Form

ETA Request for further processing –

Supplementary information 1554
Department of Home Affairs

Important information about privacy

The Privacy Act 1988 contains 13 Australian Privacy Principles which
regulate the way that the Department collects and handles personal
information. Information about how the Department collects, uses and
discloses personal information for its key functions can be found in form
1442i Privacy notice. More information about the Department’s general
information handling practices (including form 1442i) can be found in
the Department’s Privacy policy at
https://www.homeaffairs.gov.au/access-and-accountability/
our-commitments/privacy

Please open this form using Adobe Acrobat Reader.

Either type (in English) in the fields provided or print this form
and complete it (in English) using a pen and BLOCK LETTERS.
Tick where applicable 3

1 Transaction Reference Number (TRN) for the online request for further
processing

Applicant’s information
2 Family name
SYERIFAIZAL BIN MUSTAPHA
Given names

3 Applicant’s current employment status

Employed ✔ Self-employed Unemployed
Retired Student Other

4 Give details of the applicant’s current employment status including

(if relevant) their occupation, employer and length of employment.
If unemployed or retired, provide the date the applicant ceased work
QAQC MANAGER, GAMUDA ENGINEERING

EMPLOYNMENT STARTS OCTOBER 2016 UNTIL

NOW. GAMUDA ENGINEERING BUSINESS
INVOLVING CONSTRUCTION INDUSTRIES IN
MALAYSIA AND ALSO AUSTRALIA.

5 Main address where the applicant will stay in Australia (if known)

Postcode

© COMMONWEALTH OF AUSTRALIA, 2022 1554 (Design date 05/22) - Page 1

 Applicant’s travel information
6 Is the applicant travelling to Australia with travelling companions?
No
Yes ✔ Give details
Sex * Relationship to
Family name Given names Date of birth
M/F/X applicant
NUR SITI BAIZURA 24/03/1983 F WIFE
NUR SYERI ALEESYA NATASYA 26/02/2010 F DAUGHTER
NUR SYERI AREESA SOFEA 18/12/2014 F DAUGHTER
NUR SYERI AYSAARA UQAYLA 02/02/2018 F DAUGHTER

* M = Male, F = Female, X = Indeterminate / Intersex / Unspecified

7 Does the applicant have family, friends or contacts in Australia?

No
Yes ✔ Give details

Sex * Provide visa status

Relationship to Australian
Family name Given names Date of birth and reason for stay in
applicant residency status
Australia
M/F/X

Citizen WORKING VISA

Perm. resident (GAMUDA)
ALOYSIES ARROKIAM 06/07/1977 M FRIENDS
Other visa ✔
Unknown
Citizen
Perm. resident
Other visa
Unknown
Citizen
Perm. resident
Other visa
Unknown
Citizen
Perm. resident
Other visa
Unknown
Citizen
Perm. resident
Other visa
Unknown
Citizen
Perm. resident
Other visa
Unknown

* M = Male, F = Female, X = Indeterminate / Intersex / Unspecified

1554 (Design date 05/22) - Page 2 © COMMONWEALTH OF AUSTRALIA, 2022