80

Personal particulars for assessment including character assessment
Form
80
Important Please read this information carefully before you complete this form. Once you have completed this form we strongly advise that you keep a copy for your records. 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.
Please use a pen, and write neatly in English using BLOCK LETTERS. Tick where applicable
3
migrant temporary resident visitor student refugee/ humanitarian entrant
I am applying for a visa to travel to Australia as a:
Integrity of application
The Department of Immigration and Border Protection (the department) is committed to maintaining the integrity of the visa and citizenship programs. Please be aware that if you provide us with fraudulent documents or claims, this may result in processing delays and possibly your application being refused. OR I am applying in Australia for:
a further temporary stay or visit permanent residence protection
About the information you give

The department has authority under the Migration Act 1958 and the Australian Citizenship Act 2007 and other legislation it administers, to collect personal information to carry out its functions, including administration of applications for visas for entry and/or stay in Australia or for citizenship. The information provided will be used for assessing your eligibility for a visa to travel to, 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, superannuation, 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.
Part A Your details

1
Write your name and birth details as shown on your current passport, birth certificate, family book or travel document Passport Other Type of document
Note: If your passport/travel document only shows one name, write that name in the Family name box. Family name All given names
Sex Date of birth Place of birth Suburb and Town/City State/Province/ Region Country
Male
DAY MONTH
Female
YEAR
Day, month and year MUST be provided
Passport/travel document number Country of passport/travel document

DAY MONTH YEAR
Date of issue Date of expiry Nationality Place of issue/issuing authority
COMMONWEALTH OF AUSTRALIA, 2013
80 (Design date 11/13) - Page 1
Relationship status Married Engaged De facto Separated Divorced Widowed Never married or been in a de facto relationship Date of marriage Date of intended marriage Date relationship began
DAY
MONTH
YEAR
Are you of Russian descent? No Yes In English, provide your patronymic name
Have you ever been known by other names or spellings of your name? Examples of the types of other names: cultural or tribal name or name at birth clan/subclan name name before or after marriage preferred name adoptive or foster name other spellings of names alias or pseudonym No Yes Give details in English
Does the passport/travel document at Question 1 show your full name? No What is your full name? Family name Given names
1. Type of name Family name Given names
Yes
2. Type of name Did you use the passport/travel document at Question 1 to enter Australia? No Write the number of the document you used to enter Australia Family name Given names
Yes
If more than 2, give details at Part K Additional details Do you ever use a Chinese Commercial Code Number for your names shown in the passport/travel document at Question 1 No Yes Chinese Commercial Code Number (in full)
Have you ever had a different date of birth? No Yes Different date of birth
DAY MONTH YEAR
10 Are you a citizen of the country of passport/travel document at 6

Are you of Arabic descent? No Yes In English, write the full name of your fathers father (ie. your paternal grandfather) Question 1? No Yes How did you gain this citizenship (eg. birth, descent, naturalisation)?
DAY MONTH YEAR
Date you gained this citizenship
11 Do you currently have, or have you ever had, other passports/travel

documents not already shown at Question 1? No Yes Give details as they appear on the other passports/travel documents (If more than one, give details at Part K Additional details)
2. Country How did you gain this citizenship (eg. birth, descent, naturalisation)? When did you have this citizenship? From To (If you still have the citizenship, write Current) If more than 2, give details at Part K Additional details
DAY
MONTH
YEAR
Note: If the passport/travel document only shows one name, write that name in the Family name box. Family name All given names
13 Have you ever renounced any citizenship you have previously held?
No Yes Give details Country Reason
Passport/travel document number Country of passport/travel document

DAY MONTH YEAR
Date of issue Date of expiry Nationality Place of issue/issuing authority Date of renouncement
DAY
MONTH
YEAR
14 Do you currently have permanent residence rights in any country

not already shown at Question 1, Question 11 or Question 12? No Yes Give details
Are you, or have you ever been, a citizen of the country of passport/ travel document shown above? No Yes How did you gain this citizenship (eg. birth, descent, naturalisation)?
1. Country 2. Country
15 Have you ever been refused citizenship of any country?

No Yes Give details
When did you have this citizenship?

DAY MONTH YEAR
1. Country Reason for refusal
From To (If you still have the citizenship, write Current)
12 Are you currently, or have you ever been, a citizen of any other
country not already shown at Question 1 or Question 11? No Yes Give details
DAY
MONTH
YEAR
Date 2. Country Reason for refusal
1. Country How did you gain this citizenship (eg. birth, descent, naturalisation)?
DAY
MONTH
YEAR
When did you have this citizenship? From To (If you still have the citizenship, write Current)
Date
DAY MONTH YEAR
If more than 2, give details at Part K Additional details
16 Do you currently have, or have you ever had, any national identity
documents or numbers (including birth registration numbers, social security cards etc)? No Yes Give details Country of issue Identification number shown (if applicable) Name shown on document
Type of identification document
17 Your current residential address (this is the place where you

currently live) Note: A post office box or mailbox address is not acceptable as a residential address. Unit/Apartment number Address (including street number and name)
19 Your current contact numbers (include country code if outside Australia)

COUNTRY CODE AREA CODE ) ( ) ( ) ) NUMBER
Work Home Mobile/cell Fax
( (
) (
Other contact numbers you have

( ) ( ) ( ) )
Suburb and Town/City State/Province/ Region Country Postal code
20 Address in Australia where you can be contacted or will be staying

Note: A post office box or mailbox address is not acceptable.
18 Do you have an e-mail address?

Note: Do not provide the e-mail address of a migration agent. No Yes Please provide all of your e-mail addresses
POSTCODE
21 Contact telephone numbers in Australia (if known)

AREA CODE NUMBER ) )
Work Home Mobile/cell
( (
Other contact numbers

( ( ) )
22 Do you have personal contacts in Australia (including business

contacts/sponsor)? Note: Do not provide the contact details of a migration agent. No Yes Give details
2. Family name Given names
Sex
Male
DAY MONTH
Female
YEAR
1. Family name Given names Date of birth Place of birth Suburb and Town/City State/Province/ Region Country Nationality
Sex
Male
DAY MONTH
Female
YEAR
Date of birth Place of birth Suburb and Town/City State/Province/ Region Country Nationality Your personal contacts current residential address Note: A post office box or mailbox address is not acceptable as a residential address. Unit/Apartment number Address (including street number and name)
Your personal contacts current residential address Note: A post office box or mailbox address is not acceptable as a residential address. Unit/Apartment number Address (including street number and name)
Suburb and Town/City State/Province/ Region Country Postal code Telephone number E-mail address Relationship to you (eg. partner, sister, aunt, friend, business contact/sponsor)
AREA CODE ( ) NUMBER
Suburb and Town/City State/Province/ Region Country Postal code Telephone number E-mail address Relationship to you (eg. partner, sister, aunt, friend, business contact/sponsor)
AREA CODE ( ) NUMBER
Part B Your partners details

23 Do you currently have a partner?
Note: If you are widowed, you must answer Yes and give details for your deceased partner. No Yes Go to Part C
30 Is your partner of Arabic descent?

No Yes In English, write the full name of your partners fathers father (ie. paternal grandfather)
24 Your partners full name

Family name All given names
31 Is your partner of Russian descent?

No Yes In English, provide your partners patronymic name
32 Is your partner currently, or have they ever been, known by other 25 Sex 26 Date of birth
Date of death (if deceased) Male
DAY MONTH
Female
YEAR
names or spellings of their name? Examples of the types of other names: cultural or tribal name or name at birth clan/subclan name name before or after marriage preferred name adoptive or foster name other spellings of names alias or pseudonym No Yes Give details in English
Day, month and year MUST be provided
27 Your partners place of birth

Suburb and Town/City State/Province/ Region Country
28 Is your partner currently, or have they ever been, a citizen of any

country? No Yes Give details
2. Type of name Family name

DAY MONTH YEAR
1. Country When did your partner have this citizenship? From To (If they still have the citizenship, write Current) 2. Country When did your partner have this citizenship?
DAY MONTH YEAR
Given names
33 Country where your partner lives now

If in Australia, write the full address, if deceased, write DECEASED
From To (If they still have the citizenship, write Current) If more than 2, give details at Part K Additional details
29 Does your partner ever use a Chinese Commercial Code Number for
names shown at Question 24? No Yes Chinese Commercial Code Number (in full)
POSTCODE
34 Does your partner currently have, or have they ever had, any national identity documents
or numbers (including birth registration numbers, social security cards etc)? No Yes Give details Country of issue Identification number shown (if applicable) Name shown on document
Type of identification document
Part C Travel to Australia

35 Are you planning to travel to Australia with any other person(s) OR
if you are in Australia did you travel with any other person(s)? No Yes Give details Arrival date Flight number or vessel details (if known)
37 Details of proposed arrival in Australia

DAY MONTH YEAR
1. Family name City of arrival Given names
38 Are you applying for a temporary visa?

No
DAY MONTH YEAR
Yes
Details of proposed final departure from Australia

DAY MONTH YEAR
Date of birth Country of birth Nationality Relationship to you (eg. partner, sister, friend, business contact)
Departure date Flight number or vessel details (if known) City of departure
39 What is the main reason for going to Australia?

2. Family name Given names Include details of any dates that are of special significance to your time in Australia.
DAY
MONTH
YEAR
Date of birth Country of birth Nationality Relationship to you (eg. partner, sister, friend, business contact)
If more than 2, give details at Part K Additional details Go to Part E
36 Are you currently in Australia?

No Yes Go to Part D
Part D Current visa details

NOTE: Only complete this Part if you are currently in Australia
40 Do you currently hold an Australian visa?

No Yes Go to Part E
41 Visa details
Type of visa
DAY MONTH YEAR
Date of issue Place of issue
42 Details of your arrival in Australia

DAY MONTH YEAR
Arrival date City of arrival
43 Final date you must leave Australia

on this visa
DAY
MONTH
YEAR
Part E Other information

44 Have you travelled to Australia before?
No Yes Give details in chronological order (If insufficient space, give details at Part K Additional details) Date from
DAY MONTH YEAR DAY
Date to
MONTH YEAR
Type of visa (eg. visitor, student, business)
Place where visa was issued
Your names shown on visa
Reason for visit
45 Have you travelled to any country other than Australia, including any visits back to your
country of citizenship during the past 10 years (including short stays)? Note: If you are applying for a refugee/humanitarian visa you must provide all visits to any country other than Australia for the last 30 years (both month and year are required). No Yes Give details in chronological order (If insufficient space, give details at Part K Additional details) Date from
DAY MONTH YEAR DAY
Date to
MONTH YEAR
Country or countries
Reason for visit
46 List, in chronological order, the addresses of the places where you have lived during the
last 10 years (including Australia). You must account for every month/year. If you are unable to provide an address for any period of time please provide an explanation. (If insufficient space, give details at Part K Additional details) Note: If you are applying for a refugee/humanitarian visa you must provide all addresses for the last 30 years (both month and year are required with no gaps). Date from
MONTH YEAR
Date to
MONTH YEAR
Country
Full address (number, street name, suburb, state/province, region)
47 Give details of all employment including periods of unemployment.

Note: If you are unable to provide details for a period, please provide an explanation. (If insufficient space, give details at Part K Additional details) For current or previous periods of unemployment please advise how you occupied your time and how you supported yourself. Month and year are both required. If retired, please provide activities. Time gaps are unacceptable. Date from
MONTH YEAR
Date to
MONTH YEAR
Name and address of employer/business. Do not use abbreviations.
Type of business/ other activities
Your position/title/duties/how you spent your time if unemployed
48 Have you had any military service?

No Yes Give details in chronological order (If insufficient space, give details at Part K Additional details) Date from
DAY MONTH YEAR DAY
Date to
MONTH YEAR
Country of service
Full name of Unit/ Battalion/Brigade
Rank
Duties
Country of deployment
49 List all education and qualifications undertaken, including courses completed,

withdrawn or continuing. (If insufficient space, give details at Part K Additional details) Give details in chronological order. Date from
MONTH YEAR
Date to
MONTH YEAR
Country where course undertaken
Name and address of institution. Do not use abbreviations.
Course of study. Do not use abbreviations.
Course status Completed course Withdrew Currently enrolled Completed course Withdrew Currently enrolled Completed course Withdrew Currently enrolled Completed course Withdrew Currently enrolled
50 Have you undertaken an academic thesis, dissertation or publication (including

completed, withdrawn or continuing theses, dissertations or publications)? No Yes Give details
Full name of your supervisor Family name Given names
Part F About your parents

Note: You must give details for any person (living or deceased) who is or was your parent or with whom you have had a parent-like relationship. This should include, but is not limited to, natural parents, adoptive parents, surrogate parents, step-parents, foster parents, and/ or guardians. Provide details of one parent at Question 51 and the other parent at Question 52. If more than 2, give details at Part K Additional details.
h. Does this parent ever use a Chinese Commercial Code Number? No Yes Chinese Commercial Code Number (in full)
i.
Is this parent of Arabic descent? No Yes In English, write the full name of this parents father
51 Parent
a. Relationship to you (eg. natural parent, step-parent etc) j.
b.
This parents full name Family name All given names including, if applicable, patronymic name (in English), clan and sub-clan names, and middle names
Is this parent of Russian descent? No Yes In English, provide this parents patronymic name
k.
Is this parent currently, or have they ever been, known by other names or spellings of their name? Examples of the types of other names: cultural or tribal name or name at birth clan/subclan name name before or after marriage preferred name adoptive or foster name other spellings of names alias or pseudonym No Yes Give details in English
c.
Sex
Male
Female
DAY MONTH YEAR
d. Date of birth e. f. Date of death (if deceased) This parents place of birth Suburb and Town/City State/Province/ Region Country g. Is this parent currently, or have they ever been, a citizen of any country? No Yes Give details

DAY MONTH YEAR
1. Country When did this parent have this citizenship? From To (If they still have the citizenship, write Current) 2. Country When did this parent have this citizenship?
DAY MONTH YEAR
l.
Country where this parent lives now If in Australia, write the full address, if not living, write DECEASED
From To (If they still have the citizenship, write Current)

POSTCODE
52 Parent
a. Relationship to you (eg. natural parent, step-parent etc)
h. Does this parent ever use a Chinese Commercial Code Number? No Yes Chinese Commercial Code Number (in full)
b.
This parents full name Family name i. All given names including, if applicable, patronymic name (in English), clan and sub-clan names, and middle names Is this parent of Arabic descent? No Yes In English, write the full name of this parents father
j. c. Sex Male Female

DAY MONTH YEAR
Is this parent of Russian descent? No Yes In English, provide this parents patronymic name
d. Date of birth e. f. Date of death (if deceased) This parents place of birth Suburb and Town/City State/Province/ Region Country g. Is this parent currently, or have they ever been, a citizen of any country? No Yes Give details k.
Is this parent currently, or have they ever been, known by other names or spellings of their name? Examples of the types of other names: cultural or tribal name or name at birth clan/subclan name name before or after marriage preferred name adoptive or foster name other spellings of names alias or pseudonym No Yes Give details in English
1. Country When did this parent have this citizenship?

DAY MONTH YEAR
From To (If they still have the citizenship, write Current) 2. Country When did this parent have this citizenship?
DAY MONTH YEAR
From To (If they still have the citizenship, write Current) l.
Country where this parent lives now If in Australia, write the full address, if not living, write DECEASED
POSTCODE
Part G About your brothers and sisters

Note: You must give details for any person (living or deceased) who is or was your brother or sister. This should include, but is not limited to, natural brothers and sisters, adoptive brothers and sisters, stepbrothers and sisters. Provide details of one brother or sister at Question 53 and the others at Questions 5456. If more than 4, give details at Part K Additional details.
i.
Is this person of Arabic descent? No Yes In English, write the full name of this persons fathers father (ie. paternal grandfather)
j.
Is this person of Russian descent? No Yes In English, provide their patronymic name
53 Brother or sister
a. Relationship to you (eg. brother, sister, step-brother, step-sister)
b.
Family name All given names including, if applicable, patronymic name (in English), clan and sub-clan names, and middle names
k.
Is this person currently, or have they ever been, known by other names or spellings of their name? Examples of the types of other names: cultural or tribal name or name at birth clan/subclan name name before or after marriage preferred name adoptive or foster name other spellings of names alias or pseudonym No
c.
Sex
Male
Female
DAY MONTH YEAR
Yes
Give details in English
d. Date of birth e. f. Date of death (if deceased) Place of birth Suburb and Town/City State/Province/ Region Country g. Is this person currently, or have they ever been, a citizen of any country? No Yes Give details
1. Country When did this person have this citizenship?

DAY MONTH YEAR
From To (If they still have the citizenship, write Current) 2. Country When did this person have this citizenship?
DAY MONTH YEAR
l.
Country where this person lives now If in Australia, write the full address, if not living, write DECEASED
POSTCODE
From To (If they still have the citizenship, write Current) h. Does this person ever use a Chinese Commercial Code Number? No Yes Chinese Commercial Code Number (in full)
i.
b.
j.
c.
Sex
Male
Female
DAY MONTH YEAR
k.
Is this person currently, or have they ever been, known by other names or spellings of their name? Examples of the types of other names: cultural or tribal name or name at birth clan/subclan name name before or after marriage preferred name adoptive or foster name other spellings of names alias or pseudonym No Yes Give details in English

DAY MONTH YEAR
DAY MONTH YEAR
POSTCODE
l.
i.
b.
j.
c.
Sex
Male
Female
DAY MONTH YEAR
k.

DAY MONTH YEAR
DAY MONTH YEAR
POSTCODE
l.
i.
b.
j.
c.
Sex
Male
Female
DAY MONTH YEAR
k.

DAY MONTH YEAR
DAY MONTH YEAR
POSTCODE
l.
Part H About your children

Note: You must give details for any person (living or deceased) who is or was your child. This should include, but is not limited to, natural children, adoptive children, step-children. Provide details of one child at Question 57 and another at Question 58. If more than 2, give details at Part K Additional details.
i.
57 Child
a. Relationship to you (eg. son, daughter)
j.
b.
Family name All given names including, if applicable, patronymic name (in English), clan and sub-clan names, and middle names k.
Is this person currently, or have they ever been, known by other names or spellings of their name? Examples of the types of other names: cultural or tribal name or name at birth clan/subclan name name before or after marriage preferred name adoptive or foster name other spellings of names alias or pseudonym
c.
Sex
Male
Female
DAY MONTH YEAR
No Yes Give details in English

DAY MONTH YEAR
DAY MONTH YEAR POSTCODE
l.
58 Child
a. Relationship to you (eg. son, daughter)
i.
b.
j.
c.
Sex
Male
Female
DAY MONTH YEAR
k.

DAY MONTH YEAR
DAY MONTH YEAR
POSTCODE
l.
Part I Character details

59 Have you, or any other 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 or have proceedings against you overseas or in Australia been acquitted of any criminal offence or other offence on the grounds of mental illness, insanity or unsoundness of mind? been confined in a prison or psychiatric institution by order of a court made in connection with criminal proceedings overseas or in Australia? been removed or deported from any country (including Australia)? left any country to avoid being removed or deported (including Australia)? 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)? been associated with or involved in a program related to the development of weapons of mass destruction? 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? been under a probation order, good behaviour bond, on parole, released on licence or subject to a periodic detention overseas or in Australia? If you answered Yes to any of the questions at Question 59, you must state who it applies to and give ALL relevant details. If the matter relates to a criminal conviction, please give the nature of the offence, full details of sentence, court details and dates of any period of imprisonment or other detention. If insufficient space, give details at Part K Additional details No Yes
No
Yes
No
Yes
No No No No No
Yes Yes Yes Yes Yes
60 Are you currently, or have you been employed as an intelligence

officer or an agent of an intelligence or security agency? No Yes Give details of organisation, role and dates you served
No
Yes
61 Have you ever had a visa cancelled by, been refused entry to, or
No Yes been deported from, any country? No Yes No Yes Give details of dates, countries and circumstances. If insufficient space, give details at Part K Additional details
No
Yes
No
Yes
Part J Declaration
No Yes WARNING: Giving false or misleading information is a serious offence.
62 I declare that:
No Yes the information I have supplied in or with this form is complete, correct and up-to-date in every detail. I have read and understand the information supplied to me. Signature of applicant
DAY MONTH YEAR
Date
We strongly advise that you keep a copy of your application and all attachments for your records.
COMMONWEALTH OF AUSTRALIA, 2013 80 (Design date 11/13) - Page 19
Part K Additional details

63
Question number Additional information
If insufficient space, attach additional details

80 (Design date 11/13) - Page 20 COMMONWEALTH OF AUSTRALIA, 2013

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Personal particulars for assessment including character assessment

I am applying for a visa to travel to Australia as a:

a further temporary stay or visit permanent residence protection

About the information you give

Part A Your details

Day, month and year MUST be provided

Passport/travel document number Country of passport/travel document

Date of issue Date of expiry Nationality Place of issue/issuing authority

COMMONWEALTH OF AUSTRALIA, 2013

80 (Design date 11/13) - Page 1

1. Type of name Family name Given names

10 Are you a citizen of the country of passport/travel document at 6

Date you gained this citizenship

80 (Design date 11/13) - Page 2

COMMONWEALTH OF AUSTRALIA, 2013

11 Do you currently have, or have you ever had, other passports/travel

Passport/travel document number Country of passport/travel document

14 Do you currently have permanent residence rights in any country

15 Have you ever been refused citizenship of any country?

When did you have this citizenship?

1. Country Reason for refusal

From To (If you still have the citizenship, write Current)

Date 2. Country Reason for refusal

If more than 2, give details at Part K Additional details

COMMONWEALTH OF AUSTRALIA, 2013

80 (Design date 11/13) - Page 3

Type of identification document

17 Your current residential address (this is the place where you

19 Your current contact numbers (include country code if outside Australia)

Work Home Mobile/cell Fax

Other contact numbers you have

Suburb and Town/City State/Province/ Region Country Postal code

20 Address in Australia where you can be contacted or will be staying

18 Do you have an e-mail address?

21 Contact telephone numbers in Australia (if known)

Work Home Mobile/cell

Other contact numbers

80 (Design date 11/13) - Page 4

COMMONWEALTH OF AUSTRALIA, 2013

22 Do you have personal contacts in Australia (including business

2. Family name Given names

If more than 2, give details at Part K Additional details

COMMONWEALTH OF AUSTRALIA, 2013

80 (Design date 11/13) - Page 5

Part B Your partners details

30 Is your partner of Arabic descent?

24 Your partners full name

31 Is your partner of Russian descent?

Day, month and year MUST be provided

27 Your partners place of birth

1. Type of name Family name Given names

28 Is your partner currently, or have they ever been, a citizen of any

2. Type of name Family name

If more than 2, give details at Part K Additional details

33 Country where your partner lives now

80 (Design date 11/13) - Page 6

COMMONWEALTH OF AUSTRALIA, 2013

Type of identification document

Part C Travel to Australia

37 Details of proposed arrival in Australia

1. Family name City of arrival Given names

38 Are you applying for a temporary visa?

Details of proposed final departure from Australia

39 What is the main reason for going to Australia?