New editable form 80

Form
Personal particulars for assessment
including character assessment 80

Important – Please read this information carefully before you Please use a pen, and write neatly in English using BLOCK LETTERS.
complete this form. Once you have completed this form we ✓
strongly advise that you keep a copy for your records. Tick where applicable

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 I am applying for a visa to travel to Australia as a: migrant
office processing the application. temporary resident
visitor
Integrity of application
student
The Department of Immigration and Citizenship (the
department) is committed to maintaining the integrity of the refugee/ humanitarian entrant
visa and citizenship programs. Please be aware that if you OR
provide us with fraudulent documents or claims, this may
I am applying in Australia for: a further temporary stay or visit
result in processing delays and possibly your application being
refused. permanent residence
protection
About the information you give
The department is authorised to collect information provided
on this form under Part 2 of the Migration Act 1958 ‘Control of
Part A – Your details
Arrival and Presence of Non-Citizens’. The information provided
will be used for assessing your eligibility for a visa to travel to, 1 Give details as they appear on your current passport or the travel
enter and remain in Australia and for other purposes relating to document that you will use to enter Australia
the administration of the Migration Act, for example, to assist Passport
migrants with settling in Australia or for ensuring compliance
with the Migration Act. Other Type of document
The information provided might also be disclosed to agencies
who are authorised to receive information relating to adoption,
Note: If your passport/travel document only shows one name,
border control, business skills, citizenship, education, health
assessment, health insurance, health services, law enforcement, write that name in the Family name box.
payment of pensions and benefits, taxation, superannuation,
Family name
review of decisions and registration of migration agents.
The information form 993i Safeguarding your personal All given
information, available from offices of the department, gives names
details of agencies to which your information might be
disclosed.

Sex Male Female
DAY MONTH YEAR

Date of birth

Place of birth
Town/city
Country

Passport/travel document number

Country of passport/travel document

DAY MONTH YEAR

Date of issue

Date of expiry

Nationality
Place of issue/issuing authority

© COMMONWEALTH OF AUSTRALIA, 2012 80 (Design date 04/12) - Page 1

2 Does the passport/travel document at Question 1 show your 7 Have you ever been known by other names or spellings of your name?
full name? Examples of the types of other names:
No What is your full name? • name at birth • cultural or tribal name or
Family name • name before or after marriage clan/subclan name
• adoptive or foster name • preferred name
• alias or pseudonym • patronymic name
Given names (including patronymic name in English)
• other spellings of names
No
Yes Give details in English
Yes
1. Type of name

3 Are you currently in Australia? Family name

No Go to Question 5
Yes Given names

4 Did you use the passport/travel document at Question 1
to enter Australia?
No Write the number of the document you used to 2. Type of name
enter Australia Family name

Given names
Yes

5 Do you ever use a Chinese Commercial Code Number for your names
shown in the passport/travel document at Question 1 If more than 2, give details at Part J
No
8 Have you ever had an alternative date of birth?
Yes Chinese Commercial Code Number
No DAY MONTH YEAR

Yes Alternative date of birth

6 Are you of Arabic descent?
9 Are you a citizen of the country of passport/travel document at
No Question 1?
Yes In English, write the full name of your father’s father No
(ie. your paternal grandfather)
Yes How did you gain this citizenship (eg. birth, descent,
naturalisation)?

DAY MONTH YEAR

Date you gained this citizenship

80 (Design date 04/12) - Page 2 © COMMONWEALTH OF AUSTRALIA, 2012

10 Do you currently have, or have you ever had, other passports/travel 11 Are you currently, or have you ever been, a citizen of any other
documents? country not already shown at Question 1 or Question 10?
No No
Yes Give details as they appear on the other passports/travel Yes Give details
documents (If more than one, give details at Part J)
1. Country
Note: If the passport/travel document only shows one name, write
that name in the Family name box. How did you gain this citizenship (eg. birth, descent,
naturalisation)?
Family name

All given When did you have this citizenship?
DAY MONTH YEAR
names
From
To (If you still have the citizenship,
Passport/travel document number write ‘Current’)

2. Country
Country of passport/travel document
How did you gain this citizenship (eg. birth, descent,
naturalisation)?
DAY MONTH YEAR

Date of issue
When did you have this citizenship?
DAY MONTH YEAR
Date of expiry
From
Nationality To (If you still have the citizenship,
Place of issue/issuing authority write ‘Current’)
If more than 2, give details at Part J

12 Do you currently have permanent residence rights in any country
Are you, or have you ever been, a citizen of the country of passport/ not already shown at Question 1, Question 10 or Question 11?
travel document shown above?
No
No
Yes Give details
Yes How did you gain this citizenship (eg. birth, descent,
naturalisation)? 1. Country

2. Country
When did you have this citizenship?
DAY MONTH YEAR 13 Have you ever been refused citizenship of any country?
From No
To (If you still have the Yes Give details
citizenship, write ‘Current’)
1. Country
Reason for refusal

DAY MONTH YEAR

Date

2. Country
Reason for refusal

DAY MONTH YEAR

Date



14 Do 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 document Country of issue Identification number shown Name shown on document
(if applicable)

Attach certified copies of original documents and English translations

15 Details of your place of birth 18 Your current contact numbers (include country code if outside Australia)
Country COUNTRY CODE AREA CODE NUMBER

State/ Work ( ) ( )

Province/
Region Home ( ) ( )

Town/city Mobile/cell
Suburb (if Fax ( ) ( )
applicable)
Other contact numbers you have
16 Your current residential address (this is the place where you ( ) ( )
currently live)
Note: A post office box or mailbox address is not acceptable as a ( ) ( )
residential address.
Unit/Apartment number 19 Address in Australia where you can be contacted or will be staying
Address Note: A post office box or mailbox address is not acceptable.

Suburb/Town/City POSTCODE

State/Province/Region 20 Contact telephone numbers in Australia (if known)
AREA CODE NUMBER

Work ( )
Country
Home ( )

Postal code Mobile/cell
Other contact numbers
Attach certified copies of original documents and English
( )
translations that give evidence of your address
( )
17 Do you have an e-mail address?
Note: Do not provide the email address of a migration agent.
No
Yes E-mail address


21 Do you have personal contacts in Australia (including business Part B – Your partner’s details
contacts/sponsor)? Note: If you are widowed, you must give details for your deceased
partner.
No
Yes Give details 23 Your partner’s full name
1. Family name Family name
Given names All given
names

Sex Male Female
DAY MONTH YEAR

Date of birth 24 Sex Male Female
Relationship to you (eg. partner, sister, aunt, friend,
DAY MONTH YEAR
business contact/sponsor)
25 Date of birth
Date of death
AREA CODE NUMBER (if deceased)
Telephone
number ( )
26 Your partner’s place of birth
2. Family name Country
State/
Given names Province/
Region
Town/city
Sex Male Female
Suburb (if
DAY MONTH YEAR
applicable)
Date of birth

Relationship to you (eg. partner, sister, aunt, friend, 27 Is your partner currently, or have they ever been, a citizen of any
business contact/sponsor) country?
No
Yes Give details
AREA CODE NUMBER
Telephone
number ( ) 1. Country
When did your partner have this citizenship?
If more than 2, give details at Part J DAY MONTH YEAR

From
22 Relationship status
DAY MONTH YEAR To (If they still have the citizenship,
Married Date of marriage write ‘Current’)

Engaged Date of intended marriage 2. Country
De facto Date relationship began When did your partner have this citizenship?
DAY MONTH YEAR
Separated
From
Divorced
To (If they still have the citizenship,
Widowed write ‘Current’)
Never married or Go to Part C If more than 2, give details at Part J
been in a de facto
relationship
28 Does your partner ever use a Chinese Commercial Code Number for
names shown at Question 23
No


29 Is your partner of Arabic descent?
No
Yes In English, write the full name of your partner’s
father’s father (ie. paternal grandfather)

30 Is your partner currently, or have they ever been, known by other
names or spellings of their name?
Examples of the types of other names:
• name at birth • cultural or tribal name or
• name before or after marriage clan/subclan name
• adoptive or foster name • preferred name
No

1. Type of name
Family name

Given names

2. Type of name
Family name

Given names


31 Does your partner currently have, or have they ever had, any national identity documents
or numbers (including birth registration numbers, social security cards etc)?
No
Yes Give details

Type of identification document Country of issue Identification number shown Name shown on document
(if applicable)

Attach certified copies of original documents and English translations


Part C – Travel to Australia
32 Are you travelling, or did you travel to Australia with any other 33 Are you currently in Australia?
person(s)? No
No Yes Go to Part D
Yes Give details
34 Proposed arrival details
1. Family name DAY MONTH YEAR

Arrival date
Given names Flight number or vessel details (if known)

Place of arrival
DAY MONTH YEAR City
Date of birth
State
Citizenship

35 Are you applying for a temporary visa?
Relationship to you (eg. partner, sister, friend, business contact) No
Yes Proposed final departure details
DAY MONTH YEAR
2. Family name Departure date
Flight number or vessel details (if known)
Given names

Place of departure
City
DAY MONTH YEAR

Date of birth State

Citizenship
36 What is the main reason for going to Australia?
Include details of any dates that are of special significance to
Relationship to you (eg. partner, sister, friend, business contact) your time in Australia


Go to Part E


Part D – Current visa details
NOTE: Only complete this Part if you are currently in Australia

37 Do you currently hold an Australian visa?
No Go to Part E
Yes

38 Visa details
Type of visa

Visa number
V <
DAY MONTH YEAR

Date of issue
Visa conditions (if applicable)

39 Country where you lived when you were issued this visa

40 Details of your arrival in Australia
DAY MONTH YEAR

Arrival date
Place of arrival
City

State

41 Final date you must leave Australia DAY MONTH YEAR

on this visa

42 Have you been given an additional period of stay in Australia
with this visa?
No
Yes Give details


Part E – Other information
43 Have you travelled to Australia before?
No Yes Give details in chronological order (If insufficient space, give details at Part J)

Date from Date to Type of visa Country where you lived when
(eg. visitor, student, business) visa was issued Your names shown on visa Reason for visit
DAY MONTH YEAR DAY MONTH YEAR

44 Have you travelled to any countries other than Australia (including short stays) during the last 10 years?

Date from Date to
Country or countries Reason for visit

45 List, in chronological order, the addresses of the places where you have lived during the last 10 years (including Australia). You must account for every year.
If you are unable to provide an address for any period of time please provide an explanation. (If insufficient space, give details at Part J)

Date from Date to
Country Full address (number, street name, suburb, state/province, country)
MONTH YEAR MONTH YEAR


46 Give details of your employment history for the entire time since leaving school, including periods of unemployment. (If insufficient space, give details at Part J)

Date from Date to Name and address of employer/business Employer’s contact number Type of business Your position/title/duties

47 Are you currently unemployed?
No Yes Give details of how you financially support yourself,
including how long you have received this support
for and how much you receive on a monthly basis

48 Have you had any military service?

Date from Date to Country Full name of Unit/Battalian/Brigade Rank Duties


49 Have you undertaken any qualifications since secondary school (including courses completed, withdrawn or continuing)? (If insufficient space, give details at Part J)

Date from Date to Did you complete the course,
Country Name and address of institution Course of study withdraw or currently enrolled?

Completed course
Withdrew
Currently enrolled

Completed course
Withdrew
Currently enrolled

Completed course
Withdrew
Currently enrolled

Completed course
Withdrew
Currently enrolled

Completed course
Withdrew
Currently enrolled

50 Have you undertaken an academic thesis, dissertation or publication (including completed, withdrawn or continuing theses, dissertations or publications)?
No
Yes Give details

Full name of your supervisor Family name

Given names


Part F – About your parents
Note: You must give details for any person (living or deceased) who h. Does this parent ever use a Chinese Commercial Code Number,
is or was your parent or with whom you have had a parent-like National Identity Number and/or Birth Registry Number?
relationship. This should include, but is not limited to, natural parents,
No
adoptive parents, surrogate parents, step-parents, foster parents, and/
or guardians. Yes Give details
Provide details of one parent at Question 51 and the other parent at 1. Number
Question 52. If more than 2, give details at Part J. Type of number (eg. birth registry number)

51 Parent
a. Relationship to you (eg. natural parent, step-parent etc)
2. Number
Type of number (eg. birth registry number)
b. Your parent’s full name
Family name
i. Is this parent of Arabic descent?

All given names including, if applicable, patronymic name No
(in English), clan and sub-clan names, and middle names Yes In English, write the full name of your parent’s

c. Sex Male Female
DAY MONTH YEAR

d. Date of birth j. Is this parent currently, or have they ever been, known by other names
or spellings of their name?
e. Date of death (if deceased)
f. Parent’s place of birth • name at birth • cultural or tribal name or
Country • name before or after marriage clan/subclan name
State/ • adoptive or foster name • preferred name
Province/ • alias or pseudonym • patronymic name
Region • other spellings of names
Town/city No
Suburb (if Yes Give details in English
applicable)
1. Type of name
g. Is this parent currently, or have they ever been, a citizen of any
country? Family name

No
Yes Give details Given names

1. Country
When did this parent have this citizenship?
DAY MONTH YEAR

From 2. Type of name
To (If they still have the citizenship, Family name
write ‘Current’)

2. Country Given names

DAY MONTH YEAR

From
k. Country where this parent lives now
To (If they still have the citizenship, If in Australia, write the full address, if not living, write ‘DECEASED’


52 Parent
a. Relationship to you (eg. natural parent, step-parent etc)
h. Does this parent ever use a Chinese Commercial Code Number,
National Identity Number and/or Birth Registry Number?
b. Your parent’s full name
No
Family name
Yes Give details

All given names including, if applicable, patronymic name 1. Number
(in English), clan and sub-clan names, and middle names Type of number (eg. birth registry number)

2. Number

c. Sex Male Female Type of number (eg. birth registry number)
DAY MONTH YEAR

d. Date of birth i. Is this parent of Arabic descent?
e. Date of death (if deceased) No

f. Parent’s place of birth Yes In English, write the full name of your parent’s
Country
State/
Province/
Region
Town/city
Suburb (if
applicable) j. Is this parent currently, or have they ever been, known by other names
g. Is this parent currently, or have they ever been, a citizen of any
country?
No clan/subclan name
• name before or after marriage
Yes Give details • adoptive or foster name • preferred name
1. Country
DAY MONTH YEAR No
From Yes Give details in English
To (If they still have the citizenship, 1. Type of name
Family name
2. Country
When did this parent have this citizenship? Given names
DAY MONTH YEAR

From
2. Type of name
Family name

Given names

k. Country where this parent lives now
If in Australia, write the full address, if not living, write ‘DECEASED’


Part G – About your brothers and sisters
Note: You must give details for any person (living or deceased) who
is or was your brother or sister. This should include, but is not limited
to, natural brothers and sisters, adoptive brothers and sisters, step-
brothers and sisters.
Provide details of one brother or sister at Question 53 and the others at
Questions 54 – 56. If more than 4, give details at Part J.

53 Brother or sister i. Is this person of Arabic descent?
a. Relationship to you (eg. brother, sister, step-brother, step-sister) No
Yes In English, write the full name of this person’s father’s
father (ie. paternal grandfather)
b. Family name

All given names including, if applicable, patronymic name
(in English), clan and sub-clan names, and middle names

j. Is this person currently, or have they ever been, known by other names
c. Sex Male Female
DAY MONTH YEAR
d. Date of birth • preferred name
• adoptive or foster name
e. Date of death (if deceased) • alias or pseudonym • patronymic name
f. Place of birth
No
Country
State/
Province/ 1. Type of name
Region
Family name
Town/city
Suburb (if
applicable) Given names

g. Is this person currently, or have they ever been, a citizen of any
country?
No
Yes Give details 2. Type of name
Family name
1. Country
When did this person have this citizenship?
DAY MONTH YEAR
Given names
From
k. Country where this person lives now
2. Country
DAY MONTH YEAR

From

h. Does this person ever use a Chinese Commercial Code Number?
No


54 Brother or sister
a. Relationship to you (eg. brother, sister, step-brother, step-sister) i. Is this person of Arabic descent?
No

b. Family name Yes In English, write the full name of this person’s father’s


c. Sex Male Female
DAY MONTH YEAR
d. Date of birth
e. Date of death (if deceased) • adoptive or foster name • preferred name
f. Place of birth
Country
No
State/
Province/ Yes Give details in English
Region
1. Type of name
Town/city
Family name
Suburb (if
applicable)
Given names
country?
No
Yes Give details
2. Type of name
1. Country
Family name
DAY MONTH YEAR

From Given names

2. Country k. Country where this person lives now
DAY MONTH YEAR

From

No


No



c. Sex Male Female
DAY MONTH YEAR
d. Date of birth
f. Place of birth
Country
No
State/
Region
1. Type of name
Town/city
Family name
Suburb (if
applicable)
Given names
country?
No
Yes Give details
2. Type of name
1. Country
Family name
DAY MONTH YEAR

From Given names

DAY MONTH YEAR

From

No


Part H – Character details 58 Are you currently, or have you been employed as an intelligence
officer or an agent of an intelligence or security agency?
57 Have you, or any other person included in this
application, ever: No
• been convicted of a crime or offence in any Yes Give details of organisation, role and dates you served
country (including any conviction which is
now removed from official records)? No Yes
• been charged with any offence that is
currently awaiting legal action? No Yes
• been acquitted of any criminal offence or
other offence on the grounds of mental
illness, insanity or unsoundness of mind? No Yes
• been removed or deported from any country 59 Have you ever been denied or refused a visa or entry to another
(including Australia)? No Yes country?
• left any country to avoid being removed or No
deported (including Australia)? No Yes
Yes Give details
• been refused a visa for Australia or any
other country? No Yes
• been excluded from or asked to leave any
country (including Australia)? No Yes
• committed, or been involved in the
commission of war crimes or crimes against
humanity or human rights? No Yes
• been involved in any activities that would
represent a risk to Australian national Part I – Declaration
security? No Yes
• had any outstanding debts to the Australian WARNING: Giving false or misleading information is a serious offence.
Government or any public authority in 60 I declare that:
Australia? No Yes • the information I have supplied in or with this form is complete,
• been involved in any activity, or been correct and up-to-date in every detail.
convicted of any offence, relating to the • I have read and understand the information supplied to me.
illegal movement of people to any country
(including Australia)? No Yes Signature of
• been associated with or involved in a applicant
program related to the development of
DAY MONTH YEAR
weapons of mass destruction? No Yes
Date
• been associated with or received training
from an organisation engaged in violence, or
been involved in an act of violence (including We strongly advise that you keep a copy of your application
war, insurgency, freedom fighting, terrorism, and all attachments for your records.
protest) overseas or in Australia? No Yes
• Are you, or any other person included in
this application, presently under a probation
order, good behaviour bond, on parole,
released on licence or subject to a periodic
detention overseas or in Australia? No Yes

If you answered ‘Yes’ to any of the above questions, 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.
If insufficient space, give details at Part J


Part J – Additional details
61 Question number Additional information

(If insufficient space, attach additional details)


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