Form Notification of incorrect answer(s) 1023

1 1023 (Design date 10/15) - Page 1 COMMONWEALTH OF AUSTRALIA, 2015 Important Please read this information carefully before youcomplete this form . Once you have completed this form westrongly advise that you keep a copy for your provisions of the Migration Act 1958 require you toinform the Department of Immigration and Border Protection(the department) of any incorrect information that you mayhave given: in your visa application; on a passenger card; or in response to a notice given to you by the departmentinviting you to comment on possible non-compliance withan obligation to correct incorrect obligation remains even if you are subsequently granted form should be used to inform the department ofincorrect information that you may have provided in one ofthe situations outlined above.

2 Should you wish to notify thedepartment of any change in your circumstances, whichmeans that information you have previously provided to thedepartment in a application is no longer correct, you shoulduse form 1022 Notification of changes in must answer all questions on this : If you do not comply with requirements to advise thedepartment of incorrect information and give correctanswers, your visa is liable to be cancelled under theMigration Act 1958. If you have been granted a visa, the information you provideon this form will be taken into account in deciding whetheryou should continue to hold that visa. If you are an applicant for a visa which has not yet beengranted, the information you provide on this form will betaken into account when assessing your visa application.

3 If your visa is cancelled and you are in Australia, you willbecome an unlawful non-citizen. Unless you are granted afurther visa, you will be detained and removed from Australia. If your visa is cancelled and you are outside Australia, andyou subsequently travel to Australia, you will be refusedimmigration clearance and will be removed from Australia. Cancellation of a visa that already has been granted is notautomatic. If you are in Australia, you will be given anopportunity to comment on the grounds for possiblecancellation before a final decision on cancellation is of incorrect answer(s) Important information about privacyYour personal information is protected by law, including thePrivacy Act 1988.

4 Important information about the collection,use and disclosure (to other agencies and third parties,including overseas entities) of your personal information,including sensitive information, is contained in form 1442iPrivacy notice. form 1442i is available from the department swebsite or offices of thedepartment. You should ensure that you read and understandform 1442i before completing this 131 881 during business hoursin Australia to speak to an operator (recordedinformation available outside these hours).If you are outside Australia, please contactyour nearest Australian lineHome keep this information page for your referenceThis page is intentionally blankDetails of other applicantsDo you have a partner (spouse or de facto partner) and/or anydependants who are/were included in your application?

5 11 YesNoProvide details below5 Passport numberDetails from your passportCountry of passportDetails of identity card or identity number issued to you by yourgovernment (if applicable) eg. National identity : If you are the holder of multiple identity numbers because you area citizen of more than one country, you need to enter the identity numberon the card from the country that you live numberCountry of issueYour present country of citizenship7 Client number or file number issued to you by the department (if known)10 Address for correspondence(If the same as your residential address, write AS ABOVE )9 Your current residential addressNote.

6 A post office box address is not acceptable as a residential of birthCountry of birthDAYMONTHYEARC ountry of passportResidential addressPOSTCODEP assport numberFamily nameGiven namesIf insufficient space, attach additional of birthCountry of birthDAYMONTHYEARC ountry of passportPOSTCODEP assport numberFamily nameGiven of birthCountry of birthDAYMONTHYEARC ountry of passportPOSTCODEP assport numberFamily nameGiven addressResidential address1023 (Design date 10/15) - Page 3 COMMONWEALTH OF AUSTRALIA, 2015 Form1023 Notification of incorrect answer(s) Your detailsYour full nameFamily nameGiven names1 Date of birth2 Place of birth3 Town/cityCountryDAYMONTHYEARTick where applicable Please use a pen, and write neatly in English using BLOCK status4 MarriedNever married orbeen in a de factorelationshipSeparatedDe factoEngagedWidowedDivorcedDAYMONTHYEARI declare that: the information provided on or with this form is true and correct inevery detail.

7 I have read the information contained in form 1442i Privacy notice. I understand the department may collect, use and disclose mypersonal information (including biometric information and othersensitive information) as outlined in form 1442i Privacy ofapplicantDeclarationDateDetails of incorrect informationThe incorrect information provided was on:12visa applicationpassenger cardform 1022 Notification ofchanges in circumstancesList details of the information provided which was incorrect andprovide the correct information13 Information which was incorrectCorrect detailsIf insufficient space, attach additional detailsWhy was incorrect information provided?

8 141023 (Design date 10/15) - Page 4 COMMONWEALTH OF AUSTRALIA, 2015 Your visa and application detailsVisa details (if known)Date grantedStay period15 DAYMONTHYEARVisa classApplication details (if known)Date ofapplicationLodged at16 DAYMONTHYEARVisa classDAYMONTHYEARDateSignature ofother applicant(aged 18 yearsor over)DAYMONTHYEARDateSignature ofother applicant(aged 18 yearsor over)DAYMONTHYEARDateSignature ofother applicant(aged 18 yearsor over)If insufficient space, attach additional which was incorrectCorrect strongly advise that you keep a copy of this form and allattachments for your : Giving false or misleading information is a serious offence.

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