Form Personal particulars for 80 - …

1 80 (Design date 03/09) - Page 1 COMMONWEALTH OF AUSTRALIA, 2009 Personal particulars for character assessmentForm80 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 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 information form 993i Safeguarding your Personal information, available from offices of the department, gives details of agencies to which your information might be officer This form is designed for completion by applicants and requires attachment of form 80H, internally completed, before despatch for checking residentrefugee/humanitarian entrantORI am applying in Australia for:I am applying for a visa to travel to Australia as a.

2 A further temporary stayprotectionpermanent residence1 Write your name and birth details as shown on official documents such as birth certificate, family book, passport or identification nameGiven namesSexMaleFemale23 Family nameGiven namesOther names you are, or have been, known by(if insufficient space, please provide details on a separate sheet of paper)4(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 father s father)DAYMONTHYEARDate of birth5 Place of birthTown/city6 CountryState/Province7 What is your current marital status? (Tick more than one if appropriate)MarriedEngaged to be marriedLiving in a de facto marriageTemporarily separatedDivorcedWidowedNever marriedPermanently and legally separatedWhat is your current citizenship?8 How was your citizenship acquired?

3 (eg. birth, descent, naturalisation)9 DAYMONTHYEARWhen was your citizenship granted?10 Are you a dual citizen, or have you held any other citizenship?11 Provide detail including date of citizenshipNoYesDAYMONTHYEARC itizenshipDate grantedContinued on the next page80 (Design date 03/09) - Page 2 COMMONWEALTH OF AUSTRALIA, 2009 Have you ever been refused citizenship of another country?12 Provide details belowNoYesDAYMONTHYEARDateCountryReason for refusalDAYMONTHYEARDateCountryReason for refusal(If insufficient space, give details on an attachment)Details of all passports ever issued to you13 Passport numberCountry of issueDetails of any identity documents, social security cards, or any alien registration numbers you currently use or have used in the past14 Type or documentCountryNumber15 Your e-mail addresses16 Your telephone numbers( ) ( )( ) ( )COUNTRY CODEAREA CODENUMBERWorkHomeMobile( ) ( )( ) ( )FaxOther( )Contact telephone if in Australia17 Your current residential address (Not a post office box address)

4 POSTAL CODEC ountry of residenceAbout your SPOUSEFor 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. 18 Family nameGiven namesSexMaleFemaleOther names known by/used before (such as an alias, underline family name used)Write your spouse s 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 father s father)Is your spouse a dual citizen, or has she/he held any other citizenship?Provide detail including date of citizenshipNoYesDAYMONTHYEARC itizenshipDate grantedPlace and country of birthWhat is your spouse s current citizenship?Date of birth (DAY/MONTH/YEAR)Country where living now (If not living, write DECEASED )80 (Design date 03/09) - Page 3 COMMONWEALTH OF AUSTRALIA, 2009 About your FATHER19 Family nameGiven namesOther names known by/used before (such as an alias, underline family name used)Write your father s name in his own language or script.

5 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 father s father)DAYMONTHYEARC itizenshipDate grantedPlace and country of birthDate of birth (DAY/MONTH/YEAR)Country where living now (If not living, write DECEASED )About your MOTHER20 Family nameGiven namesOther names known by/used before (such as an alias, underline family name used)Write your mother s 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 father s father)DAYMONTHYEARC itizenshipDate grantedPlace and country of birthDate of birth (DAY/MONTH/YEAR)Country where living now (If not living, write DECEASED )Continued on the next pageCitizenship or nationality (Give details of all held)Citizenship or nationality (Give details of all held)80 (Design date 03/09) - Page 4 COMMONWEALTH OF AUSTRALIA, 2009 About your BROTHERS and/or SISTERS21 Family nameGiven namesOther names known by/used before (such as an alias, underline family name used)Write their name in their own language or script.

6 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 father s father)DAYMONTHYEARC itizenshipDate grantedPlace and country of birthDate of birth (DAY/MONTH/YEAR)Country where living now (If not living, write DECEASED )SexMaleFemaleCitizenship or nationality (Give details of all held)Family nameGiven namesOther 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 father s father)DAYMONTHYEARC itizenshipDate grantedPlace and country of birthDate of birth (DAY/MONTH/YEAR)Country where living now (If not living, write DECEASED )SexMaleFemaleCitizenship or nationality (Give details of all held)Family nameGiven namesOther names known by/used before (such as an alias, underline family name used)Write their name in their own language or script.

7 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 father s father)DAYMONTHYEARC itizenshipDate grantedPlace and country of birthDate of birth (DAY/MONTH/YEAR)Country where living now (If not living, write DECEASED )SexMaleFemaleCitizenship or nationality (Give details of all held)Family nameGiven namesOther 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 father s father)DAYMONTHYEARC itizenshipDate grantedPlace and country of birthDate of birth (DAY/MONTH/YEAR)Country where living now (If not living, write DECEASED )SexMaleFemaleCitizenship or nationality (Give details of all held)If you have more than four brothers and/or sisters, please provide details on a separate sheet of paper80 (Design date 03/09) - Page 5 COMMONWEALTH OF AUSTRALIA, 200922 MONTHYEARC ountryFromMONTHYEARToAddress (number, street name, suburb, state/province, country)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).

8 You must account for every year. (If insufficient space, give details on an attachment)What is your present occupation2324 MONTHYEARName and address of employerFromMONTHYEARToGive 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)CountryType of businessYour occupation/position25 MONTHYEARName and address of institution (include country)FromMONTHYEARToGive details of your education history for the entire period since leaving (high) schoolCourse studiedCourse completed or withdrawnDAYMONTHYEARFromToDAYMONTHYEAR2 6 Name used on entryGive details of all your previous visits to Australia (If none, write N/A . If insufficient space, give details on an attachment)Place where visa was issuedType of entry (visitor, student, temporary resident)Purpose of visitDAYMONTHYEARFromToDAYMONTHYEAR27 Country or countriesGive details of all visits (including short stays) to countries outside Australia for the last 10 years (If insufficient space, give details on an attachment) Reason for visit80 (Design date 03/09) - Page 6 COMMONWEALTH OF AUSTRALIA, 200928 Your current travel document details (eg.)

9 Passport, travel authority, documentary visa)Type or travel documentNumberPlace of issueDate of issue (DAY/MONTH/YEAR)Date of expiry (DAY/MONTH/YEAR)Name on passportGiven namesFamily name29 Details of contacts in AustraliaGiven namesFamily nameSexMaleFemaleDate of birth (DAY/MONTH/YEAR)Relationship to applicant (eg. family friend, mother)( )AREA CODENUMBERT elephone numberGiven namesFamily nameSexMaleFemaleDate of birth (DAY/MONTH/YEAR)Relationship to applicant (eg. family friend, mother)( )AREA CODENUMBERT elephone numberGiven namesFamily nameSexMaleFemaleDate of birth (DAY/MONTH/YEAR)Relationship to applicant (eg. family friend, mother)( )AREA CODENUMBERT elephone numberWhere are you currently located?Go to Question 32 Outside AustraliaIn Australia30Go to Question 3131 Details of intended visit to AustraliaDate of arrival or proposed arrival (DAY/MONTH/YEAR)Place of proposed arrivalPeriod of time permitted to remain in Australia as authorised on arrivalPurpose of journeyAdditional periods of stay authorised after arrival (if applicable)Proposed address in Australia (number, street name, suburb, state)Go to Question 3332 Visa details (of initial arrival)V<Visa numberType of visaPlace of issue of visaDate of issue of visa (DAY/MONTH/YEAR)Place of arrivalSpecial conditions (if applicable)Date of arrival (DAY/MONTH/YEAR)NoYesNoYesNoYesNoYes33 Please answer the following questions about yourself and any other person included in this application(a)

10 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?