1420 Form For Applicants PDF

1420 (Design date 03/14a) - Page 1 COMMONWEALTH OF AUSTRALIA, 2014
Application for a
Temporary Work (Entertainment) visa
Form
1420
The Department of Immigration and Border Protection (the
department) acknowledges that Aboriginal and Torres Strait
Islander peoples are the traditional custodians of the
Australian land.
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
About this form
Important Please read this information carefully before you
complete the application. Once you have completed the
application we strongly advise that you keep a copy for your
records.
All relevant questions on this form should be answered and
any requested information attached. The department may
decide the application on the basis of the information
provided on the application form.
All forms are available from the departments website
www.immi.gov.au/allforms/
Who should use this form?
Use this form if you:
have been nominated by an entertainment sponsor to work
in the entertainment industry in Australia; or
are a family member of a primary applicant or holder of
a Temporary Work (Entertainment) (subclass 420) visa
or Media and Film Staff (subclass 423) visa and you are
applying to join them.
Who should be included in this application?
As the primary person you should include your details as well
as all family members (secondary persons) who will be
accompanying you to Australia.
Family members include your partner, children under 18 years
of age AND children and other relatives 18 years or over who
are wholly or substantially reliant on you for financial support
for their basic needs.
Partner means your spouse or de facto partner (including a
same-sex partner).
People 18 years or over must show that they have been reliant
on you for a substantial period and that they are more reliant
on you than on any other person or source. A person may also
be considered dependent on you if they rely on you for
financial support because of a disability.
Note: A child of any age who is engaged to be married or who
has a partner is not considered dependent.
Family members joining a temporary resident in
Australia
If as a family member you intend to join the primary person in
Australia who holds a subclass 420 visa or subclass 423 visa you
will need to make a separate visa application.
All applicants for this visa must be sponsored. You must show
evidence that the organisation or eligible individual in
Australia who has sponsored the primary visa holder will also
accept responsibility for you during your stay in Australia.
Integrity of application
The department is committed to maintaining the integrity of the
visa and citizenship programs. In relation to your 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.
Complete applications
The department encourages the lodgement of complete
applications. For further information on how to make a
complete application, see www.immi.gov.au
Health insurance requirements
You are required to hold adequate private medical and hospital
health insurance for the entire time you are in Australia on a
subclass 420 visa. This insurance does not have to be held with
an Australian insurer arrangements made in your home
country may be assessed as being acceptable.
To meet this requirement you should attach to this application
evidence of your health insurance policy 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/skilled/
The above does not apply if you have enrolled with Medicare
(Australias national health cover). Information on entitlements
to Medicare is available from www.humanservices.gov.au
Medicare Levy Exemption
Subclass 420 visa holders who are not an eligible Australian
resident for Medicare benefit purposes and whose country
does not have a reciprocal health arrangement with Australia
may be eligible to obtain an exemption of the Medicare levy
payment in their tax return. Please contact Medicare directly
for further advice on 132 011 or by writing to:
Levy Exemption Certification Unit
Medicare Australia
GPO Box 9822
HOBART TAS 7001
Visa conditions
If your visa application is approved, it will be subject to a
number of conditions.
Visa condition 8107
The primary visa holder must not, during their period of stay:
cease to be employed, or cease to undertake the activity in
relation to which the visa was granted;
work in a position, or engage in an activity inconsistent
with the position or activity in relation to which the visa was
granted; or
engage in work for another person or on your own account,
while undertaking the employment or activity in relation to
which the visa was granted.
If you wish to work for another organisation which is not your
current sponsor you do not need to make a new visa
application. Before you can work for another organisation or
individual, your new sponsor must nominate you to undertake
that position. You must not commence work for the new
sponsor until the nomination is approved.
Visa condition 8109
The primary visa holder must not change details of times and
places of engagements specified in the nomination to be
undertaken in Australia during the visa period, without the
prior permission in writing of the Secretary.
Visa condition 8501
Visa holders are required to maintain adequate health
insurance while in Australia and holding a subclass 420 visa.
Visa condition 8303
Visa holders must not become involved in activities disruptive
to, or violence threatening harm to, the Australian community
or a group within the Australian community.
In addition, there may be other conditions of your entry and
stay in Australia applied to your visa.
Sponsorship obligations
The sponsor must meet a number of sponsorship obligations
in relation to the primary person and any secondary persons.
Further information about sponsorship obligations is available
from the departments website www.immi.gov.au/skilled/
If your visa application is approved, it will permit you to work
or undertake activities for your sponsor in the nominated
position, or position in relation to which your visa was
granted, for the visa validity period. Should you cease
employment or the activities with your sponsor, or if you
believe the sponsor is not meeting their sponsorship
obligations, you should contact your nearest office of the
department.
To ensure the integrity of temporary residence visas, the
department has a thorough monitoring process to assist in
ensuring compliance with all program requirements and all
relevant Australian laws.
Other obligations
The sponsor must also comply with other applicable laws of
the Commonwealth, states and territories. If the department
believes that the sponsor has breached a law of the
Commonwealth or a state or territory, the department may
take action to bar the sponsor from accessing further overseas
people for the specified period or may cancel the sponsorship.
Further information about sponsorship obligations is available
from the departments website
www.immi.gov.au/skilled/sponsor-obligations-list.htm
Residential address
You must provide the address of where you intend to live
during the period that your application is being considered.
Failure to give your residential address will result in this
application being invalid. A post office box address will not be
accepted as your residential address.
Passport information
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.
If you do not provide us with the details of any new or
additional passport you use to travel to Australia, you
may experience significant delays at the airport and
may be denied permission to board your plane.
Do NOT send your passport with your visa application.
You must provide with your visa application a certified copy of
the page from your passport showing your photo and details.
The department will advise you if your application has been
approved. Please keep a copy of the Visa Grant Notification in
a safe place for your reference.
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 in
order to meet the criteria for the grant of a subclass 420 visa.
Refer to form 1163i Health requirement for temporary entry
to Australia for further details.
How to apply
Step 1 Sponsorship and nomination
To make a valid application for a subclass 420 visa the
organisation or eligible individual who intends to nominate
you must be approved as an entertainment sponsor or have
made an application to become an entertainment sponsor.
The nomination and visa application should be made together.
Sending your visa application to your sponsor to make both
applications will result in faster processing.
The visa application will not be assessed until the nomination
is decided. The department recommends that the nomination
and visa application are not made until the sponsorship is
approved.
Step 2 Check your passports
Make sure you and all family member(s) seeking to
accompany you have valid passports. It is strongly
recommended that passports be valid for at least 6 months.
If you are already in Australia and are eligible to apply in
Australia, check the expiry date of your current visa. If you can
apply whilst in Australia, you should make your visa
application before your current visa expires.
Note: If you already have a visa for travel to Australia and you
are granted another visa, the first visa will cease.
Step 3 How to fill in this form
This form is available as a PDF file and can be completed on
screen, printed and mailed to the department or you can print
a copy and use a black or blue pen, write neatly in English
using BLOCK LETTERS.
If you need more space to answer questions or wish to
provide additional relevant information, give details at Part P
Additional information or attach a signed and dated sheet
giving the required details.
Any alterations made on this application must be initialled and
dated.
You will need to supply 2 recent passport-sized photographs
of each person included in your application.
Step 4 Making your visa application
Check if a Visa Application Charge is required.
Not all applications attract a charge, but when a prescribed
charge is applicable, the application will not be valid unless
payment has been received.
A charge is not required if you are outside Australia and have
been identified in a nomination:
relating to performing as an entertainer or supporting an
entertainer or body of entertainers in relation to one or
more engagements that are for non-profit purposes; or
made by an organisation that is funded by the
Commonwealth and approved by the Secretary of the
department.
If a charge is required, payment must accompany your
application. Payment of the charge does not guarantee this
application will be successful and is generally not refundable.
Refer to Part M Payment details of this form to calculate the
correct charge and make payment.
How to lodge your application
To make your visa application you must provide the completed
application, payment and any attachments if required. Refer to
Part N Document checklist for the list of documents required.
If you are making a visa application in certain countries, you
may need to provide biometrics, see Countries and Visa
Subclasses included in the Biometrics Program on the
departments website
www.immi.gov.au/allforms/biometrics/offshore/
The nomination and visa application should be made together.
To make a valid application, all applications are to be made at
one of the following addresses:
By mail:
Department of Immigration and Border Protection
GPO Box 9984
SYDNEY NSW 2001
By courier:
Sydney City Office
Level 2, Gateway House
26 Lee Street (near Railway Square)
SYDNEY NSW 2000
In person:
Parramatta Office
9 Wentworth Street
PARRAMATTA NSW 2150
or
Sydney City Office
Level 2, Gateway House
26 Lee Street (near Railway Square)
SYDNEY NSW 2000
Fax: 61 2 8861 4301
Pre-lodgement enquiries telephone: 131 881
Post-lodgement enquiries email:
[email protected]
Let the department know if you change your address
If you change your residential address for more than 14 days
while your application is being processed, you must tell the
department your new address and how long you will be there.
The department will send communication about your
application to the latest address for correspondence you have
provided.
Communication about your application can be sent to another
person that you have authorised, but you will be taken to have
received the communication that the department sends to
that person. The department must be informed (in writing) of
any address change for either you or your authorised person.
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.
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
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 Part L Options for receiving written
communications.
Your migration agent/exempt person should complete
form 956 Advice by a migration agent/exempt person of
providing immigration assistance.
Form 956 is available from the departments website
Applications made by people who are in Australia
If you are applying for a class of visa which may be granted in
Australia, this form also serves as an application for any class
of Bridging visa (Classes A, C or E) for which you may be
eligible to apply. Further explanation is contained in the
information form 1024i Bridging visas available at all offices of
the department in Australia.
If you need to travel overseas temporarily before the
application is decided, you should contact the processing
office to enquire about a Bridging visa B, to enable you to
return to Australia.
If you are seeking to change the work conditions of your
existing visa before the application is decided, you should
apply on form 1005 Application for a bridging visa.
You should lodge the form at the nearest office of the
department in the state or territory in which you are at the
time of application (if you are in NSW, you may lodge your
application in the ACT if it is closer to where you live).
This application will not be valid if you are a holder of a
criminal justice entry visa, or if you are a detainee who has not
made an application within the prescribed time limits, or if
you are a holder of a visa subject to a condition preventing the
grant of a substantive visa while you remain in Australia.
What happens next?
Your application will be considered and you may be asked to
provide additional information to enable a decision to be
made.
If you want to change any details after you have made the
application, or if you want to withdraw it, please contact the
office where you made the application.
You should also advise the office if any of the information you
gave in your application changes while your application is
being considered.
You will be advised in writing whether your application has
been approved or not.
If your application is refused, you will be given a reason for the
decision as well as information about your review rights.
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.
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.
To appoint an authorised recipient you should complete:
Part L 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
Consent to communicate electronically
The department may use a range of means to communicate
with you. However, electronic means such as fax or email 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.
Important information about privacy
Your personal information is protected by law, including the
Privacy Act 1988. Important information about the collection,
use and disclosure (to other agencies and third parties,
including overseas entities) of your personal information,
including sensitive information, is contained in form 1442i
Privacy notice. Form 1442i is available from the departments
website www.immi.gov.au/allforms/ or offices of the
department. You should ensure that you read and understand
form 1442i before completing this form.
When sponsorship is required for your visa subclass, the
outcome of your application may be made known to the
person/organisation who has submitted a sponsorship form
regarding your application.
www.immi.gov.au
Telephone 131 881 during business hours
in Australia to speak to an operator (recorded
information available outside these hours).
If you are outside Australia, please contact
your nearest Australian mission.
Home page
General
enquiry line
Please keep these information pages for your reference
This page is intentionally blank
Application for a
Temporary Work (Entertainment) visa
Form
1420
Part A Visa information
3
Tick where applicable
Please use a pen, and write neatly in English using BLOCK LETTERS.
How many applicants are included in this application
(including yourself and your family members)?
2
3
No
Yes
Important To apply for this visa a sponsorship
application must already be made or approved.
Sponsor name
Approval date
Organisation name
Sponsorship application ID number (if known)
DAY MONTH YEAR
Do you have a sponsor who is approved or who has made an
application for approval as an entertainment sponsor?
PHOTOGRAPH
Please attach a recent
passport-sized
photograph of yourself
AND
each person included in
this application.
5 Are you applying as member of an entertainment body?
Name of group
No
Yes
Note: In certain circumstances the Visa Application Charge (VAC) may
not be required for this visa application.
The following questions will determine if you may be eligible for a
VAC exemption. For further information see Step 4 Making your visa
application on page 3.
6
Have you been identified in a nomination:
to perform as an entertainer, or support an entertainer or a body of
entertainers, in relation to one or more specific engagements that
are for non-profit purposes?
made by an organisation who is funded by the Commonwealth and
approved by the Secretary of the department?
No
Yes
No
Yes
4 Are you identified in more than one nomination in relation to
undertaking employment or an activity in Australia?
No
Yes Give the Nomination ID number for each nomination
Note: Nomination ID number can be found on the
Nomination approval letter or on the Nomination application
acknowledgement of receipt letter that was provided to the
sponsor from the department.
Attach a copy of each letter, see Part N Document checklist.
1.
2.
3.
4.
Give the Nomination ID number
1 Are you currently outside Australia?
No
Yes Intended arrival date
DAY MONTH YEAR
Genevieve Lang
World Harp Congress Australia Limited
06-Jun-2014
1825568809

Give the following details exactly as they appear in your passport
It is strongly recommended that passports be valid for at least 6 months.
Date of birth
9
Family name
Given names
Passport number
Country of passport
Nationality of
passport holder
Date of issue
Date of expiry
Place of issue/
issuing authority
DAY MONTH YEAR
DAY MONTH YEAR
Sex Male Female
Visa subclass
No
Yes
Are you currently a holder of a visa? 8
Visa grant number (13 digit number on last visa grant letter)
10 Place of birth
Town/city
State/province
Country
11 Relationship status
Married
De facto
Engaged Divorced
Separated
Widowed
Never married or
been in a de facto
relationship
12 Are you or have you been known by any other name?
(including name at birth, previous married names, aliases)
Give details
No
Yes
List countries
No
Yes
Are you a citizen of any other country? 13
Give details
No
Yes
Do you have other current passports? 14
Passport number
Country of passport
Give details
No
Yes
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 live in.
15
Family name
Given names
Type of document
Identity number
Country of issue
16 Name in Chinese Commercial Code Number (if applicable)
17 In which country are you currently located?
Part B Your details
Are you applying as a: 7
Primary applicant
Family member applying
separately and wishing to join a
person who already holds a visa
Give details of the primary
person you intend to join and
stay with in Australia
Date of birth
Family name
Given names
Visa subclass held
DAY MONTH YEAR
Sex Male Female
Attach a written statement from the sponsor, see Part N Document
checklist.
Give details
18 Legal status in your current location
Citizen
Visitor
Work visa
Other
Permanent resident
Student
No legal status
22 Do you agree to the department communicating with you by email
and/or fax?
This may include receiving notification of the outcome of this application.
Note: We can communicate about this application more quickly using
email and/or fax.
Give details
No
Yes
Fax number
Email address
( ) ( )
COUNTRY CODE AREA CODE NUMBER
Part C Family members
Give details of ALL family members who are included in this application
and who will accompany you to Australia.
Enter the following details exactly as they appear in their passport.
It is strongly recommended that passports be valid for at least 6 months.
24 19
POSTCODE
Your current residential address
Note: A street address is required as a post office box address cannot
be accepted.
20 Address for correspondence
(If the same as your residential address, write AS ABOVE)
Country
POSTCODE
Country
21 Contact telephone numbers
Home ( ) ( )
Office ( ) ( )
Mobile/cell
Do you have any family members who will accompany you to Australia? 23
No
Yes
Go to Part D
1.
Relationship to the
primary applicant
Family name
Given names
Date of birth Female
Passport number
Country of passport
Date of issue
Date of expiry
Place of issue/
issuing authority
Give details No Yes
Is this family member or has this family member ever been known
by any other name?
List countries No Yes
Is this family member a citizen of any other country?
Give details No Yes
Does this family member have other current passports?
Passport number
Country of passport
Give details No Yes
Does this family member have national identity documents?
Type of document
Identity number
Country of issue
Name in Chinese Commercial Code Number (if applicable)
Citizenship
Relationship status
DAY MONTH YEAR
Place of birth
Town/city
Country
Male
Married
De facto
Engaged Divorced
Separated
Widowed
Never married or
been in a de facto
relationship
DAY MONTH YEAR
If more than 2 family members, give details at Part P Additional
information
1.
Have you or any other person included in this application previously
travelled to or applied to travel to Australia?
25
No
Yes Give details
Date of issue
Place of issue
DAY MONTH YEAR
Visa label
number
Full name
V <
Visa grant number (if granted a visa without a label, please provide
the 13-digit visa grant number, as shown on the letter notifying the
applicant of the grant of the visa)
Part D Visa information
Class of visa
applied for
Visa expiry date
If insufficient space, give details at Part P Additional information
Granted The visa application was/is:
Withdrawn
Refused
Pending
DAY MONTH YEAR
2.
Date of issue
Place of issue
DAY MONTH YEAR
Visa label
number
Full name
V <
Class of visa
applied for
Visa expiry date
Withdrawn
Refused
Pending
DAY MONTH YEAR
3.
Date of issue
Place of issue
DAY MONTH YEAR
Visa label
number
Full name
V <
Class of visa
applied for
Visa expiry date
Withdrawn
Refused
Pending
DAY MONTH YEAR
2.
Relationship to the
primary applicant
Family name
Given names
Date of birth Female
Passport number
Country of passport
Date of issue
Date of expiry
Place of issue/
issuing authority
Give details No Yes
Is this family member or has this family member ever been known
by any other name?
List countries No Yes
Is this family member a citizen of any other country?
Give details No Yes
Does this family member have other current passports?
Passport number
Country of passport
Give details No Yes
Does this family member have national identity documents?
Type of document
Identity number
Country of issue
Name in Chinese Commercial Code Number (if applicable)
Citizenship
Relationship status
DAY MONTH YEAR
Place of birth
Town/city
Country
Male
Married
De facto
Engaged Divorced
Separated
Widowed
Never married or
been in a de facto
relationship
DAY MONTH YEAR
26 In the last 10 years have you or any other person included in this application lived in
a country other than your usual country of residence for 12 months or more (in total)?
Full name Country Dates lived there
MONTH YEAR
Last permanent address in that country
FROM
TO
FROM
TO
FROM
TO
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
FROM
TO
TO
TO
TO
TO
TO
TO
TO
TO
TO
TO
TO
TO
TO
TO
TO
TO
Give details
No
Yes
Part E Employment or activity details
Give details of the proposed period of stay in Australia 27
What is the proposed period of employment or activity?
Note: The dates should be the same dates as given on the nomination
application provided by your sponsor.
28
Date to from
DAY MONTH YEAR DAY MONTH YEAR
Date to from
DAY MONTH YEAR DAY MONTH YEAR
Contact person details
Full name
Mobile/cell
Telephone
number
(AREA CODE )
Duties of the employment or activity
Give details of the type of employment or activity that you will be
undertaking in Australia
29
Position/role
Name of the occupation (if applicable)
1.
POSTCODE
30 Give details of ALL organisations or individuals for whom the
employment or activity will be undertaken
Name of organisation or individual
Address of organisation or individual
Full name
Mobile/cell
Telephone
number
(AREA CODE )
2.
POSTCODE
Full name
Mobile/cell
Telephone
number
(AREA CODE )
3.
POSTCODE
Full name
Mobile/cell
Telephone
number
(AREA CODE )
4.
POSTCODE
31 What is your current occupation?
Australian Business Number (ABN) (if applicable)
Name of group of entertainers or engagement (if applicable)
32
No
Yes
Give details of how you will fund your stay
Will you receive remuneration for undertaking the employment or
activity in Australia?
Part F Funding for stay
Accommodation
Meal allowance
Other living allowance
Travel allowance
Commissions, shares
and/or bonuses
Other packaged items
or benefits (including,
but not limited to, cars,
phones, laptop computers,
airline club memberships,
medical cover, child care,
clothing allowances)
AUD
AUD
AUD
AUD
AUD
AUD
Give all relevant details
If insufficient space, give details at Part P Additional
information
Attach evidence of financial capacity to support your stay in Australia,
see Part N Document checklist.
Give details of your qualifications, skills, experience and
registrations/licenses that are relevant to the proposed employment or
activity in Australia
33
Part G Qualifications, skills and experience
List relevant qualifications
List relevant skills
Describe relevant experience
Registration/Licensing/Professional membership requirements
(if applicable)
Attach a copy of registration or licences, see Part N Document
checklist.
Attach a copy of your qualifications and/or curriculum vitae.
What does the remuneration package include?
Weekly
Monthly
Annually
Salary/wages AUD
Monetary value (AUD)
Part H Additional information
34 Are you currently, or have you previously been, an AusAID subsidised
student or recipient?
Attach a copy of the letter of support form the AusAID
Minister.
No
Yes
36 Give details of the health insurance cover you have arranged for your
stay in Australia
Type of health
insurance cover
Name of health
insurer
DAY MONTH YEAR
Date to from
DAY MONTH YEAR
Period covered by health insurance
35 Is any other person included in this application currently, or have they
previously been, an AusAID subsidised student or recipient?
Give the name of each person
No
Yes
1.
2.
3.
4.
Attach a copy of the letter of support form the AusAID Minister, see
Part N Document checklist.
Attach evidence of adequate health insurance, see Part N
Document checklist.
37 Does this health insurance cover all other persons included in this
application?
Go to Question 39
No
Yes
Name of
health insurer
Name of
health insurer
Name of
health insurer
Name of
health insurer
1.
2.
3.
4.
DAY MONTH YEAR
DAY MONTH YEAR
DAY MONTH YEAR
DAY MONTH YEAR
Date
Date
Date
Date
to
to
to
to
from
from
from
from
DAY MONTH YEAR
DAY MONTH YEAR
DAY MONTH YEAR
DAY MONTH YEAR
Full name
Full name
Full name
Full name
Attach evidence of adequate health insurance, see Part N Document
checklist.
39 If the application for sponsorship or nomination is refused or
withdrawn, do you wish to withdraw this visa application?
Note: If the visa application is withdrawn, the case will be considered
closed and you will forego any review rights to which you might have
been entitled.
No
Yes
Type of health
insurance
Type of health
insurance
Type of health
insurance
Type of health
insurance
38 Give details of the other health insurance that has been arranged for all
other persons included in this application
If you decide to withdraw this application you will need to
make a written request to the department.
Attach evidence of adequate health insurance,
see Part N Document checklist.
No
Yes
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?
Do not include time spent in Australia.
40
Country(s)
1.
DAY MONTH YEAR
Full name
Date to from
DAY MONTH YEAR
Give details
Part I Health
Country(s)
2.
DAY MONTH YEAR
Full name
Date to from
DAY MONTH YEAR
Country(s)
3.
DAY MONTH YEAR
Full name
Date to from
DAY MONTH YEAR
41 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?
Give details
No
Yes
work as, or study to be, a doctor, dentist, nurse or paramedic during
your stay in Australia?
Give details
No
Yes
work, or be a trainee, at a child care centre (including preschools and
creches) while in Australia?
Give details
No
Yes
44 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)?
Give details
No
Yes
45 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?
Give details
No
Yes
46 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?
Give details
No
Yes
47 Do you, or any other person included in this application, require
assistance with mobility or care due to a medical condition?
Give details
No
Yes
49
No
No
Yes
Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
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)?
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 refused a visa for Australia or any
other country?
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 Yes
If you answered Yes to any of the above questions, you must state
who it applies to and give ALL relevant details below.
If the matter relates to a criminal conviction, please give the nature of
the offence, full details of sentence and date of any period of
imprisonment or other detention.
No Yes
Part J Character
48 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)
Please give details of the person who assisted you
No
Yes
50 Did you receive assistance in completing this form?
Part K Assistance with this form
Go to Part L
Family name
Given names
Title: Mr Mrs Miss Ms Other
POSTCODE
Address
Telephone number or daytime contact
( ) ( )
Office hours
Mobile/cell
51 Is the person an agent registered with the Office of the Migration
Agents Registration Authority (Office of the MARA)?
No
Yes Go to Part L
No
Yes
Go to Part L
No
52 Is the person/agent in Australia?
53 Did you pay the person/agent and/or give a gift for this assistance?
Yes
Part L Options for receiving written
communications
54 All written communications about this application should be sent to:
(Tick one box only)
Myself
You should complete form 956A Appointment
or withdrawal of an authorised recipient
Authorised
recipient
Migration agent
Exempt person
Your migration agent/exempt person should
complete form 956 Advice by a migration
agent/exempt person of providing
immigration assistance
OR
OR
OR
55 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.
Part M Payment details
AUD
AUD
AUD
AUD
AUD
AUD
AUD
AUD
AUD
Visa subclass you are applying for
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.
Base Application Charge
Write the amount shown on the reference table for your visa subclass
Non-internet Application Charge (if applicable)
(1)
(2)
(3)
(4)
(5)
+
+
+
=
+
Additional Applicant Charge aged 18 years or over at the time your application is lodged
Additional Applicant Charge under 18 years of age at the time your application is lodged
Subsequent Temporary Application Charge (if applicable)
Total (1) + (2) + (3) + (4) + (5)
Total
X (multiplied by)
X (multiplied by)
X (multiplied by)
=
=
=
Write the amount shown on the
reference table for your visa subclass
Number of additional applicants
aged 18 years or over
Number of additional applicants
under 18 years of age
Number of applicants
56
Give details below
Cannot be used for applications lodged by mail
Bank cheque
Money order
Debit card
Credit card
How will you pay your application charge?
Note: A surcharge may apply to payments made by credit card. Further information is available from www.immi.gov.au/fees-charges/how-to-pay.htm
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.
MasterCard
American Express
Visa
Diners Club
JCB
Payment by (tick one box) Australian Dollars
AUD
Credit card number
:
: : : :
MONTH
:
: : : : : : : : : : : : : :
YEAR
Expiry date
Cardholders name
Address
POSTCODE
Signature of
cardholder
Credit card information will be used for charge paying purposes only.
As the cardholder I acknowledge and accept that a credit card
surcharge may apply to the transaction.
Telephone
number
( ) ( )
-
Identity page (showing photo and personal details)
of your passport
Passport size photograph
Full birth certificate
To establish your identity
Identity page (showing photo and personal details) of
their passport
Passport size photograph
Full birth certificate
To establish the identity of family members included in this
application, for each family member
You must provide:
Family Register Document
Identity card
Details of any name change (eg. by marriage or
deed poll)
Depending on your circumstances, you may also be required to provide:
You must provide:
Marriage certificate
Family Register Document
Identity card
Details of any name change (eg. by marriage or
deed poll)
Evidence if in a de facto relationship
For a child under 18 years of age, unless both parents
are included in this application documents
identifying custody and assess arrangements
Completed form 47A Details of a child or other
dependent family member aged 18 years or over, for
each dependant listed in this application who has
turned 18 and who is not married or in a de facto
relationship with the principal applicant. Form 47A
is available form the departments website
Depending on their circumstances, you may also be required to provide:
If applying separately as a family member, a
written statement from the sponsor that they
will meet the sponsorship obligations for all
applicants included in this application
7
AusAID student or recipient letter of support
form AusAID Minister
3435
Certified copy of evidence of adequate health
insurance (eg. a health insurance certification
letter, health insurance schedule or a
Medicare card) for you and any family
members listed in this application
3638
Evidence of financial capacity to support
your stay in Australia (eg. bank statements
or a letter from your financial institution
stating your financial position). Allowances,
accommodation and other assistance can
also be considered when looking at your
ability to support yourself and any family
members
32
Copy of your qualifications and/or
curriculum vitae
33
Copy of registration or licences to allow you
to undertake the work
If authorising another person, provide either:
completed form 956 Advice by a
migration agent/exempt person of
providing immigration assistance; or
54
completed form 956A Appointment or
withdrawal of an authorised recipient
The Nomination approval letter or
Nomination application acknowledgement
of receipt letter that was provided to the
sponsor by the department
4
Question Document Attached?
Part N Document checklist
57 Attach the following documents (where relevant) to this application. You
should provide certified copies of original documentation. Documents
not in English must be accompanied by accredited English translations.
Refer to the question to see if you need to attach the document.
3
Tick when completed
If your stay in Australia, including any time
already spent in Australia is more than
12 months, you must obtain police
clearances for each applicant who is
16 years of age or older
26
This declaration must be signed by the primary applicant and each
person aged 18 years or over who is included in this application.
I declare that I:
have read and understood the information provided in this
application;
have provided complete and correct information in every detail in
this application, and in any attachments to it;
understand that if any fraudulent or misleading document or
information is found, this application is likely to be refused and I may
become ineligible to be granted a visa for a period of time;
will inform the Department of Immigration and Border Protection in
writing immediately as I become aware of a change in
circumstances (including change of address) or if there is any
change relating to information I have provided in or with this
application, while it is being considered;
will respect Australian values as outlined on page 1 of this form,
during my stay in Australia and will obey the laws of Australia;
have read the information contained in form 1442i Privacy notice;
understand the Department of Immigration and Border Protection
may collect, use and disclose my personal information (including
biometric information and other sensitive information) as outlined in
form 1442i Privacy notice.
For offshore applicants who are required to provide their fingerprints
and facial image.
I declare that I:
understand that my fingerprints and facial image and my
biographical information held by the Department of Immigration and
Border Protection may be given to Australian law enforcement
agencies to help identify me, to help determine my eligibility for grant
of the visa I have applied for, and for law enforcement purposes.
I consent to:
Australian law enforcement agencies disclosing my biometric,
biographical and criminal record information to the Department of
Immigration and Border Protection for any of the purposes outlined
above;
the Department of Immigration and Border Protection using the
information obtained for the purposes of the Migration Act 1958 or
the Australian Citizenship Act 2007.
If a visa is granted, I understand that:
I must abide by the conditions of the visa;
if a no further stay 8503 condition is imposed on this visa, it will
limit the ability to remain in Australia beyond the authorised period
of stay of the visa.
For the primary applicant, I understand that:
I will be responsible for any registration or licensing that is required
before I can begin employment in Australia;
I must abide by Australian employment conditions and awards.
Signature
of primary
person
Date
DAY MONTH YEAR
Name
Signature
We strongly advise that you keep a copy of your application
and all attachments for your records.
Name
Signature
Name
Signature
Name
Signature
Name
Signature
Signature of family members included in this application
Part O Declaration
58
WARNING: Giving false or misleading information is a serious offence.
-
-
-
-
-
-
59
Part P Additional information
Question number Additional information
If insufficient space, attach additional details.

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