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.

2 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.

3 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: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.

4 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?

5 8 How was your citizenship acquired?(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( )

6 ( )( ) ( )COUNTRY CODEAREA CODENUMBERWorkHomeMobile( ) ( )( ) ( )FaxOther( )Contact telephone if in Australia17 Your current residential address (Not a post office box address)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.

7 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?

8 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. Please also write Chinese names in Chinese commercial code numbers.

9 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.

10 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)