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:
Given names:
Sex:
Date of birth:
Passport details:
Passport number:
Country of passport:
Nationality of passport holder:
Date of issue:
Date of expiry:
Place of issue / issuing 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?:

Pacific-Australia Card
The Pacific-Australia Card is issued through an invitation process to Pacific leaders. If the
applicant does not hold a Pacific-Australia Card, please select 'No' for this question.

Is the applicant a Pacific-Australia Card holder?

Place of birth
Town / City:
State / Province:
Country of birth:
Relationship status:
Other names / spellings:
Is this applicant currently, or have they ever been known by any other names?:
Citizenship:
Is this applicant a citizen of the selected country of passport (PHILIPPINES)?:
Is this applicant a citizen of any other country?:

Give details of any significant dates on which the applicant needs to be in Australia:

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Previous travel to Australia
Has this applicant previously travelled to Australia?:

Has this applicant previously applied for a visa to Australia?:

Grant number
Does this applicant have an Australian visa grant number?:

Australian visa grant number (if known):

Other passports or documents for travel

Does this applicant have any other passports or documents for travel?

Other identity documents

Other identity documents

Does this applicant have other identity documents?:

Other identity documents (type of document: Birth Certificate, Marriage Certificate, Driver’s
License etc)
Enter details exactly as shown on the identity document.

Family name:
Given names:
Type of document:
Identification number:
Country of issue:

Health examination
Has this applicant undertaken a health examination for an Australian visa in the last 12 months?:

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.

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Travelling companions
Each person travelling to Australia must submit a separate visitor visa application. This includes
children and other family members. Listing a person's name on this page does NOT mean that
the person has applied for a visa.

Are there any other persons travelling with the applicant to Australia?:

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?

Residential address

Note that a street address is required. A post office address cannot be accepted as a residential
address.

Country:
Address:
Suburb / Town:
State or Province:
Postal code:
Contact telephone numbers:
Home phone:
Business phone
Mobile / Cell phone:
Postal address

Postal address
Is the postal address the same as the residential address?:
Email address:
Intended state of residence:

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.

This person is referred to as the 'authorised recipient'.

Electronic communication

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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:

Email address:

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.

Non-accompanying members of the family unit

Does the applicant have any members of their family unit not travelling to Australia who are not
Australian citizens or Australian permanent residents?:
Non-accompanying member of the family unit #1
Non-accompanying member of the family unit
Relationship to the applicant:
Family name:
Given names:
Sex:
Date of birth:
Country of birth:

Non-accompanying member of the family unit

Relationship to the applicant:
Family name:
Given names:
Sex:
Date of birth:
Country of birth:

Entry to Australia
Proposed period of stay:
Does the applicant intend to enter Australia on more than one occasion?:
How long does the applicant plan to stay in Australia?:

Length of stay in Australia:

Planned arrival date:

Planned final departure date:

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.

Study while in Australia

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Will the applicant undertake a course of study in Australia?:

Relatives, friends or contacts in Australia

Will the applicant visit any relatives, friends or contacts while in Australia?:

Contact in Australia #1

Contact in Australia
Relationship to applicant
Relationship to the applicant:
Contact's details
Family name:
Given names:
Sex:
Date of birth:
Residential address:

Note that a street address is required. A post office address cannot be accepted as a residential
address.

Country:
Address:
Suburb / Town:
State / Territory:
Postcode:
Contact telephone numbers:

Contact telephone numbers

Enter numbers only with no space

Home phone:

Business phone:
Mobile / Cell phone:

Electronic communication
Email address:

Australian residency status

Australian residency status:

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Current overseas employment

Visa applicant's current overseas employment

Employment status:
Name, address, and contact number of employer:
Date started:

Funding details
Give details of how the applicant's stay in Australia will be funded:
What funds will the applicant have available to support their stay in Australia?:

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.:

Does any applicant intend to enter a hospital or a health care facility (including nursing homes)
while in Australia?:

Does any applicant intend to work as, or study to be a doctor, dentist, nurse or paramedic during
their stay in Australia?:

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?

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?

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
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  mental illness
 pregnancy
 respiratory disease that has required hospital admission or oxygen therapy
 other?

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?

Does any applicant require assistance with mobility or care due to a medical condition?

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?

Has any applicant ever been convicted of an offence in any country (including any conviction
which is now removed from official records)?

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?

Has any applicant ever been the subject of an arrest warrant or Interpol notice?
Has any applicant ever been the subject of an arrest warrant or Interpol notice?

Has any applicant ever been found guilty of a sexually based offence involving a child (including
where no conviction was recorded)?
Has any applicant ever been found guilty of a sexually based offence involving a child (including
where no conviction was recorded)?

Has any applicant ever been named on a sex offender register?

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Has any applicant ever been named on a sex offender register?

Has any applicant ever been acquitted of any offence on the grounds of unsoundness of mind
or insanity?
Has any applicant ever been acquitted of any offence on the grounds of unsoundness of mind
or insanity?

Has any applicant ever been found by a court not fit to plead?
Has any applicant ever been found by a court not fit to plead?

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?
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?

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?
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?

Has any applicant ever been associated with a person, group or organisation that has been or is
involved in criminal conduct?
Has any applicant ever been associated with a person, group or organisation that has been or is
involved in criminal conduct?

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?
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?

Has any applicant ever served in a military force, police force, state sponsored / private militia or
intelligence agency (including secret police)?

Has any applicant ever undergone any military/paramilitary training, been trained in
weapons/explosives or in the manufacture of chemical/biological products?

Has any applicant ever been involved in people smuggling or people trafficking offences?

Has any applicant ever been removed, deported or excluded from any country (including
Australia)?

Has any applicant ever overstayed a visa in any country (including Australia)?

Has any applicant ever had any outstanding debts to the Australian Government or any public
authority in Australia?

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Visa history
Has the applicant held or does the applicant currently hold a visa to Australia or any other
country?

Give details:

Has the applicant ever been in Australia or any other country and not complied with visa
conditions or departed outside their authorised period of stay?

Has the applicant ever had a visa for Australia or any other country refused or cancelled?

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.

Have provided complete and correct information in every detail on this form, and on any
attachments to it.
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.

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.

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.

Understand that the department may collect, use and disclose the applicant's personal
information (including biometric information and other sensitive information)

Understand that 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.

Agree not to undertake study or training for more than three months.

Agree to leave Australia on or before the expiry of the period of stay of the visa.

Give consent to the collection of their fingerprints and facial image if required.

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Provide fingerprints and facial image
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.

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.

Understand that the Visitor visa does not permit them to work in Australia.

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.

Visa ceases to be in effect

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.

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