80 - Form Personal particulars for assessment including...

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80 (Design date 11/12) - Page 1 © COMMONWEALTH OF AUSTRALIA, 2012 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 for visas for Australia who are 16 years of age or over, as requested by the office processing the application. Integrity of application The Department of Immigration and Citizenship (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. About the information you give The Department of Immigration and Citizenship (the department) has authority under the Migration Act 1958 and the Australian Citizenship Act 2007 and other legislation it administers, to collect personal information to carry out its functions, including administration of applications for visas for entry and/or stay in Australia or for citizenship. The information provided will be used for assessing your eligibility for a visa to travel to, 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 agents. The information form 993i Safeguarding your personal information , available from offices of the department, gives details of agencies to which your information might be disclosed. student refugee/ humanitarian entrant visitor migrant temporary resident OR I am applying in Australia for: I am applying for a visa to travel to Australia as a: a further temporary stay or visit protection permanent residence Sex Male Female Family name Nationality Passport/travel document number All given names DAY MONTH YEAR Date of birth Tick where applicable Please use a pen, and write neatly in English using BLOCK LETTERS. Place of birth Town/City 1 Write your name and birth details as shown on your current passport, birth certificate, family book or travel document Passport Other Type of document Part A – Your details Note : If your passport/travel document only shows one name, write that name in the Family name box.
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