable) Place of arrival Date of arrival (DAY//) Relationship to applicant (eg. family friend, mother) Telephone number AREA CODE Relationship to applicant (eg. family friend, mother) Telephone number AREA CODE 30 Where are you currently located? Outside Australia Go to Question 31 In Australia Go to Question Please answer the following questions about yourself and any other person included in this application (a) Have you, or any other person included in this application, ever been convicted of, or found guilty of, ANY offences overseas or in Australia (include all traffic offences which went to court, including offences declared in your permanent residence application, and any spent convictions)? te: Spent convictions are convictions which are not, under legislation in certain countries, normally required to be disclosed, for example because of the time that has passed since the conviction, or because of a pardon for reasons other than wrongful conviction. (b) Have you, or any other person included in this application, ever been confined in a prison or in a psychiatric institution by order of a court made in connection with criminal proceedings overseas or in Australia? (c) Have you, or any other person included in this application, ever committed, or been involved in the commission of war crimes or crimes against humanity or human rights overseas or in Australia? (d) 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 periodic detention overseas or in Australia? 80 (Design date 10/07a) - Page 6

7 (e) Are you, or any other person included in this application, aware of any proceedings pending against you overseas or in Australia for an offence, including proceedings by way of appeal or review? (f) Have you, or any other person included in this application, ever been involved in any activity, or been convicted of any offence, relating to the illegal movement of people to any country (including Australia)? (g) Have you, or any other person included in this application, ever been charged with any offence overseas or in Australia that is currently awaiting legal action? (h) Have you, or any other person included in this application, ever been associated with or received training from an organisation engaged in violence, or been involved in an act of violence (including war, insurgency, freedom fighting, terrorism, protest) overseas or in Australia? (i) Have you, or any other person included in this application, ever been associated with or involved in a program related to the development of weapons of mass destruction? 34 Have you ever served in the military, either for your own country or another country that was not considered mandatory service? Give details of any periods of military service including name of unit, locations where posted, rank achieved and duties performed 35 Are you currently, or have you been employed as an intelligence officer or an agent of an intelligence or security agency? Give details of organisation, role and dates where you served If you answered to any of the above questions, give details of all occurrences. Include the following where appropriate: the name of the court; the offence; the name of the terrorist organisation; the nature of the terrorist association; details of terrorist acts; the sentence received; relevant dates; to whom it applies (you or a person included in this application). 36 Have you ever been denied or refused a visa or entry to another country? Give details Declaration 37 I hereby declare that the information I have supplied in this form is, so far as I know or could reasonably find out, correct in every detail. I declare that I have read and understand the information supplied to me. Signature of applicant Date We strongly advise that you keep a copy of your application and all attachments for your records. If there is insufficient space on this form to provide details of offences, provide the details on a separate sheet of paper 80 (Design date 10/07a) - Page 7