Personal particulars for character assessment

Form

80

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. All questions must be completed. The Department of Immigration and Citizenship (the department) is authorised to collect information provided on this form under Part 2 of the Migration Act 1958 Control of Arrival and Presence of Non-Citizens. The information provided will be used for assessing your eligibility for a visa to travel, 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.

(a) Write your name in your own language or script. For Russian citizens, include Patronymic name

(b) Your name in Chinese commercial code numbers (if applicable)

(c) If you are of Arabic descent, write the full names of your paternal grandfather (ie. your fathers father)

DAY

MONTH

YEAR

5 6

Date of birth Place of birth Town/city State/ Province Country

For officer This form is designed for completion by

applicants and requires attachment of form 80H, internally completed, before despatch for checking purposes. I am applying for a visa to travel to Australia as a: OR I am applying in Australia for: refugee/ humanitarian entrant temporary resident a further temporary stay migrant visitor student permanent residence protection Write your name and birth details as shown on official documents such as birth certificate, family book, passport or identification document.

What is your current marital status? (Tick more than one if appropriate) Never married Married Engaged to be married Widowed Divorced Temporarily separated Permanently and legally separated Living in a de facto marriage

What is your current citizenship?

How was your citizenship acquired? (eg. birth, descent, naturalisation)

DAY

MONTH

YEAR

Family name Given names

10 When was your citizenship granted? 11 Are you a dual citizen, or have you held any other citizenship?
No Yes Provide detail including date of citizenship Citizenship Date granted
DAY MONTH YEAR

2 3

Sex

Male

Female

Other names you are, or have been, known by (if insufficient space, please provide details on a separate sheet of paper) Family name Given names Continued on the next page

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12 Have you ever been refused citizenship of another country?

No Yes Date Country Reason for refusal
DAY MONTH YEAR

17 Your current residential address (Not a post office box address)

Provide details below

DAY MONTH YEAR POSTAL CODE

Country of residence

18 About your SPOUSE

For the purposes of this form, the term spouse means a legally married husband or wife, or a partner in a de facto marriage, or an intended spouse. If you do not have a spouse, write N/A and go to Question 19. Family name Given names

Date Country Reason for refusal (If insufficient space, give details on an attachment)

13 Details of all passports ever issued to you

Passport number Country of issue Sex Male Female Other names known by/used before (such as an alias, underline family name used)

14 Details of any identity documents, social security cards, or any alien

registration numbers you currently use or have used in the past Type or document Number Country Write your spouses name in his/her own language or script. Please also write Chinese names in Chinese commercial code numbers. For Russian citizens, include Patronymic name. If your spouse is of Arabic descent, write the full names of his/her paternal grandfather (ie. his/her fathers father)

15 Your e-mail addresses

Place and country of birth

Date of birth (DAY/MONTH/YEAR)

What is your spouses current citizenship?

16 Your telephone numbers

COUNTRY CODE AREA CODE ) ( ) ( ) NUMBER

Is your spouse a dual citizen, or has she/he held any other citizenship? No Yes Provide detail including date of citizenship Citizenship Date granted
DAY MONTH YEAR

Work Home Mobile Fax Other

( (

( (

) ( ) (

) )

Contact telephone if in Australia

Country where living now (If not living, write DECEASED)

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19 About your FATHER

Family name Given names

20 About your MOTHER

Family name Given names

Other names known by/used before (such as an alias, underline family name used)

Other names known by/used before (such as an alias, underline family name used)

Write your fathers name in his own language or script. Please also write Chinese names in Chinese commercial code numbers. For Russian citizens, include Patronymic name. If your father is of Arabic descent, write the full names of his paternal grandfather (ie. his fathers father)

Write your mothers name in her own language or script. Please also write Chinese names in Chinese commercial code numbers. For Russian citizens, include Patronymic name. If your mother is of Arabic descent, write the full names of her paternal grandfather (ie. her fathers father)

Place and country of birth

Date of birth (DAY/MONTH/YEAR)

Place and country of birth

Date of birth (DAY/MONTH/YEAR)

Citizenship or nationality (Give details of all held) Citizenship Date granted

DAY MONTH YEAR

Citizenship or nationality (Give details of all held) Citizenship Date granted

DAY MONTH YEAR

Country where living now (If not living, write DECEASED)

Country where living now (If not living, write DECEASED) Continued on the next page

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21 About your BROTHERS and/or SISTERS

Family name Given names Family name Given names

Sex

Male

Female

Sex

Male

Female

Other names known by/used before (such as an alias, underline family name used)

Other names known by/used before (such as an alias, underline family name used)

Write their name in their own language or script. Please also write Chinese names in Chinese commercial code numbers. For Russian citizens, include Patronymic name. If they are of Arabic descent, write the full names of their paternal grandfather (ie. their fathers father)

Write their name in their own language or script. Please also write Chinese names in Chinese commercial code numbers. For Russian citizens, include Patronymic name. If they are of Arabic descent, write the full names of their paternal grandfather (ie. their fathers father)

Place and country of birth

Date of birth (DAY/MONTH/YEAR)

Place and country of birth

Date of birth (DAY/MONTH/YEAR)

Citizenship or nationality (Give details of all held) Citizenship Date granted

DAY MONTH YEAR

Citizenship or nationality (Give details of all held) Citizenship Date granted

DAY MONTH YEAR

Country where living now (If not living, write DECEASED) Family name Given names

Country where living now (If not living, write DECEASED) Family name Given names

Sex

Male

Female

Sex

Male

Female

Other names known by/used before (such as an alias, underline family name used)

Other names known by/used before (such as an alias, underline family name used)

Write their name in their own language or script. Please also write Chinese names in Chinese commercial code numbers. For Russian citizens, include Patronymic name. If they are of Arabic descent, write the full names of their paternal grandfather (ie. their fathers father)

Write their name in their own language or script. Please also write Chinese names in Chinese commercial code numbers. For Russian citizens, include Patronymic name. If they are of Arabic descent, write the full names of their paternal grandfather (ie. their fathers father)

Place and country of birth

Date of birth (DAY/MONTH/YEAR)

Place and country of birth

Date of birth (DAY/MONTH/YEAR)

Citizenship or nationality (Give details of all held) Citizenship Date granted

DAY MONTH YEAR

Citizenship or nationality (Give details of all held) Citizenship Date granted

DAY MONTH YEAR

Country where living now (If not living, write DECEASED)

Country where living now (If not living, write DECEASED)

If you have more than four brothers and/or sisters, please provide details on a separate sheet of paper

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22 Previous addresses of the places where you have lived for 12 months or more, either continuously or cumulatively, during the
last 10 years (including Australia). You must account for every year. (If insufficient space, give details on an attachment) From
MONTH YEAR MONTH

To
YEAR

Country

Address (number, street name, suburb, state/province, country)

23 What is your present occupation 24 Give details of your employment history for the entire period since leaving school until now, including periods of unemployment
(If insufficient space, give details on an attachment) From
MONTH YEAR MONTH

To
YEAR

Name and address of employer

Country

Type of business

Your occupation/ position

25 Give details of your education history for the entire period since leaving (high) school
From
MONTH YEAR MONTH

To
YEAR

Name and address of institution (include country)

Course studied

Course completed or withdrawn

26 Give details of all your previous visits to Australia (If none, write N/A. If insufficient space, give details on an attachment)
From
DAY MONTH YEAR DAY

To
MONTH YEAR

Type of entry (visitor, student, temporary resident)

Place where visa was issued

Name used on entry

Purpose of visit

27 Give details of all visits (including short stays) to countries outside Australia for the last 10 years (If insufficient space, give details on an attachment)
From
DAY MONTH YEAR DAY

To
MONTH YEAR

Country or countries

Reason for visit

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28 Your current travel document details (eg. passport, travel authority,

documentary visa) Type or travel document Number Place of issue Date of issue (DAY/MONTH/YEAR) Date of expiry (DAY/MONTH/YEAR) Name on passport Family name Given names

31 Details of intended visit to Australia

Date of arrival or proposed arrival (DAY/MONTH/YEAR) Place of proposed arrival Period of time permitted to remain in Australia as authorised on arrival Purpose of journey Additional periods of stay authorised after arrival (if applicable) Proposed address in Australia (number, street name, suburb, state)

29 Details of contacts in Australia

Family name Given names

Go to Question 33

32 Visa details (of initial arrival)

Type of visa Visa number V < Place of issue of visa Date of issue of visa (DAY/MONTH/YEAR) Special conditions (if applicable)
NUMBER )

Sex

Male

Female

Date of birth (DAY/MONTH/YEAR) Relationship to applicant (eg. family friend, mother) Telephone number Family name Given names
AREA CODE (

Place of arrival Date of arrival (DAY/MONTH/YEAR)

33 Please answer the following questions about yourself and any other
person included in this application (a) Have you, or any other person included in this application, ever been convicted of, or found guilty of, ANY offences overseas or in Australia (include all traffic offences which went to court, including offences declared in your permanent residence application, and any spent convictions)? Note: Spent convictions are convictions which are not, under legislation in certain countries, normally required to be disclosed, for example because of the time that has passed since the conviction, or because of a pardon for reasons other than wrongful conviction. (b) Have you, or any other person included in this application, ever been confined in a prison or in a psychiatric institution by order of a court made in connection with criminal proceedings overseas or in Australia? (c) Have you, or any other person included in this application, ever committed, or been involved in the commission of war crimes or crimes against humanity or human rights overseas or in Australia? (d) Are you, or any other person included in this application, presently under a probation order, good behaviour bond, on parole, released on licence or subject to periodic detention overseas or in Australia?

Sex

Male

Female

Date of birth (DAY/MONTH/YEAR) Relationship to applicant (eg. family friend, mother) Telephone number Family name Given names
AREA CODE ( ) NUMBER

No

Yes

Sex

Male

Female

Date of birth (DAY/MONTH/YEAR) Relationship to applicant (eg. family friend, mother) Telephone number
AREA CODE ( ) NUMBER

No

Yes

No

Yes

30 Where are you currently located?

Outside Australia In Australia Go to Question 31 Go to Question 32

No

Yes

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COMMONWEALTH OF AUSTRALIA, 2009

(e) Are you, or any other person included in this application, aware of any proceedings pending against you overseas or in Australia for an offence, including proceedings by way of appeal or review? (f) Have you, or any other person included in this application, ever been involved in any activity, or been convicted of any offence, relating to the illegal movement of people to any country (including Australia)? (g) Have you, or any other person included in this application, ever been charged with any offence overseas or in Australia that is currently awaiting legal action? (h) Have you, or any other person included in this application, ever 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? (i) Have you, or any other person included in this application, ever been associated with or involved in a program related to the development of weapons of mass destruction?

34 Have you ever served in the military, either for your own country or
another country that was not considered mandatory service? No No Yes Yes Give details of any periods of military service including name of unit, locations where posted, rank achieved and duties performed

No

Yes

No

Yes

35 Are you currently, or have you been employed as an intelligence officer

or an agent of an intelligence or security agency? No Yes No Yes Give details of organisation, role and dates where you served

No

Yes

If you answered Yes to any of the above questions, give details of all occurrences. Include the following where appropriate: the name of the court; the offence; the name of the terrorist organisation; the nature of the terrorist association; details of terrorist acts; the sentence received; relevant dates; to whom it applies (you or a person included in this application).

36 Have you ever been denied or refused a visa or entry

to another country? No Yes Give details

Declaration
37 I hereby declare that the information I have supplied in this form is,
so far as I know or could reasonably find out, correct in every detail. I declare that 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.

If there is insufficient space on this form to provide details of offences, provide the details on a separate sheet of paper

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