Tourist Visa Part 1x

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Application Ap tion for a Visitor visa Tourist stream Visit Visito a Tour Touris am m
Form
1419 1419
Please se use a pen, and a w e neatly atly in English using u OCK LETTERS. write BLOCK Tick ck k where applicable applica a
Indicate ndicate ate if you u are a applying i outside de Australia or in Australia: A ralia: Outside A Australia Aus In n Aus Australia Austral Go to Question 2 Go t to Question uestion 5 uesti
Applicants A Appli nts outside utside A Aust Australia
Part Pa t A Your deta details d
When hen do you wish to visit visi Australia? A tra

DAY MONTH
Give e the followin following deta details exactly tly as they th the appear pp in your passport assport
YEAR YEA
DAY
MONTH NTH
YEAR
Make sure your p passport pa port is valid for the period perio of stay you are applying applyin for. Family nam name
Date
from 01-Apr-2014 -2014
to 30-Sep-2014 0-S 014
How long do you wish to stay in Aust Australia? a? Up t to 3 months nths Up p to 6 months month
Given names mes
Sex
Male e
DAY Y
Female
YEAR YEA
Up to 12 months
MONTH
Note: The stay s period pe d granted nted may be less l than th the period requested. requested reque You shou should che he terms of any visa granted. g ted. check the Do yo D you intend ntend to o enter Australia Austr on o more e than one occasion? occasion occa Go to Ques Question 7 Give details
Date of b birth
23-Aug-1989 23-Aug-19
Passport Pa o number umber
Country C ntry of passport assport PHILIPPINES ES Nationality nality of passport holder pas as hold issue Date o of is
No N Yes
FILIPINO NO
DAY
MONTH
YEAR
13-Mar-2013 Mar-20 12-Mar-2018 12
expiry Date of e iry
Plac of Place f issue/ issuing uing authority
DFA MANILA A A
Go to Question 7
Place of b birth Tow Town/city
Applicants in A Australia tralia
ANILA MANILA
Specif the date Specify ate you ou wish to extend your stay to o exte ext
DAY
MONTH
YEAR Y
Stat rovince e State/province Country ountry
Provide ovid detailed tailed rea reasons for fo requesting equesting ting this further furt stay sta
PHILIPPINES PHI S
Relationship stat status Married Marri M Engaged E ged ed
Separated Separat
Divorced Divorc
Never married or mar f o been in a de facto relat ship relationship
De facto cto
Widowed W wed
COMMONWEALTH OF A AUSTRALIA AUSTRALIA, 2013
1419 (Design gn date e 07/13) - Page 7
10 1 0 Are you or have you been k known wn by any other o ot name? nam
No Yes
18 What at is your lega legal status in your current cu ent t location? locat
Citizen Visitor sitor Permanent resident Permane Perm Student
(including luding name at birth revious evious married names, nam aliases) ) birth, previous Give details G
Work vis visa
status No legal st sta
11 Do you currently hold an Australian ralian visa?

No Yes
Other
Give detai details
Note e: If this s visa application applicatio app is approved, roved, your current cu visa a ay cease. may
19 W What is the e purpose of yo your stay in your ur current location loca and what at is
ur vis atus? tus? your visa status?
1 2 Have 12 ve you applied applie for a Parent Pare (subclass ass 103) visa? visa
No Yes
DAY
I AM A N NATURAL BORN RN FILIPINO FILIP
MONTH ONTH
YEAR
Please Ple provide ovid your ovide r queue date
13 Do y you c currently ently hold, old o or have e you applied d for, or, an APEC Business Bu Busine Travell
C (ABTC)? Card TC)? No N Yes
20 Your ur current rrent residential residen ad address ss
this visa is the Note: If thi sa application applica plic s approved, appro app he Australian visa associated with your ABTC will cease. as associa ABT w
Note te: A street address ad ired as a post t office o ddress dress cannot is required box address be accepted.
BLOCK LOC 4
SUBD. UB
14 Are you a c citizen en of f any other country?

N No Yes Y List countrie countries
BARANGAY B A Y RIZAL AL
POSTCODE POS
Country ountry
PHILIPPINES IPPINES
21 Address dress for correspondence respondence ondence

1953M 1
(If the ( e same sa as your ur residential address, add s, write rite AS ABOVE)
15 Do you ha have other er current passports passports? pass

No Yes Give deta details
MANILA ILA
Passport assport number numbe
POSTCODE
Country of pas passport ort
Country Country
PHILIPPINES P IPP
16 6 D Do you hold old an n identity card or identity id ty number mber issued to t you by y your
gov nment nt (eg. National Nationa identity iden card) (if applicable applicable)? government Note because you ote: If you are the holder holde of f multiple iple identity numbers numb n are e a citizen of more m than n one e country, you need to enter r the identity number on the ca he country that you yo live ve in. card from the No Yes es Give details
22 Co Contact act telephone lephone numbers num

Home ome
( (
COUNTRY CODE COU
AREA CO CODE
N NUMBER
) (
) )
Office
) (
Mobile/cell Mob Mobile/ce
+63 3
Family name F
23 D Do you agree to the department de departm nt communicating mmunicatin wi with you by e-mail eand/or nd/or fax fax?
ven names na es n Given
This may inclu include re receiving ving notification of t the outcome ou ome of f this th application. icatio ication application Note: We W can communicate mmunicate nicate about this th app ation more quickly quic using u e-mail ma and/ ax ax. and/or fax. Give deta details
Type o of document ent Identity number Id
N o No
Y Yes
Country of f issue
E-mail mail address Fax x nu number
@hotmail.com
AREA COD CODE
TRY CODE DE COUNTRY
NUMBER ER
17 In what coun country are you currently countr rr locat located located?
PHILIPPINES PHIL
) (
1419 9 (Design date 07/13) - Page 8
COMMONWEALTH OF AUSTRALIA, A AUSTRALIA 2013
Part P art B Family Famil travelling travelling ellin to to Australia Au A ia with you yo
24 Are re you travelling to, to or are you ou currently in, in Au Australia with ith h any family members? m
No Yes Give ve details tails of each family fa member em ember Make ke sure all the appl app tions are lodged at the same time. me. e. applications Full name ame Relationship R to o you Name of f sponsor (if ( applicable) li ble) If insuffic insufficient uff space, space, give space g details etails s at Part O
Part C F Family Family NOT NOT travelling N travelling t ng to Australia Aus Australia with you
25 D Do you have ve a partner, any an children, dre or fianc nc who will NOT N be b travelling, ravelling, ling, or has NOT travelled, tra led, to Australia with wit you? yo
No Yes Give details
Full ull name ame
Date ate of bir birth

MONTH ONTH NTH
DAY DA
Y YEAR
Relationship to you
Their address addr while wh you are in n Australia Austral
/ / / /
/ / / /
If insufficient sufficient cient space, give giv details de s at Part O
Part D De Details tails s of your visit v visit to Australia

N No Yes Ye
26 Is it likely lik yo you will be travelling from Australia Au alia a to any other country c (eg. g. New w Zealand, Singapore, Singapo Papua ua New Guinea) Guine and back Guinea ck k to Australia?
Attach itiner itinerary d details ails
27 7 Do you have any relatives an rela es in Australia?

No Yes Give ve details tails Full name
Date of birth bir

MO MONTH
DAY
YEAR
Relationship elationship to you
Address Add
Citizen or permanent pe nent p resident of Australia r Aus A No No No No Yes Yes
/ / / /
/ / / /
Yes Ye Yes
If insuf insufficient space, give insuffic ve details at a Part O
1419 (Design gn date e 07/13) - Page 9
28 2 8 Do you have any friends frie or contacts ntacts ts in Au Australia? Aus a?
No Yes Give details ails Full name ame Date of birth
MONTH DAY YEAR Y
Relationship ship ip to you
Address Addres
Citizen tizen en or o permanent pe manent nt resident re ent of Australia ustralia No s Yes
DENNIS S
/ 1981 98
FRIEND ND
SA 5086 50
MYLENE YLENE
1987 /
/ /
FRIEND FRIE
QLD LD 4115 11
No
Yes Yes
/ /
No No
Yes
Yes
f insufficient insuffic ce give ve details tails ls at Part O If space,
29 Why do you want ant to o visit v Australia? ustra ustralia
Inc Include tails of any ny dates da that hat are ar of special a pecial ial significance significanc to your ur visit. t. details
I HEARD D A LOT OF STORIES S FROM FR MY FRIENDS FR ABOUT AUSTRALIA SPECIFICALLY ALL ADELAIDE AND ND BRISBANE. RISBANE. NOT NO ONLY THAT HA AUSTRALIA, USTR ACCORDING CCORDIN TO RECORD, ORD, IS ONE OF THE COUNTRIES UNTRIES HAS THE LOWEST RATE, WHICH H OWEST CRIME CR TE, IT OFFERS FERS A LOT OF ATTRACTIONS EDUCATIONAL, OT O IONS LIKE E ONA HISTORICAL GALLERY AND MUSEUM, HI M UM AND ND ART A GALLERY ASIDE GA IDE FROM ITS NATURAL AL FEATURES. URE I HAVE BEEN TIME, AND EN WORKING WORKIN FOR THE E LONGEST LONG A HAVE BEEN SAVING SAVIN UP MONEY NEY FOR A VERY V I WONDERFUL TRIP TR I HOPE I WOULD EXPERIENCE. EXP HAVE TO AVE ALWAYS ALWAY DREAMT T OF TRAVELING TRAVE AUSTRALIA, AND I KNOW AUSTRALIA OW THIS JOURNEY IS S WORTH WOR EVERY I DO HOPE AND PRAY VERY PENNY. P O EARNESTLY EARNEST APPROVAL THAT A AL BE GIVEN TO MY APPLICATION. LICATION.
If insufficie insufficient spa space, give details at Part O
30 Do y you int intend d to do a course of study while hile in Australia?

No No Yes Y Give deta details
Name me of the cours course Name of th the institution institutio stitu
How w long l g will the course co last? la
1419 9 (Design date 07/13) - Page 10
Part P rt E Health details d tails ls
35 During ring ing your propos proposed propo visit to o Australia, Austr a, do you expect Aus exp to incur ncur medical
require treatment or medical costs, sts, or requir req medic follow llow ow up u for: or: r: blood disorder; d cancer; ca can heart disease; se; ; hepatitis s B or C and/or and/o liver disease; se; HIV AIDS; V Infection, including inclu inc idney disease, diseas including dialysis; ialysis; kidney mental illness; illn ill pregnancy; preg sease ease that has required respiratory disease dmission or oxygen ox oxy y; hospital admission therapy; th other? No Yes Give details
31 In the last 5 years, ha have h you visited or lived outside out your country of
passport for more than an 3 consecutive months? month Do not iinclud Australia. include time spent in Austr No Yes Give details
1. . Country(s) Country(s
DAY
MONTH
YEAR
DAY AY
MONTH
YEAR
Date D
from
to
2. Country(s) 2 ntry(s ntry(s)
DAY
MONTH ONTH NTH
YEAR YEA
DAY
MONTH
YEAR Y
Date
from f
to o
3 C 3. Country(s) ntry(s) )
DAY
MONTH TH
YEAR
DAY
MONTH NTH
YEAR
Date
from
t to
36 Do you require a assistance stance with mobility or care due to o a medical

conditio condition? No Yes
If insufficient insufficien space, insuff pace, , give details at Part Par O
32 Do yo you intend ntend d to enter a hospital hospita ho or health lth care facility fac (including ng
nursing n ng g homes) while in Australia? Aus ia? No Yes s Give de details s
Give details
37 Have 3 e yo you undertaken ndertaken dertaken a healt health examination xamination ation for an Austra A Australian n visa a in
ast 12 1 months? nths? ths? the last No o Yes
33 Do you inte intend to work rk as, or study to be, b a doctor, d or, dentist, entist, nurse or o
parame g your ur stay in Australia? Austr paramedic du during No Yes Give ive details
Give details eta (including ncluding cluding HAP H ID if available) vailable) le)
34 4 H Have you: ou: u:
ever have, ev had, ad, , or currently curr e, tuberculosis? rculosis? been een in close ose e contact co cont with a family member mem that t has active tuberculosis? rculo rculosi an abnormality? ever ev had a chest eve es x-ray ay which showed sho rmality? No Yes Gi details Give ls
are applying long stay Note: If y you ar pplying ng for a lon st Visitor or visa vis or r are 75 years y assessment or ove over, you will ill be asked to undergo under a health assess asse nt t and may m asked to medical insurance be aske o show ow that you have m cal ins ns e to cover co your c intended Please contact nearest office of the inte ed stay in Australia. Austral Plea act your you n st of off department partment ent for further furthe advice advi before re lodging your yo application. a on. If consultations decision additional dditional medical medica cons ations are required, a de o on your visa vis delayed. application w will be d yed.
1419 (Design n date 07/13) - Page 11
Part P rt F Character Characte Chara details detai ta Part art G Em Employment ment status men
Employed/ Em Emp selfself-employed
38 Have ave you ever:
39 What is you your employment nt status? sta
been convicted convict of a crime or offence con offen in any country coun (including (i uding g any conviction convictio which wh is now records)? n removed r oved from official reco record been b n charged arged with any offence offen that is tly awaiting legal l a on? currently action?
Give det details detai Employer/business name Employe nam Address
No No
Yes
Yes
been acquitted of any a criminal nal offence or other offence on the offe e grounds nds of mental menta illness, or unsoundness ess, insanity ess insan i nsoundness of mind? mind been be removed bee ved or deported from fro any an country (including cou coun cluding ding Australia)? Australia
1800
CITY
No No o No No
Yes Ye
CITY TY
PHILIPPINES PHI
DE E COUNTRY CODE
POSTCODE
Yes s Yes Yes
Telephone number Te mber

( ) (
avoid being left any ny country coun to co o avo be g removed moved or deported? dep ? been en excluded exc d from fro or asked fr sked ed to leave any an (inc Aus Austra ? country (including Australia)? committed, committ or committed r been be involved volve in the volved he co comm on of, war wa crimes s or crimes c commission against ag st humanity manity or human hum rights? ts s?
AREA COD CODE
ER NUMBER
Position osition sition you hold
PATIENT ATIEN CARE ADVOCATE DVOCAT
No
Yes
How long have you Ho employed by this been e be employer/business? e emplo ness? ss? Year r of retirem retirement retireme
2 YEARS S
been that een involved volved in any activities acti a t would wou epresent a risk to Australian Au alian national na nat represent ecurity? security?
Retired
No
Yes
Student tudent
had any outstanding outs ding debts to the Australian Austr A Governm ve ny public authority in i Government or any A Austra ? Australia? been b n involved olved in any activity, activity ac n or been offence relating o lating to o the t convicted of any offence, moveme of people p ple to o any country illegal movement Austra Au (including Australia)? served in a military m tary ary force or state spon sponsore private rivate militia, unde undergon any ny sponsored/private undergone milita paramilitary military training, training or been en military/paramilitary tr ed in weapons/explosives weapons/explosive weapons/ex se trained use however ever described)? described) (however
Give e details course Your curren current cour
No
Yes
Name of educational Na ducational ins institution institutio
No
Y Yes
How long have you been this institution? studying at t tution? Give G ive d details ls
Other her er
No N o
Yes s
If you answered Yes to any of the above qu questio questions, , give ALL relevant details below.
Unemployed
Explain nw why you ou are unemployed ou u loyed d and give details deta of f your la last e ym (if applicable) pplicable) plicable) employment
nsufficient sufficient spac ils at P tO If insufficient space, give details Part
1419 9 (Design date 07/13) - Page 12
Part P art H Funding Fund for r stay
Alll visitors to Australi Australia Austra must ust be e able to demonstrate demons dem they y have adequate adequat funds to cov cover all costs sts associated ssociated with wit their visit. t. Providing Pr ing ng evidence evidenc eviden of of funds wi will help expedite xpedite te the processing proces o a visitor or visa application. a catio t may statements Exam Examples y include lude personal bank b tements ements showing showin a financial history, pay hi history ay slips, ps, audited accounts, account taxation axation records or details d detai of funds ds tha sitors s will be taking with them em or r funds that are a available ava le to them. t that visitors Relevant levant factors may also include ude the number of o persons pers your r are supporting, porting, the type ty of activities ivities s planned and the th length l th of stay sought. sought
40 0 Giv Give details G etails of how w you will maintain maintai yourself your f financially cially while you yo are ar
Australia in Au Aus
AS REFLECTED EF TED IN THE ENCLOSED OSED B BANK STATEMENT, I HAVE SUFFICIENT EME H FICIENT FUNDS TO SUSTAIN N MY M STAY IN AUSTRALIA, USTRALI FURTHER, HER, MY SPONSOR WILL ON WIL BE EXTENDING XTENDING FINANCIAL IAL ASSISTANCE TO BE STAYING ASSIST O ME AND I WILL W AYING WITH HIM H AND HIS HI FAMILY MIL DURING G MY VISIT VI TO AUSTRALIA. O AUS
41 Is your spon sponsor r or someone else providing provid p g support pport for your visit to Australia? ustralia
an organisation. Note: This No T s includes des support from f ation. Give det details Full name me No
Yes
Date of birth Da rth

MONTH ONTH
DAY
YEAR
Relationship Re Relation p to you ou
Their address addre while a le you y are in n Australia Aust
Type of support provided provid
Financial inancial Accommodatio Accommodation Accom Other her
DENNIS DE
1981 /
/ / /
FRIEND D
SA 5086 S 50
/ / /
nsu icient ent space, give details d ils at Part O If insufficient
Attach ach details. det s. The person d pe n or people you have hav listed list will need to provide provid evidence evid ce of f their ability to provide prov e this support.
Part P art I Previous Previo applications applica plica ions
Austr a and not complied with A been in Australia cond ns or c r departed Australia Aus visa conditions o outsid our authorised period of stay? ay? ? outside your
42 Have ave you ever:
Part art K Op Options for fo receiving eceivi written w tten communications commun ommun
(T one box only) (Tic nly) (Tick Myself OR
47 All wr written communications writ nications abo abou about this application plic n should plicat hould be sent to:
No
Yes
had h an application pplication for entry to or further ther tay in Australia refused, refused ref stay or had a visa for ustralia cancelled? cancell Australia
No
Yes
u answered answe Yes to any of the above abo qu ions, give details If you questions,
Authori Author Authorised re recipient OR
You should c complete form 956A co 95 Appointment Appoi ent Appoint or withdra uthorised thorised r ent withdrawal of an authorised recipient
Migration agent M ge OR
Exempt person perso pe
Your migration ation tion agent/exempt agent/exe person should shou ete form 956 Advice A ration complete by a migration ent/exempt nt/exempt person pers of providing ding agent/exempt as immigration assistance
Part J Assistance sistance with this form f rm

Go to Par Part K
43 Did y you receive ive assistance in completing co leting g this form? form
No Yes
Please giv Pleas give details etails of the person who assisted sisted you Mrs rs Miss Ms M Other Othe
Title:
Mr
Family nam Famil name
Give ames s Given names Address ddress s
POSTCODE
Telephone Telep ne number mber or daytime daytim contact co act

COU COUNTRY COD CODE
AREA CODE
NUMB NUMBER
Office e hours Mobile/cell
) (
44 Is 4 s the per person n an agent registered register with wit the he Office ffice of the Migration Migratio M
gent ent Registration egistration gistration Authority Authori (Office (Of of the he MARA)? Agents No N Yes s Go o to Part P K
45 5 Is the person/agent on/ on/a in Australia?

No Go to Part Pa K Yes Y
46 Did you pay the person/agent per pe t and and/o and/or give e a gift gif for this s assistance? sistance
No Yes
1419 9 (Design date 07/13) - Page 14
Part P art L Payment Payme details tails
48 IMPORTANT PORTANT: You must m refer to the departments depart departmen website te e at www.immi.gov.au/fees-charges www.im fees-charges to complete this part of of your you application. yo cation. ation.
show reference eference nce tables with w the Visa sa Application Ap ation Charges Charg applicable Cha ble to each visa v subclass. The website shows subc s you ou are applying for Visa subclass ase Application Charge Charg Ch Base
600
rite the amount amoun shown sho on the he reference table ta for f your visa subclass subcla subc Write
AUD 335.00
) (1)
n-inter Application lication Charge Cha ( applicable) pplicable) ble) Non-internet (if
AUD AU
(2)
Additional itio Applicant ition pplicant Charge Cha aged 18 years or over ove at t the time your application applicati app is s lodged ed d Wr the Write W he amount am t shown wn on the reference eren table for your erence our visa subcla subclass AUD D Number of additional additiona applicants ad pplicants ants yea or r over aged 18 years =
X (multiplied multiplied by)
AUD UD
(3)
Additional Charge A ddit nal Applicant Applica pli harg under harge er 18 8 years of age ag at the e time e your application is lodged dged ed amount shown Write the amo own on ow o the e for your visa subclass reference tab table fo isa s sub ss AUD Number additional applicants ber of addition ap ants under 18 y years of age =
X (multiplied tiplied by)
AUD
(4)
Subsequent Charge (if applicable) Sub Subsequ t Temporary orary Application Applicati Applica Ch app able) a shown on the Write te the amount sho your visa subclass reference ference table f for yo ubclass AUD AU
mber ber of applicant ap Number applicants
X (multiplied lti by) y)
AUD D
(5)
Total al
(1) T Total ) + (2) + (3) + (4) (4 + (5) (5
AUD 335.00 0
Yo must pay ay the total a amo applic ll not be valid. You amount or your visa application will ote: A second instalment instalmen ins f the Visa Application Applicatio Charge Ch ge must ust also be Note of d before we can ca grant gra some visas. paid
49 How will yo you pay your ur application plication charg charge?
credit methods If f applying apply in Australia ustralia alia, debit card or c dit it card are the preferred pref ethods ds of payment. Debit De Deb cards ards cannot ot be used u for applications plications ns lodged by lodg b mail. If f paying by bank b ch ue or r money order please pleas make payable to the Department Dep ment of f Immigration Imm Im ion and an Citizenship. a zenship. ship. cheque If ap ing outside tside Australia Aust ase check with the Australian Aust an Government overnment office off where w re you u intend to lodge lo ppl pplica n as to applying , please your application at methods thods of payment pay a rencies they can ca acc t and to whom the payment paym t should d be made payable. pay payab what and currencies accept Bank nk cheque order Money ord Debit card Deb
Cannot be us used fo pplications ations lodged by mail ma for applications Give deta details b below w
Credit Cre card d
Payment P nt t by (tick one box) box MasterCard M sterCard rCard Visa sa
Australian Austra Dollars ars
COUN ODE COUNTRY CODE
AREA REA CODE
BER NUMBER
Diners rs Club JCB CB
American can Express Ex ess E
AUD 335.00
Telephone number Addres Address
) (
Credit Cre card number Cre er : : : : :
POSTCODE POSTCOD
MONTH M MON
YEA YEAR
Expiry xpiry iry date
Signature gnature of cardholder
Cardholders name
Credit card information Cre formation mation will be used u f for charge arge paying purposes pur only. y.
Part P art M Application Applicat Appli ion n checklist che klist
you must in include include:
Additional ditional documents doc do ts
50 With your completed and d signed ned application applicatio form fo 1419, ,
a valid passport assport t with a certified certif c copy y of the identity page personal pa (showing wing photo and per pe al details) ails) and other othe pages ages which provide evidence evid e of travel to any other ntries countries a recent passport passpo photograph pas hotograph graph (not more than th tha month old) old of f yourself urself 6 months the th Visa Application cation Charge (if applicable) ap cable)
Under the Migration M Act 195 1958, decision-makers cisio ak s are not obliged to cisiont seek addition additiona n from the applicant can before cant re making a decision decis o additional information on a application. It the visa a t is therefore in i the your best bes interest i erest est to submit su e following documentation, applicable, with your application: fo umentation, entation, if a ap ication: atio evidence vidence ence of access acce ac to funds to o support your y stay tay evidence of o your medical/travel cal/travel /travel insurance insura requ (if requested)
medical examination mination or tests test (if requested) ted)
a completed om ompl form 1257 12 Un Undertaking rtaking ng declaration, for cants u r 18 ye ge, staying in Austr applicants under years of age, Australia wi someone with meone o an a parent, legal guardian guard g other than or relative ela (if applicable) ppli pplic a completed complet form 1229 Consent com sent t to g grant nt an Austra n visa a to t a child hild under und the u th age of 18 years, Australian plicants nts under und 18 years ear of age, ears e, travelling avelling alone for applicants out one or both b of o their parents par paren r legal or without or ia (if f applicable applica guardians applicable)
a letter er from your employer em confirming irming rming your leave leav lea
evidence evide evidenc of f enrolment e at school, chool, college or university y If visiting a clo close family y member in Australia A (who o is a citizen or p citize manen resident ident of Australia): A permanent le of invitation vitation to t visit a letter
If you authorise ano another r person n to receive re e all written w communica communications out your application applica e about with the department: epart completed comp ed Part art K Options for r eiving written wri w receiving co munications; ions; ; and communications; orm 956 Advice by a migration mi ation agent/exempt person pers form immigrat n assistance; imm istance; or of providing immigration Appointment A ment t or r withdrawal of an form 956A Appo authori recipient re ient authorised
other information to show that you ou have an incentive ince nd authority to return retur to o your country ntry of residence, re and pro significa signific assets in your such as property or other significant ome country coun home
documents requested. Important: Do not provide origin Import original doc ments unless un reques should provide of You sho ide certified copies copies c f original documentation. docum docu Documents Docu ents not in English should shou sho be e accompanied ccompanied by b accredited ac English E ish translations. nslations.
When you have ve e lodged your application, ap applic on, you should your attach y att ur receipt ceipt to this sheet. shee s
1419 9 (Design date 07/13) - Page 16
Part P rt N Declaration Declarat Decla on and an consent cons Part art O A Ad Additional na information nal informatio nform
Question n number WARNING ARNIN : Giving false fa or misleading sleading information informat infor erious offence. offence is a serious this form form, I d are that: declare
52
A Add Additional dditio information formation ormation
51 Having read the Conditions onditions ions for a Visit Visitor visa vis to o Australia Austra on page 1 of
I understand und stand d that the visa I am applying a lying g for does not permit p perm me to k in Australia; Australia work
rstand that the t visa vi I am applying for does d not n permit it me to I understand longe than tha 3 months nths in Australia; study for longer intent to visit sit Australia stralia is genuine gen a I will abide by the my intention and ditions and di a d period od of stay of the t visa; vis conditions
hav access h ess to adequate funds fun to t meet all costs associated associ th h I have with he visit to and d from Australia; Austr the e never nev had d tuberculo tube s or any serious condition conditio con kely to o I have tuberculosis likely end r or be b a cost ost to Australia a (otherwise, (otherwise I attach att h details); tails); endanger
unders nde rther stay 8503 850 condition co tion is s imposed I understand that if a no further visa it will limit lim my ability to remain remai in r n Australia tralia beyond the on this visa, authoris period p f the visa; vis authorised of which has in any part p t of this his form f h been en completed ompleted with the t assistance assi nce of another anoth person, on that t the information formation as set down d wn is true with t e and d correct and has been included nclu nclude ith my full fu knowledge, kn ledge, e, consent t and understanding; understand understa ;
if f granted a visa, visa I will w advise the Australian A alian Visa V Office fice should my circumstances circumstan change; c nge; I understand that unders at if I do not abide by b the th conditions tions imposed im sed on o my visa, v my visa a may be cancelled or o I may y be b subject bject to other her penalties. may also p penal s. If applicable, pplicable, my sponsor spons s so be penalised; alised
I have ve truthfully uthfully declared declare all relevant evant nt details requested requ requeste of me in this t application. plication. For r offshore appli applicants who ho are e required to provide p provid their heir fingerprints fingerp nge and nd facial imag image. I declare that II:
understand unders d that hat my fingerprints fingerpr and a faciall image and my biographical biog phical information held h by b the Department of Immigration Immig tion and Citizenship tizenship hip may be given giv to Australian ustralian law enforcement enforceme agencies enforc cies to help p identify me, to t help determine etermine my eligibility eligibi for fo grant rant of the visa I have applied for, and a for law aw enforcement enforcemen purposes. pur ses. to: I consent to law disclosing Australian Aust w enforcement forcement agencies age sclosing my biometric, biomet biographical information of b biogra cal and criminal record r ormation tion to the Department Departm Dep Im gration on and Citizenship Citizensh for fo any of the he purposes outlined outli d above; ove; Immigration
he Department epartment of Immigration Immig ion and Citizenship using the he information the btained for the th purposes purp s of the he Migrati Migration A Act 1 obtained 1958 or r the Ac 2007 20 Citizenship Act 007. Signa Signature of appl applicant
ate Date
11-Feb-2014 11 1F b2
We strongly W ongly advise ongly ad e that you keep a copy cop of your ur application applicat and a ac me ts for your records. record re all attachments
If insuf insufficient ent space, ace, attach additio additional a l details.
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Tourist Visa Part 1x

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Tourist Visa Part 1x

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Applicants A Appli nts outside utside A Aust Australia

Part Pa t A Your deta details d

When hen do you wish to visit visi Australia? A tra

from 01-Apr-2014 -2014

to 30-Sep-2014 0-S 014

Given names mes

Passport Pa o number umber

13-Mar-2013 Mar-20 12-Mar-2018 12

expiry Date of e iry

Plac of Place f issue/ issuing uing authority

Place of b birth Tow Town/city

Applicants in A Australia tralia

Stat rovince e State/province Country ountry

Relationship stat status Married Marri M Engaged E ged ed

Never married or mar f o been in a de facto relat ship relationship

COMMONWEALTH OF A AUSTRALIA AUSTRALIA, 2013

1419 (Design gn date e 07/13) - Page 7

Work vis visa

status No legal st sta

11 Do you currently hold an Australian ralian visa?

Give detai details

I AM A N NATURAL BORN RN FILIPINO FILIP

Please Ple provide ovid your ovide r queue date

20 Your ur current rrent residential residen ad address ss

14 Are you a c citizen en of f any other country?

21 Address dress for correspondence respondence ondence

15 Do you ha have other er current passports passports? pass

Passport assport number numbe

Country of pas passport ort

22 Co Contact act telephone lephone numbers num

COUNTRY CODE COU

Mobile/cell Mob Mobile/ce

ven names na es n Given

Type o of document ent Identity number Id

E-mail mail address Fax x nu number

TRY CODE DE COUNTRY

1419 9 (Design date 07/13) - Page 8

COMMONWEALTH OF AUSTRALIA, A AUSTRALIA 2013

Full ull name ame

Date ate of bir birth

Their address addr while wh you are in n Australia Austral

If insufficient sufficient cient space, give giv details de s at Part O

Part D De Details tails s of your visit v visit to Australia

27 7 Do you have any relatives an rela es in Australia?

Date of birth bir

Relationship elationship to you

Citizen or permanent pe nent p resident of Australia r Aus A No No No No Yes Yes

If insuf insufficient space, give insuffic ve details at a Part O

COMMONWEALTH OF A AUSTRALIA AUSTRALIA, 2013

1419 (Design gn date e 07/13) - Page 9

Relationship ship ip to you

Citizen tizen en or o permanent pe manent nt resident re ent of Australia ustralia No s Yes

f insufficient insuffic ce give ve details tails ls at Part O If space,

29 Why do you want ant to o visit v Australia? ustra ustralia

If insufficie insufficient spa space, give details at Part O

30 Do y you int intend d to do a course of study while hile in Australia?

Name me of the cours course Name of th the institution institutio stitu

How w long l g will the course co last? la

1419 9 (Design date 07/13) - Page 10

COMMONWEALTH OF AUSTRALIA, A AUSTRALIA 2013

2. Country(s) 2 ntry(s ntry(s)

MONTH ONTH NTH

36 Do you require a assistance stance with mobility or care due to o a medical