Australia Immigration Form 80 – Fill Out and Use This PDF

Personal particulars for assessment

including character assessment

Form

80

Important – Please read this information carefully before you complete this form. Once you have completed this form we strongly advise that you keep a copy for your records.

This form is to be completed in English by applicants who are 16 years of age or over, as requested by the office processing the application.

Please use a pen, and write neatly in English using BLOCK LETTERS.

Tick where applicable 3

If you need more space for any answers, give details at Part T –

Additional information

Integrity of application

The Department of Immigration and Border Protection (the department) is committed to maintaining the integrity of the visa and citizenship programs. Please be aware that if you provide us with fraudulent documents or claims, this may result in processing delays and possibly your application being refused.

Important information about privacy

Your personal information is protected by law, including the Privacy Act 1988. 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 1442i Privacy notice. Form 1442i is available from the department’s website www.border.gov.au/allforms/ or offices of the department. You should ensure that you read and understand form 1442i before completing this form.

Part A – Applicant details

1Please provide your details as they appear in your official documents. For example, passport, identity document, travel document, birth certificate.

Note: If you have one name only, please write it in the ‘Family name’ field.

Family name

All given names

Sex	Male			Female
		Day		Month	Year
Date of birth							Day, month and year
							MUST be provided

Suburb of birth

Town/City of birth

State/Province/Region

Country

2Do you ever use a Chinese Commercial Code Number for your names shown in the passport/travel document at Question 1?

No

Yes			Chinese Commercial Code Number (in full)

3Are you of Russian descent? No

Yes	In English, provide your patronymic name

4Have you been known by any other name(s)? Include:

•	name at birth		•	cultural or tribal name or
• name before or after marriage				clan/subclan name
• adoptive or foster name			•	preferred name
•	alias or pseudonym		• other spellings of names
No
Yes	Give details in English
Type of name
Family name

Given names

If more than one name, give details at Part T – Additional information

5Have you ever had a different date of birth to the one shown at Question 1?

No			Day	Month	Year
Yes		Different date of birth

6Do you currently have citizenship from any country?

No, I am stateless			Give details

Yes			How did you gain this citizenship (eg. birth, descent,
			naturalisation)?
				Day	Month	Year
			Date you gained this citizenship

7Do you hold or have you held citizenship from any other country (including dual citizenships and all previous citizenships)?

No

Yes

Country

How did you gain this citizenship (eg. birth, descent, naturalisation)?

When did you have this citizenship?

	Day	Month	Year		Day	Month	Year
				to
From

Note: If you still have the citizenship, write ‘CURRENT’.

If more than one country, give details at Part T – Additional information

8Do you currently have permanent residency rights in any country other than those declared in Questions 6 or 7?

No

Yes			List all other countries

Part B – Passport / Travel document details

9Do you have a current passport or travel document?

No	Go to Question 13
Yes	Give details

Passport/travel document number

Country of passport/travel document

	Day		Month		Year
Date of issue
Is this the original issue date?
			Give original issue date
No
				Day	Month		Year

Yes

Day Month Year

Date of expiry

Nationality

Place of issue/issuing authority

Name on the document (if the same as Question 1, write ‘SAME AS QUESTION 1’)

Family name

Given names

10Do you have any other current passport or travel document? No

Yes

Give details

Passport/travel document number

Country of passport/travel document

Day Month Year

Date of issue

Date of expiry

Nationality

Place of issue/issuing authority

Name on the document (if the same as Question 1, write ‘SAME AS QUESTION 1’)

Family name

Given names

11Have you ever had any previous passports or travel documents (including expired, lost or stolen documents)?

No	Go to Part C

Yes

12What happened to this document (Tick one only)

Expired

Lost/stolen

Other		Give details

13Do you have, or remember, any of the document details? No

Yes	Give as much information as possible

Passport/travel document number

Country of passport/travel document

Day Month Year

Date of issue

Date of expiry

Nationality

Place of issue/issuing authority

Name on the document (if the same as Question 1, write ‘SAME AS QUESTION 1’)

Family name

Given names

Part C – Identity documents

14Do you currently have, or have you ever had, any national identity documents or numbers (including birth registration numbers, social security cards etc)?

No

Yes		Give details
Type of identification			Country of issue	Identification number
	document			shown (if applicable)

Home

(	) (	)

Date from		Date to
Month	Year	Month	Year

Full address (house number, street name, suburb, town/city, postcode)

Country

	Date from			Date to
Day	Month	Year	Day	Month	Year

Reason for visit

Country

Part H – Proposed travel or further stay details

21Are you currently in Australia? No

Yes	Go to Question 25

Proposed travel

22Why are you travelling to Australia? Include any relevant dates or events

23Do you have any proposed or booked travel dates for your journey to Australia?

No

Yes

Day Month Year

Arrival date

Flight number or vessel details (if known)

City of arrival

Give details of countries you will visit on your way to Australia

(write ‘N/A’ if not applicable)

List the towns/cities you will visit during your time in Australia

24Are you applying for a temporary visa?

No

Yes

Month Year

Departure date

Flight number or vessel details (if known)

City of departure

Give details of countries you will visit after your departure from Australia (write ‘N/A’ if not applicable)

Now go to Part I

Further stay

25What is your main reason for remaining in Australia?

26List the towns/cities you will visit during your further stay in Australia

27Give details of your arrival in Australia

Day Month Year

Arrival date

City of arrival

28Are you applying for a temporary visa?

No	Go to Part I
Yes

29Do you have any proposed or booked travel for your departure from Australia?

No

Yes

Month Year

Departure date

Flight number or vessel details (if known)

City of departure

Give details of countries you will visit after your departure from Australia (write ‘N/A’ if not applicable)

Part I – Address(es) in Australia

30Are you currently in Australia?

No

Yes	Go to Question 33

Located outside Australia

31Do you know any details of the places you will stay during your time in Australia (eg. hotel, friends, relatives)?

No		Go to Part J
Yes		Give the residential address and contact numbers
		Note: A post office box is not acceptable.

Address (including hotel name and/or unit and building number and street name)

Suburb and town/city

State or territory					Postcode
Telephone numbers
Office hours		(Area code			)
Mobile/cell

32Will you stay at any other address?

No		Go to Part J
Yes		Give the residential address and contact numbers

Address (including hotel name and/or unit and building number and street name)

Suburb and town/city

State or territory					Postcode
Telephone numbers
Office hours		(Area code			)
Mobile/cell

If you will stay at any other address(es), give details at Part T – Additional information.

Now go to Part J

Located in Australia

33Do you have any other addresses in Australia that have not been declared at Question 17?

No		Go to Part J
Yes		Give the residential address and contact numbers

Address (including hotel name and/or unit and building number and street name)

Suburb and town/city

State or territory					Postcode
Telephone numbers
Office hours		(Area code			)
Mobile/cell

When and in what circumstances did you reside, or stay, at this address?

If you have more than one other address in Australia that has not been declared above or at Question 17, give details at Part T – Additional information.

Type of visa you hold (eg. visitor, business)

Reason for journey

Name used on entry

Place of visa issue

Arrival date

Day Month Year

Type of visa you held (eg. visitor, business)

Reason for journey

Name used on entry

Place of visa issue

	Arrival date			Departure date
Day	Month	Year	Day	Month	Year

Part K – Character

36Have you, or any other person included in this application, ever:

•been charged with any offence that is currently awaiting legal action?

•been convicted of an offence in any country (including any conviction which is now removed from official records)?

•been the subject of an arrest warrant or Interpol notice?

•been found guilty of a sexually based offence involving a child (including where no conviction was recorded)?

•been named on a sex offender register?

•been acquitted of any offence on the grounds of unsoundness of mind or insanity?

•been found by a court not fit to plead?

•been directly or indirectly involved in, or associated with, activities which would represent a risk to national security in Australia or any other country?

•been charged with, or indicted for: genocide, war crimes, crimes against humanity, torture, slavery, or any other crime that is otherwise of a serious international concern?

•been associated with a person, group or organisation that has been/is involved in criminal conduct?

•been associated with an organisation engaged in violence or engaged in acts of violence (including war, insurgency, freedom fighting, terrorism, protest) either overseas or in Australia?

No

No

No

No No

No No

No

No

No

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

• served in a military force, police force, state
sponsored/private militia or intelligence
agency (including secret police)?	No		Yes
• undergone any military/paramilitary training,
been trained in weapons/explosives or in the
manufacture of chemical/biological products?	No		Yes
• been involved in people smuggling or people
trafficking offences?	No		Yes
• been removed, deported or excluded from any
country (including Australia)?	No		Yes
• overstayed a visa in any country (including
Australia)?	No		Yes

•had any outstanding debts to the Australian Government or any public authority in

Australia?

No

Yes

If you answered ‘Yes’ to any of the questions at Question 36, you must state who it applies to and give ALL relevant details. If the matter relates to a criminal conviction, please give the nature of the offence, full details of sentence and dates of any period of imprisonment or other detention.

Part M – Employed by intelligence or security agency

38Are you currently, or have you been employed as an intelligence officer or an agent of an intelligence or security agency?

No

Yes			Give details of organisation, role and dates you served

Part O – Deportations

40Have you ever been excluded, asked to leave, deported or removed from any country?

No

Yes			Give details of dates, countries and circumstances

Part N – Visa refusals

39Have you ever been refused a visa to any country? No

Yes			Give dates of refusal, countries and circumstances of
			refusal

Part P – Citizenship refusals

41Have you ever been refused, renounced or rescinded citizenship of any country?

No

Yes			Give dates of refusal, countries and circumstances of
			refusal

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes

(If not applicable, write ‘N/A’)

No

Yes

Child 1

Give details

(If not living, write ‘DECEASED’ in ‘Country of current residence’ column)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes

(If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes

(If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

No

Yes

Give details

(If not living, write ‘DECEASED’ in ‘Country of current residence’ column)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes

(If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes

(If not applicable, write ‘N/A’)

No

Yes

Give details

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Place of birth

Town/City	State/Province/Region	Country

Citizenship(s) and year granted

Country of current residence

Relationship to you

Family name

Given names

(include patronymic name)

Any other names

(eg. maiden or tribal name)

Sex		Date of birth
M/F	Day	Month	Year

Chinese commercial codes (If not applicable, write ‘N/A’)

Place of birth

Town/City	State/Province/Region	Country

Citizenship(s) and year granted

Country of current residence

47Do you have any personal contacts in Australia?

Personal contacts include visa sponsors, any relatives, friends, family members and acquaintances in Australia.

No	Go to Part R
Yes	Provide as much information about one of your personal
	contacts as possible

Family name

Given names

Sex

Male

Female

Relationship to you (eg. partner, sister, aunt, friend)

Day Month Year

Date of birth

Town/City of birth

State/Province/Region

Country

Nationality

Your personal contact’s current residential address

Note: A post office box is not acceptable.

Address (including building/unit/house number and street name)

Suburb and town/city

State or territory				Postcode
Telephone numbers
Office hours	(Area code			)
Mobile/cell
Email address

48Do you have any other personal contacts in Australia?

No	Go to Part R
Yes	Give details

Family name

Given names

Sex

Male

Female

Relationship to you (eg. partner, sister, aunt, friend)

Day Month Year

Date of birth

Town/City of birth

State/Province/Region

Country

Nationality

Your personal contact’s current residential address

Note: A post office box is not acceptable.

Address (including building/unit/house number and street name)

Suburb and town/city

State or territory				Postcode
Telephone numbers
Office hours	(Area code			)
Mobile/cell
Email address

Give details of all other contacts at Part T – Additional information

State or territory

Postcode

State or territory

Postcode

54

Question

number

Additional information