 Part 1 :

 Main Applicant & Spouse :

Name Relationshi Marriage Country City of Military New Old DOB
p Status & City of Birth Passport Passport
Living Number Number Persian Gregorian
Calendar Calendar
Main
Applicant

Spose

Question 1: Have you or your family ever had mental problem, HIV, any disability?

Question 2: Have you or your family ever been involved in any criminal offence?

Question 3: Have you or your family ever been involved in any crime and waiting for a court decision?

Question 4: Have you or your family ever had any mental illness and released a court because of that?

Question 5: Have you or your family ever been deported from any country including Australia?

Question 6: Have you or your family ever left any country not to be deported?

Question 7: Have you or your family ever deported from any country but changed the decision?

Question 8: Have you or your family ever involved in war activities?

Question 9: Have you or your family ever involved in any activities which is dangerous for Australia?

Question 10: Have you or your family ever had any debts to Australia?

Question 11: Have you or your family ever helped people to migrate illegally?

Question 12: Have you or your family ever served in the military service?

Question 13: Have you or your family ever served in the army or work with the weapons?

Question 14: Have you been ever employed to the Intelligence or Security agencies?

Question 15: Do you ever use a Chinese Commercial Code Number for your names shown in the passport/travel
document?

Question 16 :Are you of Russian descent?

Question 17:Have you been known by any other name(s)?

Question 18:Have you ever had a different date of birth?

Question 19:Have you ever been excluded, asked to leave, deported or removed from any country?

Question 20:Have you ever been refused, renounced or rescinded citizenship of any country?

English Question & Answer

1
Question 21:Have you ever been overstayed a visa in any country (including Australia)?

Question 22Have you been charged with/involved with any offence including the offences listed below;

 people smuggling or people trafficking offences

 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
 been associated with a person, group or organisation that has been/is involved in criminal conduct
 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 directly or indirectly involved in, or associated with, activities that would represent a risk to
national security in Australia or any other country
 been found by a court not fit to plead
 been acquitted of any offence on the grounds of unsoundness of mind or insanity
 been named on a sex offender register
 been found guilty of a sexually based offence involving a child (including where no conviction was
recorded)
 been the subject of an arrest warrant or Interpol notice
 been the subject of a domestic or family violence order, or any other order, of a tribunal or court or
other similar authority, for the personal protection of another person

Question 23:

 Living Addresses for last 30 years:

*Provide correct and complete addresses

COMPLETE ADDRESS FROM TO

MM/YYYY MM/YYYY

*If any member of the family has had a different living address for the last 30 years please include below with the name of
the relevant family member on the application:

English Question & Answer

2
  Home phone number:

 Contact details of main applicant:

Mobile:
Email:

 Contact details of second applicant:

Mobile:
Email:

 Details of dependent over 18 years:

Complete name:
Passport number:
Date of Birth:
Mobile:
Email:

 Details of children:
Complete name:
Passport number:
Date of Birth:

 Details of children:
Complete name:
Passport number:
Date of Birth:

 Previous country of residence

Give details of the last permanent address in this country.

Country:

Address:

Suburb / Town:

State or Province:

Postal Code:

Date from:

Date to:

Question 24:
 Family of Main Applicant:
*Specify the date of death (if there is/are any deceased family member)

Name and Relationship Marriage Country City of DOB Date of Death- If Migrating with
Surname Status & City of Birth Applicable the main
Living Applicant
Gregorian Gregorian

English Question & Answer

3
 Calendar Calendar
Father

Mother

Sister

Sister

Sister

Brother

Brother

Brother

 Family of Second Applicant:

*Specify the date of death (if there is/are any deceased family member)

Name and Relationship Marriage Country & City of DOB Date of Death- If Migrating
Surname Status City of Birth Applicable with the
Living main
Applicant
Gregorian Gregorian
Calendar Calendar
Father

Mother

Sister

Sister

Sister

Brother

Brother

Brother

Question 25:

 Work Experience of Main Applicant:

*give the full employment history since Birth. If there is a time of unemployment please specify what you were
doing to support yourself in that time. There should be no gaps also explain during School Holidays what have you
been doing and how you been financially supported.

Name of Type of Phone Name of Position Start Date Finish Date

English Question & Answer

4
 Business in Business Boss (dd/mm/yyyy) (dd/mm/yyyy)
FULL
Gregorian Gregorian
Calendar Calendar

FULL Address
of business

FULL Address
of business

FULL Address
of business

FULL Address
of business

 Work Experience of Second Applicant:

*give the full employment history since Birth. There should be no gap and also explain If there is a time of
unemployment please specify what you were doing to support yourself in that time. There should be no gaps also
explain during School Holidays what have you been doing and how you been financially supported.

Name of Type of Phone Name of Position Start Date Finish Date

Business in Business Boss (dd/mm/yyyy) (dd/mm/yyyy)
FULL
Gregorian Gregorian
Calendar Calendar

English Question & Answer

5
 FULL Address
of business

FULL Address
of business

FULL Address
of business

FULL Address
of business

Question 26:

 Education of Main Applicant:

*provide dates completely and correctly as well as the full school/institutes name

Level of School Name of City Start Date End Date Educational Level Complete Major
School Name of the Subjects
Course Studies
Finish
Primary School

FULL Address
of the school/
university

Finish
Secondary School

English Question & Answer

6
FULL Address of
the school/
university

Diploma

FULL Address of
the school/
university

Degree/University

FULL Address of
the school/
university

Other courses

FULL Address of
the school/
university

 Education of Second Applicant

*provide dates completely and correctly as well as the full school/institutes name

Level of School Name of City Start Date End Date Educational Level Complete Major
School Name of the Subjects
Course Studies
Finish
Primary School

FULL Address
of the school/
university

Finish
Secondary School

FULL Address of
the school/
university

Diploma

FULL Address of
the school/
university

Degree/University

FULL Address of

English Question & Answer

7
 the school/
university

Other courses

FULL Address of
the school/
university

 Education of any applicant over the age of 16 years: Dependent

*provide dates completely and correctly as well as the full school/institutes name

Level of School Name of City Start Date End Date Educational Level Complete Major
School Name of the Subjects
Course Studies
Finish
Primary School

FULL Address
of the school/
university

Finish
Secondary School

FULL Address of
the school/
university

Diploma

FULL Address of
the school/
university

Degree/University

FULL Address of
the school/
university

Other courses

English Question & Answer

8
FULL Address of
the school/
university

 Education of any applicant over the age of 16 years: Dependent

*provide dates completely and correctly as well as the full school/institutes name

Level of School Name of City Start Date End Date Educational Level Complete Major
School Name of the Subjects
Course Studies
Finish
Primary School

FULL Address
of the school/
university

Finish
Secondary School

FULL Address of
the school/
university

Diploma

FULL Address of
the school/
university

Degree/University

FULL Address of
the school/
university

Other courses

FULL Address of
the school/
university

English Question & Answer

9
 Question 27: Do you or your spouse or any other person on this application have any other passport? Please provide the
following details for each Passport.
Passport
Family Name:
Given Name:
Passport number:
Date of Issue:
Date of Expiry:
Place of the Issue and the Issuing Authority:
Passport status (Cancelled/Lost)

Passport
Family Name:
Given Name:
Passport number:
Date of Issue:
Date of Expiry:
Place of the Issue and the Issuing Authority:
Passport status (Cancelled/Lost)

Passport
Family Name:
Given Name:
Passport number:
Date of Issue:
Date of Expiry:
Place of the Issue and the Issuing Authority:
Passport status (Cancelled/Lost)

Passport
Family Name:
Given Name:
Passport number:
Date of Issue:
Date of Expiry:
Place of the Issue and the Issuing Authority:
Passport status (Cancelled/Lost)

Question 28: Have you or your spouse or any other person on this application previously visited Australia? Give the
details of date, type of visa and reason of visit.

Date of Entry to Date of Exit from Australia Type of Visa Reason for Visit Place where the Visa was
Australia issued

English Question & Answer

10
Question 29:
 Please list Every Country visited during last 30 years of Main Applicant:
*Complete dates of entry and exit to every country is needed

Country From (Date) To (Date) Reason of the Trip

 Countries visited during last 30 years of Second Applicant:

*Complete dates of entry and exit to every country is needed

Country From (Date) To (Date) Reason of the Trip

 Countries visited during last 30 years of Person over the age of 16 years:
*Complete dates of entry and exit to every country is needed

Country From (Date) To (Date) Reason of the Trip

English Question & Answer

11
  Countries visited during last 30 years of Person over the age of 16 years:
*Complete dates of entry and exit to every country is needed

Country From (Date) To (Date) Reason of the Trip

Question 30:
 Friend or Family in Australia:

Name Relationship Date of Type of Visa Type of Residency Telephone Occupation Details of the
entry Employer

Address

Address

Question 31: Do you or your spouse or any other person on this application have citizenship or permanent residency of
another country?

Question 32: Have you or your spouse or any other person on this applications application for a visa has been refused?

Question 33: Have you ever worked for any security organization in your country or any other country? Has anyone else
on this application?

Question 34: For dependents over the age 18

The following documents must be provided:
1. The amount paid to the dependents per months for his/ her expense
2. Bank Statement to be provided as evidence regarding dependents life expenses and the money paid to them for
their personal expenses
3. School/ enrolment certificate
4. State Dec from third parties confirming the dependents are fully depending and living with the main applicant
English Question & Answer
12
Question 35: Please answer the following questions for every person that is on the application:

History or Informed of:

1. Have you ever been diagnosed with Tuberculosis? Have you ever had to take treatment for Tuberculosis?
2. Have you ever been in close contact at work or at home with a person known to have Tuberculosis?
3. Have you ever admitted to hospital and/or received medical treatment for an extended period for any reason
(including for major operation or treatment of psychiatric illness)?
4. Do you suffer, or have you ever suffered, from mental health problem?
5. Have you ever been told you have HIV positive?
6. Do you have or ever had, Hepatitis, problem with your liver or yellowing of the skin?
7. Do you have or ever had Cancer in the last 5 years?
8. Do you have high blood sugar / Diabetes?
9. Do you have heart problems, including high blood pressure or a heart condition that you have been born with?
10. Do you have a blood condition?
11. Do you have bladder or kidney problems?
12. Do you have a physical or intellectual disability that makes it difficult for you to function independently (For
example, to move around or learn) or work full- time?
13. Do you need to take drugs or drink alcohol regularly?
14. Are you taking any prescribed pills or medication (excluding oral contraceptives, Over the counter medication
and natural supplements) If yes please list these.

Question 36:Do you ever use a Chinese Commercial Code Number for your names shown in the passport/travel
document? \Are you of Russian descent?

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

Have you ever had a different date of birth?

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

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

Have you ever been overstayed a visa in any country (including Australia)?

English Question & Answer

13
Have you been charged with/involved with any offence including below list

 people smuggling or people trafficking offences

 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
 been associated with a person, group or organisation that has been/is involved in criminal conduct
 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 directly or indirectly involved in, or associated with, activities which would represent a risk to national security in
Australia or any other country
 been found by a court not fit to plead
 been acquitted of any offence on the grounds of unsoundness of mind or insanity
 been named on a sex offender register
 been found guilty of a sexually based offence involving a child (including where no conviction was recorded)
 been the subject of an arrest warrant or Interpol notice
 been the subject of a domestic or family violence order, or any other order, of a tribunal or court or other similar authority, for
the personal protection of another person?
 been charged or convicted of family or domestic violence offences or similar related offences?

 Part 2 :

Question 2.1 What is your religion?

Question 2.2 What is your ethnic group?

Question 2.3 What social/kinship structures do you belong to (eg. tribe, clan, chiefdom, or equivalent)?

English Question & Answer

14
Question 2.4 Give details of any medals/accolades/awards you have received in the table below Name of
medal/accolade/award (If applicable please provide the details including the day, Month, Year /Reason for award (eg. for
participation in a specific operation) Name of person who presented you with the award)

Question 2.5

• Have you ever been a member or supporter of a liberation or militia group? No / Yes
• Are you still a member or supporter of a liberation or militia group? No / Yes
• Have you ever been a government official (eg. mayor, judge, hospital administrator)? No / Yes
• Have you ever held a senior religious or cultural position in your community? Do not include
No / Yes
positions held in Australia.
• Have you ever been associated with or held membership of a political organisation? No / Yes
• Have you ever been discharged from your service in the military, paramilitary, security, detention
No / Yes
centre, prison or transit camp, intelligence, police or secret police service?
• Have you ever undertaken any other military, paramilitary, security, intelligence, police or secret
No / Yes
police service?
• Have you ever been a guard/official at a detention centre, prison or transit camp? No / Yes
•Have you ever undertaken any military service? (Tick the right answer)

o No - Conscription did not exist

o No- Conscription existed but I was exempted
o No-Conscription existed but I did not serve (Please explain how)
o Yes -It was compulsory
o Yes-I joined voluntarily

 Important If you answer ‘Yes’ to the Questions 2.5, give full details of your service history including the commence/ finish dates, full Location(s) where you
were deployed/posted, position, rank, group, Unit name and number – include your Unit, Battalion, Brigade, Division, and Corps, Name of direct supervisor/
Commanding officer and their rank, Name of group/organisation, What specific operations did you take part in

Note: You must attach documentation (and translations if applicable) to support your answers (military book, discharge papers etc).

Question 2.6 Have you ever been a witness of war crimes or crime against humanity?

No /Yes

If yes give details, including knowledge you may have of perpetrators, relevant groups involved, when and where the crimes took place.

English Question & Answer

15
Question 2.7 Have you ever participated in a war or armed conflict in any way?

No/Yes

If yes give details, including date, location and how you were involved

Question 2.8 Have you ever participated in the crime of genocide or a crime against humanity or a war
crime?

No /Yes

If yes give reasons for your involvement, including details of who issued orders to commit these crimes, likely punishments if you
did not participate, and actions you may have taken to avoid committing these crimes

Question 2.9 Have you ever participated in any physical or psychological abuse against prisoners or
civilians?

No /Yes

If yes give details, including a description of the situation, dates, location(s) and how you were involved

Question 2.10 Have you ever participated in the capture of civilians in a war or armed conflict?

No /Yes

If yes give details, including a description of the situation, dates, location(s) and how you were involved

Question 2.11 Have you ever been detained or arrested during a war or armed conflict?

No /Yes
English Question & Answer
16
If yes give details, including by whom, when, where and details of your release

Question 2.12 Give full details of your training history during your career, including military training.

Date from Date to Name of ame of course Course details Qualification

group/organisation (content/skills received (if
that provided the acquired) applicable)
training
DD/MM/YY DD/MM/YY

AUTHORITY FORM (For Over 16 applicants)

This authority form entitles Ausilink Immigration PTY LTD the use of my signature on all
legal forms and necessary documents related to my visa application in the event that I am
not able to sign the form or document or in case of emergency where there is no time to get
the form to myself for signing.

Full Name (main applicant): ……………………………………………………………

Email address: ………………………………………………………………..

Signature:

English Question & Answer

17
Date:

Full Name (2nd applicant): ……………………………………………………………

Email address: ………………………………………………………………..

Signature:

Date:

Full Name (3rd applicant): ……………………………………………………………

Email address: ………………………………………………………………..

Signature:

Date:

English Question & Answer

18
Full Name (4th applicant): ……………………………………………………………

Email address: ………………………………………………………………..

Signature:

Date:

Full Name (5th applicant): ……………………………………………………………

Email address: ………………………………………………………………..

Signature:

Date:

English Question & Answer

19
Full Name (6th applicant): ……………………………………………………………

Email address: ………………………………………………………………..

Signature:

Date:

**Please note that Ausilink Immigration PTY LTD will let each individual know when their
signature is being used and for what reason.

A copy of every form/document that has used the individuals signature will be sent to the main
applicants nominated email address.

Ausilink Immigration PTY LTD will not use the client’s signature for any incriminating documents,
signatures will only be used for legal documents and forms related to the clients visa application.

English Question & Answer

20