Terms and Conditions: Record of Responses

OFFICIAL: Sensitive
Personal Privacy
Department of Home Affairs Record of

Application for a Temporary Activity Visa Responses
Terms and Conditions

View Terms and Conditions View Privacy statement
I have read and agree to the terms and conditions
Yes
Application context
Current location
Give details of the applicant's current location.
Current location: INDIA
Legal status: Citizen
Proposed period of stay
Give details of the proposed period of stay in Australia.
Length of stay in Australia: Up to 3 months
Date from: 20 Apr 2023
Date to: 25 Apr 2023
Note: If granted, the stay period may be less than the period requested. The applicant should check
the Grant Notification Letter to confirm their period of stay in Australia.
Activity/Event
Invited Participants information

Yes
Entertainment information
No
AGEE information
No
Activity type: Invited for other social/cultural activity
Group processing
Personal Privacy
OFFICIAL: Sensitive
This form submitted by : [email protected]
Role(s) : Self-registered user
Submitted on : 28/03/2023 09:36
Generated: Tue, 28 Mar 2023 09:36:59, AEDT Reference Number: EGOWZWIIQ6 Page 1 of 13
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Personal Privacy
Application for a Temporary Activity Visa
Is this application being lodged as part of a group of applications?

No
Visa application charge concession
Is the applicant eligible for a Visa Application Charge (VAC) concession?

No
Primary applicant
Information: Entering names incorrectly may result in denial of permission to board an aircraft to
Australia, or result in delays in border processing on arrival to Australia, even if the applicant has
been granted a visa.
Passport details
Enter the following details as they appear in the applicant's personal passport.
Family name: vishal kumar
Given names: vishal kumar
Sex: Male
Date of birth: 27 Jan 1995
Passport number: W6465548
Country of passport: INDIA - IND
Nationality of passport holder: INDIA - IND
Date of issue: 07 Dec 2022
Date of expiry: 06 Dec 2032
Place of issue / issuing CHANDIGARH
authority:
It is strongly recommended that the passport be valid for at least six months.
National identity card
Does this applicant have a national identity card?

Yes
National identity card

Enter details exactly as shown on the national identity card.
Family name: KUMAR
Given names: VISHAL
Identification number: 209906640057
Country of issue: INDIA
Note: If the National identity card does not have a Date of issue or a Date of expiry, do not enter a
date. Leave the field/s blank.
Date of issue:
Date of expiry:
Personal Privacy
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OFFICIAL: Sensitive
Personal Privacy
Place of birth
Town / City: KHAJURI

State / Province: HARYANA
Country of birth: INDIA
Relationship status
Relationship status: Never Married

Other names / spellings
Is this applicant currently, or have they ever been known by any other names?
No
Citizenship
Is this applicant a citizen of the selected country of passport (INDIA)?

Yes
Is this applicant a citizen of any other country?
No
Other passports
Does this applicant have other current passports?

No
Other identity documents
Does this applicant have other identity documents?

No
Health examination
Has this applicant undertaken a health examination for an Australian visa in the last 12 months?
No
Critical data confirmation
All information provided is important to the processing of this application.
If the information included on this page is incorrect, it may lead to denial of permission to board an
aircraft to Australia, even if a visa has been granted.
Confirm that the following information is correct and that it is in the correct fields.
Family name: vishal kumar

Given names: vishal kumar
Sex: Male
Date of birth: 27 Jan 1995
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
Country of birth: INDIA

Passport number: W6465548
Country of passport: INDIA - IND
Is the above information Yes

correct?
Additional identity questions
Provide further details below, where available.
Previous travel to Australia
Has this applicant previously travelled to Australia or previously applied for a visa?
No
Accompanying members of the family unit
Are there any accompanying members of the family unit included in this application?
No
Contact details
Country of residence
Usual country of residence: INDIA

Department office
The applicant may be required to attend an Australian Government Office for an interview. Which is
the closest office to the applicant’s current location?
Office: India, New Delhi

Residential address
Note that a street address is required. A post office address cannot be accepted as a residential
address.
Country: INDIA
Address: Vill Khajuri, PO Baindi
Teh Jagadhri
Suburb / Town: Yamunanagar
State or Province: HARYANA
Postal code: 135133
Postal address
Is the postal address the same as the residential address?
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
Yes
Contact telephone numbers
Enter numbers only with no spaces.
Home phone:
Business phone:
Mobile / Cell phone: 9671010878
Email address
Email address: [email protected]

Authorised recipient
Does the applicant authorise another person to receive written correspondence on their behalf?
This authorises the department to send the authorised person all written correspondence that would
otherwise be sent directly to the applicant.
No
This person is referred to as the 'authorised recipient'.
Electronic communication
The Department prefers to communicate electronically as this provides a faster method of
communication.
All correspondence, including notification of the outcome of the application will be sent to:
Note: The holder of this email address may receive a verification email from the Department if the
address has not already been verified. If the address holder receives a verification email, they should
click on the link to verify their address before this application is submitted.
Australian organisation
Give details of the organisation(s) for which the activity will be undertaken in Australia.
Organisation details
Legal registered name: All Japan Karate do Federation Gojukai Australia inc
Trading name: All Japan Karate do Federation Gojukai Australia inc
Organisation website (if www.jkfgojukaiaust.com
available)
Industry type: Other Services
Registration identifiers
Give details of all registration identifiers for the business / organisation.
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
Registration identifier
Give details of a registration identifier for the business / organisation.
Business registration type: Australian Business Number (ABN)
Business registration ID: 41533198180
Office address
Give details of the organisation's office address in Australia.
Country: AUSTRALIA
Address: 15 Horatio Street
Suburb / Town: Rosemeadow
State / Territory: New South Wales
Postcode: 2560
Contact person details
Give details of the contact person within the organisation.
Family name: Stephenson
Given names: Glenn
Position: President
Contact telephone numbers
Enter numbers only with no spaces.
Business phone: 61412668965
Mobile / Cell phone:
Email address

Activity
Position details
Give details of the type of activity the applicant will be undertaking in Australia.
Position: Participant
Occupation grouping: Other
Occupation (ANZSCO) Sportspersons nec
Duties / activities: Participation in Karate Tournament and attending training
seminar on karate
Events
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
Give details of the event(s) in which the applicant will participate.

Event details
Give details of the event.
If the 'Event name' displayed above is incorrect, go back to the first page of the application form and
change the 'Event name' selected.
Event name: JKF GOJUKAI SEMINAR
Applicant's role in event: trainee
Applicant's role description: I will be attending seminar on Karate which will be done by
Japanese master Seiichi Fujiwara
Event details
Give details of the event.
If the 'Event name' displayed above is incorrect, go back to the first page of the application form and
change the 'Event name' selected.
Event name: JKF GOJUKAI TOURNAMENT
Applicant's role in event: Competitor
Applicant's role description: I shall be competing in Karate tournament. Details given above.
Qualifications, skills and experience
Give details of the applicant's qualifications, skills and experience that are relevant to the proposed
activity in Australia.
Relevant qualifications: Karate Certificates of participation and merits on District, State
and national level
Relevant skills: Karate Black Belt
Relevant experience: I am participating on District, State and national level in Karate
tournaments since last 10 years.
Registration / Licensing / I am a member of Gojuryu Karate Federation, District Karate
Professional membership Membership and all India Karate Federation Member.
requirements:
Financial support
Remuneration package
Will remuneration be received for undertaking the activity in Australia?
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
No
Give details of how the stay will be funded:
I am having credit cards and bank balance to support my
accommodation and air fare for this trip. The tentative expenses
would be around 5000 AUD which i am capable to pay. I have
attached my bank statements and details for your consideration.
Previous countries of residence
In the last 10 years have any of the applicants lived in a country other than their usual country of
residence for 12 months or more (in total)?
No
Additional information
AusAID or Foreign Affairs supported
Are any applicants currently or have they previously been an AusAID or Foreign Affairs supported
student or recipient?
No
Health insurance
Give details of any health insurance arranged for the applicants during their stay in Australia.
Health insurance details

Give details of the health insurance.
Applicant(s) covered: VISHAL KUMAR, Vishal Kumar (27 Jan 1995)
Type of health insurance International Travel Insurance
cover:
Name of health insurer: The Oriental Insurance Company Limited
Period covered by health insurance.

Health declarations
In the last five years, has any applicant visited, or lived, outside their country of passport, for more
than 3 consecutive months? Do not include time spent in Australia.
No
Does any applicant intend to enter a hospital or a health care facility (including nursing homes) while
in Australia?
No
Does any applicant intend to work as, or study or train to be, a health care worker or work within a
health care facility while in Australia?
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
No
Does any applicant intend to work, study or train within aged care or disability care while in Australia?
No
Does any applicant intend to work or be a trainee at a child care centre (including preschools and
creches) while in Australia?
No
Does any applicant intend to be in a classroom situation for more than 3 months (eg. as either a
student, teacher, lecturer or observer)?
No
Has any applicant:
• 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
During their proposed visit to Australia, does any applicant 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
Does any applicant require assistance with mobility or care due to a medical condition?
No
Character declarations
If the applicant answers ‘Yes’ to any of the character declarations they must give all relevant details.
For combined applications, state which applicant the declaration applies to.
If the matter relates to a criminal conviction, provide:
• the date and nature of the offence
• full details of the sentence
• dates of any period of imprisonment or other detention.
Has any applicant ever been charged with any offence that is currently awaiting legal action?
No
Has any applicant ever been convicted of an offence in any country (including any conviction which is
now removed from official records)?
No
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
Has any applicant ever been the subject of a domestic violence or family violence order, or any other
order, of a tribunal or court or other similar authority, for the personal protection of another person?
No
Has any applicant ever been the subject of an arrest warrant or Interpol notice?
No
Has any applicant ever been found guilty of a sexually based offence involving a child (including
where no conviction was recorded)?
No
Has any applicant ever been named on a sex offender register?
No
Has any applicant ever been acquitted of any offence on the grounds of unsoundness of mind or
insanity?
No
Has any applicant ever been found by a court not fit to plead?
No
Has any applicant ever been directly or indirectly involved in, or associated with, activities which
would represent a risk to national security in Australia or any other country?
No
Has any applicant ever been charged with, or indicted for: genocide, war crimes, crimes against
humanity, torture, slavery, or any other crime that is otherwise of a serious international concern?
No
Has any applicant ever been associated with a person, group or organisation that has been or is
involved in criminal conduct?
No
Has any applicant ever been associated with an organisation engaged in violence or engaged in
acts of violence (including war, insurgency, freedom fighting, terrorism, protest) either overseas or in
Australia?
No
Has any applicant ever served in a military force, police force, state sponsored / private militia or
intelligence agency (including secret police)?
No
Has any applicant ever undergone any military/paramilitary training, been trained in weapons/
explosives or in the manufacture of chemical/biological products?
No
Has any applicant ever been involved in people smuggling or people trafficking offences?
No
Has any applicant ever been removed, deported or excluded from any country (including Australia)?
No
Has any applicant ever overstayed a visa in any country (including Australia)?
No
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
Has any applicant ever had any outstanding debts to the Australian Government or any public
authority in Australia?
No
Paying for visa sponsorship

Warning:
Giving false or misleading information is a serious offence.
Section 245AS of the Migration Act 1958 prohibits offering to provide or providing a benefit in return
for the occurrence of a 'sponsorship-related event' as defined by section 245AQ of that Act. Refer
toPaying for visa sponsorship - declaration requirementfor more information.
The applicant declares that no persons included in this application have engaged in conduct that
constitutes a contravention of subsection 245AS(1) of the Migration Act 1958.
Yes
Declarations
Warning:
Giving false or misleading information is a serious offence.
The applicants declare that they:
Have read and understood the information provided to them in this application.
Yes
Have provided complete and correct information in every detail on this form, and on any attachments
to it.
Yes
Understand that if any fraudulent documents or false or misleading information has been provided
with this application, or if any of the applicants fail to satisfy the Minister of their identity, the
application may be refused and the applicant(s), and any member of their family unit, may become
unable to be granted a visa for a specified period of time.
Yes
Understand that if documents are found to be fraudulent or information to be incorrect after the grant
of a visa, the visa may subsequently be cancelled.
Yes
Understand that if this application is approved, any person not included in this application will not
have automatic right of entry to Australia.
Yes
Will inform the Department in writing immediately as they become aware of a change in
circumstances (including change of address) or if there is any change relating to information they
have provided in or with this application, while it is being considered.
Yes
Have read the information contained in the Privacy Notice(Form 1442i).
Yes
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
Understand that the department may collect, use and disclose the applicant's personal information
(including biometric information and other sensitive information) as outlined in the Privacy
Notice(Form 1442i).
Yes
Give consent to the collection of their fingerprints and facial image if required.
Yes
Understand that, if required to provide their fingerprints and facial image, the applicant's fingerprints
and facial image and biographical information held by the Department may be given to Australian law
enforcement agencies to help identify the applicant and determine eligibility for grant of the visa being
applied for, and for law enforcement purposes.
Yes
Give consent to Australian law enforcement agencies disclosing the applicant's biometric,
biographical and criminal record information to the Department to help identify the applicant, to
determine eligibility for grant of a visa and for law enforcement purposes.
Yes
Give consent to the Department using the applicant's biometric, biographical and criminal record
information obtained for the purposes of the Migration Act 1958 or the Citizenship Act 2007.
Yes
As an applicant:
I understand that if my visa ceases to be in effect and I do not hold another visa to remain in Australia
at that time, I will be an unlawful non-citizen under the Migration Act 1958. As such, I will be expected
to depart from Australia, and be subject to removal under the Migration Act 1958.
Yes
Australian values
Each applicant who is 18 years or over has read, or had explained to them, information provided by
the Australian Government on Australian society and values, and agrees to the Australian values
statement.
Yes
Life in Australia booklet Australian values statement
Personal Privacy
OFFICIAL: Sensitive
OFFICIAL: Sensitive
Personal Privacy
Supporting evidence
Applicant 1 - vishal kumar vishal kumar (27 Jan 1995)

Evidence type Document type Description Date received Filename
Personal Financial Status, Evidence Bank Statement - Personal Bank Statement 28/03/2023 1 Banking_compressed (1).pdf
of
Personal Financial Status, Evidence Payslip Salary Slips 28/03/2023 3 Salary Slip.pdf
of
Personal Financial Status, Evidence Government Benefits Statement National Pension 28/03/2023 5 NPS.pdf
of Scheme
Personal Financial Status, Evidence Letter/Statement - Bank/Financial Fixed Deposit 28/03/2023 7 Fixed deposit.pdf
of institution
Personal Financial Status, Evidence Letter/Statement - Accountant CA Report and 28/03/2023 9 CA Report & Valuation.pdf
of Valuation Report
Health Insurance, Evidence of Health Insurance Document Health Insurance 28/03/2023 Health Insurance.pdf
Identity, Evidence of Other (specify) Certificates and 28/03/2023 Identity and Certificates.pdf
Cover Letter
Personal Financial Status, Evidence Superannuation Document Other Financial 28/03/2023 Other Finance.pdf
of Documents
Invitation to participate, Evidence of Conference Registration Fees Deduction for 28/03/2023 Sponsor_removed (2).pdf
registeration
Invitation to participate, Evidence of Other (specify) Support Letter from 28/03/2023 Sponsor_removed (1).pdf
My Coach
Invitation to participate, Evidence of Letter/ Statement - Australian Invitation from 28/03/2023 Sponsor_removed.pdf
Organisation Australia
Invitation to participate, Evidence of Itinerary Hotel Booking for the 28/03/2023 vishal hotel_merged.pdf
event
Travel Document Passport Passport 28/03/2023 vishal passport.pdf
Identity, Evidence of National ID Card Aadhar Card 28/03/2023 aadhar card.pdf
Personal Privacy
OFFICIAL: Sensitive

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Department of Home Affairs Record of

Terms and Conditions

Invited Participants information

Is this application being lodged as part of a group of applications?

Is the applicant eligible for a Visa Application Charge (VAC) concession?

Does this applicant have a national identity card?

National identity card

Town / City: KHAJURI

Relationship status: Never Married

Is this applicant a citizen of the selected country of passport (INDIA)?

Does this applicant have other current passports?

Does this applicant have other identity documents?

Family name: vishal kumar

Country of birth: INDIA

Is the above information Yes

Usual country of residence: INDIA

Office: India, New Delhi

Is the postal address the same as the residential address?

Email address: [email protected]

Email address: [email protected]

Give details of the event(s) in which the applicant will participate.

Will remuneration be received for undertaking the activity in Australia?

AusAID or Foreign Affairs supported

Health insurance details

Period covered by health insurance.

Paying for visa sponsorship

Applicant 1 - vishal kumar vishal kumar (27 Jan 1995)

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