Withdrawal of application

for migration or refugee review

- MR Division

Please read the explanatory notes at the bottom before you complete this form. This form should be
completed by the applicant or by his or her representative.

Case file no: Applicant’s date of birth:

DAY/MONTH/YEAR

Applicant’s name:

Applicant’s
postal address:

Daytime phone: Mobile:

Fax: Email:

I wish to withdraw the application for review for the following applicant/s:

All applicants (if you are the only review applicant, tick this box)

The following named applicants only:

Note - If you wish to withdraw applications made by your family members, you must have their authority to
do so.

I understand that upon receiving this advice, you will consider whether the application for review is validly
withdrawn. I understand that, once you decide that an application for review is withdrawn, you cannot take
any further action in relation to the application for review.

Name of person requesting

withdrawal (please print):

Signature: Date:
DAY/MONTH/YEAR

MR10 (December 2018)

 Explanatory notes:

This form can be used to withdraw an application for review before the Migration and Refugee Division.
An application for review can be withdrawn at any time prior to a decision being made on the review. Upon
receiving this completed form, we will consider whether the application for review is validly withdrawn. Where
we decide that an application for review is withdrawn, we cannot take any further action on the application for
review, the decision under review remains unchanged, and the Department of Home Affairs is notified of the
withdrawal. If you wish to withdraw applications made by your family members, you must have their authority
to do so.

For cases where an application fee has been paid, the application fee cannot be refunded unless:

• the withdrawal has followed the death of a review applicant, or the death of a visa applicant, or
the death of a member of the visa applicant’s family unit; or

• the withdrawal has followed the grant of a visa of the same class (other than on a
reconsideration of the points score); or

• in relation to an application for a parent visa, the visa applicant applied for another parent visa
after the review application was lodged and the visa applicant wishes to have a decision made
on the application for the other parent visa.

If the applicant is entitled to get a refund of all or part of the application fee, a form will be given to the
applicant to provide bank account details for receiving the refund through electronic funds transfer (EFT).

MR10 (December 2018)