Additional personal particulars
information
Form
1221
About this form
This is a supplementary form required to support your visa application and is to be completed by all applicants who are 18 years of age or over.
Important – Plea read this information carefully before you complete this form. Once you have completed this form we strongly advi that you keep a copy for your records.
Integrity of application
The Department of Immigration and Border Protection
(the department) is committed to maintaining the integrity of the visa and citizenship programs. Plea be aware that if you provide us with fraudulent documents or claims, this may result in processing delays and possibly your application being refud.
Important information about privacy
Your personal information is protected by law, including the Privacy Act 1988. Important information about the collection, u and disclosure (to other agencies and third parties, including overas entities) of your personal information, including nsitive information, is contained in form 1442i Privacy notice . Form 1442i is available from the department’s website v.au/allforms/ or offices of the
department. You should ensure that you read and understand
form 1442i before completing this form.
Tick where applicable
Plea u a pen, and write neatly in English using BLOCK LETTERS.Part A – Your details
v.au
Telephone 131 881 during business hours in Australia to speak to an operator (recorded
information available outside the hours). If you are outside Australia, plea contact your nearest Australian mission.
Home page General
enquiry line Family name Given names
1
3
Your full name
(as shown in your passport or travel document)Name in your own language or script
(if applicable)
2
Other names you are, or have been, known by
(including name at birth, previous married names, alias)
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Female
6
Place of birth 5Date of birth
7Sex 8
中国好声音毅光年Relationship status
Married De facto
Engaged
Divorced Separated
Widowed
relationship
reveal9
Citizenship or nationality (give details of all held)
Date granted
4
Name in Chine Commercial Code Numbers
(if applicable)
Country
State/province/
region
Suburb and
town/city
11Your contact details
Home telephone Mobile/cell All email
2014年中考分数线address
If insufficient space, give details at Part O – Additional details
12
Your propod residential address in Australia (if known)
Passport/travel document number 13Details from your passport/travel document
Place of issue/issuing authority
Date of issue Date of expiry Part B – Travel details
Country of passport/travel document
10Your current residential address (this is the place where you currently live)
Note : A post office box, migration agent address or mailbox address is not acceptable as a residential address. Unit/Apartment number
blockoutPostal code
Address (include street number and name)
Country State/province/region Suburb and town/city
15Have you ever had a visa refud or cancelled by, been refud entry to, or been deported from, any country?
Give details of dates, countries and circumstances
(If insufficient space, give details at Part O – Additional details)
Give details in chronological order
(If insufficient space, give details at Part O – Additional details)
No
Yes
Have you previously held an Australian visa?
16Give details
No
Yes
Do you currently have, or have you ever had, any national identity documents or numbers
(including birth registration numbers, social curity cards etc)?free是什么意思
1417
What is the general purpo of your journey/further stay?
18If you are outside Australia, give details of your intended arrival
Intended date of arrival
Flight number or vesl details (if known)
19
mg什么意思Intended date of departure
No Yes
20
道具英文Give details of any intended stopovers on your way to Australia
Places of intended stopovers
21Give details of any propod onward locations after your departure
from Australia
22
Are you fully funding your trip?
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No
Yes
Give details of the person/institution funding your trip
Full name
Name of institution (if applicable)
Address
Telephone number
Email address of person/institution
Part C – Details of travelling dependents/family members
23Give details of dependents/family members travelling to Australia with you
Given names
Family name Date of birth Relationship to you (eg. partner, sister, aunt)
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1.Suburb and town/city of birth
Country of birth
Part D – Current employment details
Employment commenced Name of employer
Address of employer
Contact telephone
Email address (if applicable)
Type of business Occupation/Position Detailed job description
24Are you currently employed
Give details of your current employment
Yes Given names
Family name Date of birth Relationship to you (eg. partner, sister, aunt)
2.Country of birth
If insufficient space, give details at Part O – Additional details
No
Give details of how you occupy your time and how you support yourlf
Suburb and town/city of birth
25Give details of your employment status in the last 10 years (including internships, work experience, lf employment and periods of unemployment)
Part F – Military rvice
26Have you had any military rvice
?
Give details in chronological order
(If insufficient space, give details at Part O – Additional details)No Yes
Part E – Employment status in the last 10 years
