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Declarable Circumstances Form

Sensitive: Personal (After First Entry) Sensitive: Personal (After First Entry) Declarable Circumstances form | Page 1 Version October 2016 Declarable Circumstances form Privacy Notice The Department of Immigration and Border Protection (the Department) is collecting your personal information and the personal information of your associates for the purposes of assessing your Declarable circumstance(s) and determining your ongoing eligibility to hold or maintain a Commonwealth security clearance and/or an Employment Suitability Clearance (ESC). Failure to provide your personal information or the information requested about third parties associated with you will result in the Department not being able to assess your Declarable circumstance and/or make a determination as to your entitlement to hold, or maintain, an ESC and may result in you not being eligible for employment or association with the Department and/or not being eligible to have non- public access to the Department s assets.

Sensitive: Personal (After First Entry) Sensitive: Personal (After First Entry) Declarable Circumstances Form | Page 2 Version 1.2 – October 2016

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