Australia Business visa Application

Transcription

1 Mail documents to Tel VisaHQ.com Inc. Embassy Row 2005 Massachusetts Ave. NW Washington, DC ( Australia Business visa Application Please enter your contact information Name Tel Mobile The latest date you need your passport returned in time for your travel Australia business visa checklist Filled out and signed Australia business visa application form. The form is enclosed. tarized copy of Egypt passport. A NOTARIZED copy of your valid, signed Egypt passport with at least 6 months validity. Please do NOT send your original passport. 1 Photographs. Standard passport photographs 2x2 inches on a white background. Payment. Credit Card Authorization form, Certified Check, or Money Order payable to VisaHQ.com. Return mailer. Prepaid self-addressed return label or payment for FedEx. If you wish to prepay return shipping, please add the shipping fee to the total and provide return address FedEx 2nd day delivery - From $29 Name FedEx Standard Overnight - From $42 Company FedEx Priority Overnight - From $43 Address FedEx Saturday delivery - From $60 FedEx First Overnight - From $72 Prepaid self addressed mailer - $0 Local pick up in Washington - $0 City State Zip * Actual prices may vary based on location per FedEx.com. VisaHQ.com Inc., Embassy Row 2005 Massachusetts Ave. NW, Washington, DC T ( E info@visahq.com

2 Mail documents to Tel VisaHQ.com Inc. Embassy Row 2005 Massachusetts Ave. NW Washington, DC ( Proof of Status. Copy of Green Card or other proof of legal status in the US (such as copy of I-20, DS-2019, H1B approval notice, etc. Itinerary. Copy of an itinerary or flight reservation from an airline or travel agent. Please do not purchase tickets until the visa has been issued. Immediate Family Information. Evidence of immediate family members in country of residence. Please provide a copy of their valid ID and their contact information. Mortgage/Lease. A copy of the applicant's mortgage or lease. If renting without a lease, please submit a letter from the owner of the house stating the duration and the contract terms of your stay. Business Letter. A business letter from the sending company in the US. The letter should be printed on the company letterhead stationery, addressed to "The Consulate of Australia, Visa Section", and signed by a senior manager (an equivalent to Vice-President or above. The business letter must adhere to the following guidelines Briefly introduce the applicant (please specify employment status/position held in the company by applicant. State the nature of the business to be conducted (ie. business meetings, contract negotiations, etc. and the names and addresses of companies to be contacted in Australia. Specify the Type and desired Validity of the visa (ie. a one year multiple entry business visa. Guarantee of sufficient funds for travel. The sample format for this letter can be found here Business Invitation. A business invitation letter from the sponsoring company in Australia. The letter should be printed on company letterhead stationery, addressed to "The Consulate of Australia, Visa Section", and signed by a senior manager (an equivalent to Vice-President or above. The business letter must adhere to the following guidelines Briefly introduce the applicant (please specify employment status/position held in the company by applicant. State the nature of the business to be conducted (ie. business meetings, contract negotiations, etc. and the names and addresses of companies to be contacted in Australia. Specify the Type and desired Validity of the visa (ie. a one year multiple entry business visa. Military Service Record. If applicant has served in the military, please provide a certified copy of military service record or discharge papers (for former military. Proof of Name Change. If applicant has changed their legal name at any point in time, please provide a copy for the proof of name change. VisaHQ.com Inc., Embassy Row 2005 Massachusetts Ave. NW, Washington, DC T ( E info@visahq.com

3 Mail documents to Tel VisaHQ.com Inc. Embassy Row 2005 Massachusetts Ave. NW Washington, DC ( Form 956A. Applicants must fill out this form in order for the visa to be processed. It can be found within the last 4 pages of the application form you download when completing the order or under "Download PDF." Additional business documents 1. Evidence of why you need to visit Australia on business, such as -Conference registration details -A letter from your employer stating the reasons for your visit -Your itinerary, with contact details of the business parties involved 2. Evidence of why you need to visit Australia on business 3. Your current employment and your role during your visit to Australia. 4. Details of previous contacts with Australian business people or organisations. 5. Documents to show that the company you work for is an actively operating business, such as a business registration certificate or annual report. Additional required documents for minors (under If you are younger than 18 years of age evidence that every person with a legal right to decide where you live consents to your travel to Australia on this visa. If one or both parents are not coming with you, provide a statutory declaration giving their permission. The declaration form can be found here. Form 1229 Consent form to grant an Australian visa to a child under the age of 18 years. If you use this form, you will have to attach a certified copy of your parent s or guardian s government-issued identification document (such as a passport or drivers licence with their photograph and their signature. This form can be found here. 2. If you are younger than 18 years of age and you will stay in Australia with someone other than a parent, legal guardian or relative. a declaration signed by the person who will be responsible for you in Australia. Form 1257 Undertaking declaration. This form can be found here. 3. Evidence of enrollment at school, college or university. Please be advised that the Embassy of Australia may extend the processing time up to 6 weeks for certain applicants. This decision is entirely at the embassy's discretion. VisaHQ.com Inc., Embassy Row 2005 Massachusetts Ave. NW, Washington, DC T ( E info@visahq.com

4 Mail documents to Tel VisaHQ.com Inc. Embassy Row 2005 Massachusetts Ave. NW Washington, DC ( Australia business visa fees for citizens of Egypt Type of visa Validity Visitor Visa (Subclass 600 up to 365 days Processing time Embassy fee Service fee Total business days $ $ This order is subject to Terms of Service, posted on VisaHQ website. All fees and requirements may change without notice. VisaHQ.com Inc., Embassy Row 2005 Massachusetts Ave. NW, Washington, DC T ( E info@visahq.com $334.00

5 Mail documents to VisaHQ.com Inc. Embassy Row 2005 Massachusetts Ave. NW Washington, DC Tel ( Credit Card Authorization Form By signing this form i accept VisaHQ.com Terms of Service and authorize to charge my credit card for the amount of $ Name on the Credit Card Credit Card number - Exp. date / - - Credit Card Billing Address Signature Comments Thank you! We accept all major credit cards. VisaHQ.com Inc., Embassy Row 2005 Massachusetts Ave. NW, Washington, DC T ( E info@visahq.com

6 Application for a Visitor visa Business Visitor stream Please use a pen, and write neatly in English using BLOCK LETTERS. Tick where applicable Form 1415 PHOTOGRAPH Please attach a recent passport-sized photograph of yourself. 1 4 When do you wish to visit Australia? Date from Town/city to State/province te The stay period granted may be less than the period requested. You should check the terms of any visa granted. 2 Country 5 Do you intend to enter Australia on more than one occasion? Place of birth Relationship status 6 Married Separated Engaged Divorced De facto Widowed Never married or been in a de facto relationship Are you or have you been known by any other name? (including name at birth, previous married names, aliases Part A Your details 3 Give the following details exactly as they appear in your passport Make sure your passport is valid for the period of stay you are applying for. 7 Do you currently hold an Australian visa? Family name Sex Male Female 8 Do you currently hold, or have you applied for, an APEC Business Travel Card (ABTC? Date of birth Passport number Country of passport Nationality of passport holder 9 Date of issue te If this visa application is approved, your current visa may cease. te If this visa application is approved, the Australian visa associated with your ABTC will cease. Are you a citizen of any other country? List countries Date of expiry Place of issue/ issuing authority COMMONWEALTH OF AUSTRALIA, (Design date 03/14a - Page 5

7 10 Do you hold an identity card or identity number issued to you by your government (eg. National identity card (if applicable? te If you are the holder of multiple identity numbers because you are a citizen of more than one country, you need to enter the identity number on the card from the country that you live in. 15 Your current residential address te A street address is required as a post office box address cannot be accepted. Family name Country 16 Address for correspondence (If the same as your residential address, write AS ABOVE Type of document Identity number Country of issue 11 Do you have other current passports? Country 17 Contact telephone numbers Passport number Country of passport 12 In what country are you currently located? Home ( ( Office ( ( Mobile/cell 18 Do you agree to the department communicating with you by and/or fax? 13 What is your legal status in your current location? This may include receiving notification of the outcome of this application. Citizen te We can communicate about this application more quickly using and/or fax. Permanent resident Visitor Student Work visa address legal status Other Fax number 14 What is the purpose of your stay in your current location and what is your visa status? 1415 (Design date 03/14a - Page 6 COMMONWEALTH OF AUSTRALIA, 2014 ( (

8 Part B Employment status Part C Details of your visit to Australia 19 What is your employment status? Employed/ self-employed 20 Describe your intended principal business visitor activity in Australia Employer/business name Address Telephone number ( ( Position you hold How long have you been employed by this employer/business? Are you visiting Australia as part of your current employment? Retired Year of retirement Student Your current course If insufficient space, give details at Part L 21 Do you have an Australian business contact? Contact person Name of educational institution Business name (if applicable How long have you been studying at this institution? Other Address Telephone number ( 22 Do you intend to do a course of study while in Australia? Unemployed Explain why you are unemployed and give details of your last employment (if applicable Name of the course Name of the institution How long will the course last? COMMONWEALTH OF AUSTRALIA, (Design date 03/14a - Page 7

9 Part D Funding for stay All visitors to Australia must be able to demonstrate they have adequate funds to cover all costs associated with their visit. Providing evidence of funds will help expedite the processing of a Visitor visa application. Examples may include showing personal bank statements showing a financial history, pay slips, audited accounts, taxation records or details of funds that visitors will be taking with them or funds that are available to them. Relevant factors may also include the number of persons you are supporting, the type of activities planned and the length of stay sought. 23 of how you will maintain yourself financially while you are in Australia 24 Is someone else, other than your employer or business, providing support for your visit to Australia? te This includes support from an organisation. Date of birth Full name / / / / / / / / Relationship to you Their address while you are in Australia If insufficient space, give details at Part L Attach details. The person or people you have listed will need to provide evidence of their ability to provide this support (Design date 03/14a - Page 8 COMMONWEALTH OF AUSTRALIA, 2014 Type of support provided Financial Accommodation Other

10 Part E Health details 28 Have you 25 In the last 5 years, have you visited or lived outside your country of passport for more than 3 consecutive months? Do not include time spent in Australia. s ever had, or currently have, tuberculosis? s been in close contact with a family member that has active tuberculosis? s ever had a chest x-ray which showed an abnormality? 1. Country(s Date from to 2. Country(s 29 During your proposed visit to Australia, do you expect to incur medical Date from to 3. Country(s Date from to If insufficient space, give details at Part L 26 Do you intend to enter a hospital or a health care facility (including costs, or require treatment or medical follow up for s blood disorder; s cancer; s heart disease; s hepatitis B or C and/or liver disease; s HIV Infection, including AIDS; s kidney disease, including dialysis; s mental illness; s pregnancy; s respiratory disease that has required hospital admission or oxygen therapy; s other? nursing homes while in Australia? 30 Do you require assistance with mobility or care due to a medical 27 Do you intend to work as, or study to be, a doctor, dentist, nurse or condition? paramedic during your stay in Australia? 31 Have you undertaken a health examination for an Australian visa in the last 12 months? COMMONWEALTH OF AUSTRALIA, 2014 (including HAP ID if available 1415 (Design date 03/14a - Page 9

11 Part F Character details Part G Assistance with this form 32 Have you ever s been convicted of a crime or offence in any country (including any conviction which is now removed from official records? 33 Did you receive assistance in completing this form? s been acquitted of any criminal offence or other offence on the grounds of mental illness, insanity or unsoundness of mind? s been removed or deported from any country (including Australia? s left any country to avoid being removed or deported? s been excluded from or asked to leave any country (including Australia? s been involved in any activities that would represent a risk to Australian national security? s had any outstanding debts to the Australian Government or any public authority in Australia? s been involved in any activity, or been convicted of any offence, relating to the illegal movement of people to any country (including Australia? s served in a military force or state sponsored/private militia, undergone any military/paramilitary training, or been trained in weapons/explosives use (however described? Go to Part H Please give details of the person who assisted you Title s been charged with any offence that is currently awaiting legal action? s committed, or been involved in the commission of, war crimes or crimes against humanity or human rights? Mr Mrs Miss Ms Other Family name Address Telephone number or daytime contact Office hours ( ( Mobile/cell 34 Is the person an agent registered with the Office of the Migration Agents Registration Authority (Office of the MARA? Go to Part H 35 Is the person/agent in Australia? Go to Part H 36 Did you pay the person/agent and/or give a gift for this assistance? If you answered to any of the above questions, give ALL relevant details below. Part H Options for receiving written communications 37 All written communications about this application should be sent to (Tick one box only Myself OR Authorised recipient You should complete form 956A Appointment or withdrawal of an authorised recipient OR Migration agent OR Exempt person If insufficient space, give details at Part L 1415 (Design date 03/14a - Page 10 COMMONWEALTH OF AUSTRALIA, 2014 Your migration agent/exempt person should complete form 956 Advice by a migration agent/exempt person of providing immigration assistance

12 Part I Payment details 38 IMPORTANT You must refer to the department s website at to complete this part of your application. The website shows reference tables with the Visa Application Charges applicable to each visa subclass. Visa subclass you are applying for Base Application Charge (1 AUD Write the amount shown on the reference table for your visa subclass + (2 AUD n-internet Application Charge (if applicable Additional Applicant Charge aged 18 years or over at the time your application is lodged Write the amount shown on the reference table for your visa subclass + Number of additional applicants aged 18 years or over X (multiplied by AUD = Additional Applicant Charge under 18 years of age at the time your application is lodged Write the amount shown on the reference table for your visa subclass (3 AUD + Number of additional applicants under 18 years of age = X (multiplied by AUD Subsequent Temporary Application Charge (if applicable Write the amount shown on the reference table for your visa subclass (4 AUD + Number of applicants = X (multiplied by AUD (5 AUD = Total Total (1 + (2 + (3 + (4 + (5 AUD You must pay the total amount or your visa application will not be valid. te A second instalment of the Visa Application Charge must also be paid before we can grant some visas. 39 How will you pay your application charge? te A surcharge may apply to payments made by credit card. Further information is available from If applying in Australia, debit card or credit card are the preferred methods of payment. Debit cards cannot be used for applications lodged by mail. If paying by bank cheque or money order please make payable to the Department of Immigration and Border Protection. If applying outside Australia, please check with the Australian Government office where you intend to lodge your application as to what methods of payment and currencies they can accept and to whom the payment should be made payable. Bank cheque Money order Debit card Cannot be used for applications lodged by mail Credit card below Payment by (tick one box Australian Dollars MasterCard Diners Club American Express JCB Telephone number Address AUD ( ( Visa Credit card number Expiry date Cardholder s name As the cardholder I acknowledge and accept that a credit card surcharge may apply to the transaction. Signature of cardholder Credit card information will be used for charge paying purposes only. COMMONWEALTH OF AUSTRALIA, (Design date 03/14a - Page 11

13 Part J Application checklist 40 With your completed and signed application form 1415, you must include s a certified copy of relevant pages of your passport, as necessary s a recent passport photograph (not more than 6 months old of yourself Additional documents Under the Migration Act 1958, decision-makers are not obliged to seek additional information from the application before making a decision on a visa application. It is therefore in the your best interest to submit the following documentation, if applicable, with your application s evidence of access to funds to support your stay s evidence of your medical/travel insurance (if asked s the Visa Application Charge (if applicable If you authorise another person to receive all written communications about your application with the department s completed Part H Options for receiving written communications; and s form 956 Advice by a migration agent/exempt person of providing immigration assistance; or s form 956A Appointment or withdrawal of an authorised recipient When you have lodged your application, you should attach your receipt to this sheet. s medical examination or tests (if asked s evidence that there is a need for you to be in Australia for business purposes eg. a letter from your employer detailing the reasons for your visit and your proposed duties, a letter of invitation from the host organisation in Australia, an itinerary with contact details of the business parties or conference registration details s evidence that your business background is relevant to the nature of your proposed business in Australia eg. evidence of educational qualifications, evidence of current employment position and your role during the visit, details of any previous contacts with Australian business people or organisations, documentation indicating that the company is an actively operating business (business registration certificate, annual report s other information to show that you have an incentive and authority to return to your country of residence such as a history of international travel s other information to show that you have an incentive and authority to return to your country of residence, such as property or other significant assets in your home country Important Do not provide original documents unless requested. You should provide certified copies of original documentation. Documents not in English should be accompanied by accredited English translations (Design date 03/14a - Page 12 COMMONWEALTH OF AUSTRALIA, 2014

14 Part K Declaration and consent Part L Additional information WARNING Giving false or misleading information is a serious offence. 42 Question number Additional information 41 Having read the Conditions for a Visitor visa Business Visitor stream on page 1 of this form, I declare that s I understand that the visa I am applying for does not permit me to work in Australia; s I understand that the visa I am applying for does not permit me to study for longer than 3 months in Australia; s my intention to visit Australia is genuine and I will abide by the conditions and period of stay of the visa; s I understand that if I do not abide by the conditions imposed on my visa, my visa may be cancelled or I may be subject to other penalties; s I have adequate funds to meet all costs associated with the visit to and from Australia; s I have never had tuberculosis or any serious condition likely to endanger or be a cost to Australia (otherwise, I attach details; s I understand that if a no further stay 8503 condition is imposed on this visa, it will limit my ability to remain in Australia beyond the authorised period of the visa; s in any part of this form which has been completed with the assistance of another person, that the information as set down is true and correct and has been included with my full knowledge, consent and understanding; s if granted a visa, I will advise the Australian Visa Office should my circumstances change prior to my travel to Australia; s I have truthfully declared all relevant details requested of me in this application; s I have read the information contained in form 1442i Privacy notice; s I understand the department may collect, use and disclose my personal information (including biometric information and other sensitive information as outlined in form 1442i Privacy notice. For offshore applicants who are required to provide their fingerprints and facial image. I declare that I s understand that my fingerprints and facial image and my biographical information held by the Department of Immigration and Border Protection may be given to Australian law enforcement agencies to help identify me, to help determine my eligibility for grant of the visa I have applied for, and for law enforcement purposes. I consent to s Australian law enforcement agencies disclosing my biometric, biographical and criminal record information to the Department of Immigration and Border Protection for any of the purposes outlined above; s the Department of Immigration and Border Protection using the information obtained for the purposes of the Migration Act 1958 or the Australian Citizenship Act Signature of applicant Date We strongly advise that you keep a copy of your application and all attachments for your records. If insufficient space, attach additional details. COMMONWEALTH OF AUSTRALIA, (Design date 03/14a - Page 13

15 Appointment or withdrawal of an authorised recipient Form 956A Who should use this form? Authorised recipient This form should be used to notify the Department of Immigration and Border Protection (the department that you are An authorised recipient is a person appointed to receive documents from the department relating to matters arising under the Migration Act 1958 (the Act or the Migration Regulations 1994 on behalf of another person. appointing an authorised recipient to receive documents that the department would otherwise have sent to you; or withdrawing the appointment of your authorised recipient. Return the completed form to the office where you lodged your application or for any other matter (eg. proposed visa cancellation, to the office of the department that is responsible for that matter. If you are unsure which office is responsible for your matter, this form may be submitted to the nearest office of the department. Do not use this form if you are appointing a migration agent or exempt person to provide you with immigration assistance and they will also be your authorised recipient. In this case the migration agent or exempt person should complete form 956 Advice by a migration agent/exempt person of providing immigration assistance. Who is an exempt person? The following people do not have to be registered as migration agents in order to provide immigration assistance a close family member (spouse, child, adopted child, parent, brother or sister; The most common times an authorised recipient would be appointed is during visa application processes, visa cancellation processes, sponsorship processes (including monitoring or sanctions or ministerial intervention requests. The department cannot discuss matters relating to you with the authorised recipient unless they are also acting on your behalf as your migration agent/exempt person, or you have separately provided the department with consent to disclose your personal information to them. You may only appoint one authorised recipient at any time for a particular application or matter. The department will send documents to the most recently appointed authorised recipient. The department is required under the Act to send your authorised recipient any documents relating to your matter (eg. visa application or cancellation of a visa, that would otherwise have been sent to you. Under most circumstances, you will not receive a separate copy of the documents. You are taken to have received any documents sent to your authorised recipients as if they had been sent to you. You should be aware that the documents sent to your authorised recipient might include sensitive information about matters such as your health and character. a member of parliament or their staff; If you change your authorised recipient or end their appointment you must promptly advise the department. You may use this form for that purpose. an official whose duties include providing immigration assistance; Dependent applicants a member of a diplomatic mission, consular post or international organisation. All persons listed on this form will be considered to have appointed the same authorised recipient. An exempt person must not charge a fee for their service. It is an offence for an exempt person to charge a fee for providing immigration assistance and penalties of up to 10 years jail can apply. If a person 16 years of age or older wants to appoint a different authorised recipient they should complete a separate form 956A. a sponsor or nominator of a visa applicant; COMMONWEALTH OF AUSTRALIA, A (Design date 04/16 - Page 1

16 Consent to communicate electronically The department may use a range of means to send documents to your authorised recipient. However, electronic means such as fax or will only be used if your authorised recipient indicates their agreement to receiving documents on your behalf in this way. To process your matter with the department (such as visa application or visa cancellation action, the department may need to communicate with you about sensitive information, for example, health, police checks, financial viability and personal relationships. This means the information may be contained in the documents that are sent to your authorised recipient. Electronic communications, unless adequately encrypted, are not secure, and any information about you sent electronically to your authorised recipient may be viewed by others or interfered with. If your authorised recipient agrees to the department sending your documents to them by electronic means, the details they provide will only be used by the department for the purpose of sending documents. They will not be added to any mailing list. The Australian Government accepts no responsibility for the security or integrity of any information sent to the department over the internet or by other electronic means. Important information about privacy Your personal information is protected by law, including the Privacy Act Important information about the collection, use and disclosure (to other agencies and third parties, including overseas entities of your personal information, including sensitive information, is contained in form 1442i Privacy notice. Form 1442i is available from the department s website or offices of the department. You should ensure that you read and understand form 1442i before completing this form. Home page General enquiry line Telephone during business hours in Australia to speak to an operator (recorded information available outside these hours. If you are outside Australia, please contact your nearest Australian mission. Please keep these information pages for your reference 956A (Design date 04/16 - Page 2 COMMONWEALTH OF AUSTRALIA, 2016

17 Form Appointment or withdrawal of an authorised recipient Please use a pen, and write neatly in English using BLOCK LETTERS. Tick where applicable 1 3 Address for correspondence (If the same as business or residential address, write AS ABOVE Are you using this form to notify the department that you are appointing an authorised recipient Complete Part A and Part C You do not need to complete Part B withdrawing the appointment of an authorised recipient Complete Part B and Part C You do not need to complete Part A 9 Telephone numbers Office hours Are you a (tick one only ( ( Mobile/cell Part A New appointment Your details A 10 Names of other persons 16 years of age or older who are appointing the same authorised recipient in relation to the same matter visa applicant sponsor or sponsor applicant 1. Family name nominator or nominator applicant proposer or proposer applicant visa holder whose visa is being considered for cancellation or has been cancelled 2. Family name person requesting ministerial intervention 3 3. Family name Do you have a DIBP Client ID number (CID? Have you appointed a migration agent or exempt person to provide you Full name (For an organisation, provide the name of the contact person with immigration assistance? Title Mr Mrs Miss Ms Other of the migration agent/exempt person Family name Family name 5 If there are more than 3 other persons, give details at Question 30 DIBP Client ID number (CID Date of birth If applicable Migration Agent Registration Number (MARN Organisation name (if applicable 7 DIGITS Offshore Agent ID Number 7 te Your migration agent/exempt person should complete form 956 Advice by a migration agent/exempt person of providing immigration assistance Business or residential address COMMONWEALTH OF AUSTRALIA, A (Design date 04/16 - Page 3

18 Appointment details Authorised recipient s details 12 Are you appointing an authorised recipient in relation to an application process, a cancellation process or another matter (eg. a sponsorship monitoring and sanction activity by the department, or only one stage of a two stage visa application, or ministerial intervention? Application process 14 Full name Title Mr Mrs Miss Ms Other Family name Type of application 15 Date of birth t yet lodged Date lodged 16 Business or residential address Cancellation process Subclass of visa 17 Address for correspondence Date visa granted (If the same as business or residential address, write AS ABOVE Another matter give details 18 Telephone numbers Office hours ( ( Mobile/cell 19 Does this person agree to the department communicating with them by fax, or other electronic means? If insufficient space, give details at Question 30 Go to Part C 13 Provide the DIBP ID number (if known attached to the matter listed in Question 12 in relation to which you are appointing an authorised recipient DIBP Request ID number (RID Fax number address Go to Part C DIBP Transaction Reference Number (TRN 956A (Design date 04/16 - Page 4 ( COMMONWEALTH OF AUSTRALIA, 2016 (

19 Part B Withdrawing an appointment 20 Your details 25 Authorised recipient s details Full name (For an organisation, provide the name of the contact person Full name Family name Family name 26 Are you withdrawing the appointment of an authorised recipient in Date of birth relation to an application process, a cancellation process or another matter (eg. sponsorship monitoring and sanction activity by the department, or only one stage of a two stage visa application, or ministerial intervention? Organisation name (if applicable Telephone numbers Office hours ( ( Application process Type of application Mobile/cell DIBP Client ID number (CID (if known Date lodged 21 Names of other persons 16 years of age or older who are Cancellation process withdrawing the appointment of the same authorised recipient in relation to the same matter Subclass of visa 1. Family name Date visa granted Another matter give details 2. Family name 3. Family name Your contact details 22 Business or residential address If insufficient space, give details at Question 30 Telephone number Office hours ( ( 27 Provide the DIBP ID number (if known attached to the matter in relation to which you are withdrawing your appointment of the authorised recipient DIBP Request ID number (RID 23 Address for correspondence (If the same as business or residential address, write AS ABOVE DIBP Transaction Reference Number (TRN 24 Do you agree to the department communicating with you by fax, or other electronic means? Fax number ( ( address COMMONWEALTH OF AUSTRALIA, A (Design date 04/16 - Page 5

20 Part C Declarations Authorised recipient declaration Your declaration 28 Tick one only 29 Tick one only Appointment Appointment I understand that I have been appointed by the persons named in Part A of this form to be their authorised recipient; and as the authorised recipient all documents that would otherwise be sent to the persons named in Part A will be sent to me, including by electronic means as indicated in Question 19 (if applicable. I declare that I have appointed the authorised recipient named in Question 14 of this form to receive all documents relating to the matter indicated in Question 12 on my behalf. Withdrawal of appointment I declare that the authorised recipient named in Question 25 of this form is no longer authorised to receive documents relating to the matter indicated in Question 26 on my behalf. Withdrawal of appointment I understand that future correspondence from the department will be sent to the last address that I have provided in Question 22, 23 or 24. I understand that I am no longer acting as authorised recipient for the persons named in Part B of this form in relation to the matter indicated in Part B of this form. Signature of authorised recipient I declare that Date I will inform the department of any changes to my address for correspondence. I have read the information contained in form 1442i Privacy notice. I understand the department may collect, use and disclose my personal information (including biometric information and other sensitive information as outlined in form 1442i Privacy notice. Your signature Date Signatures of other persons 16 years of age or older who are appointing or withdrawing the appointment of the same authorised recipient in relation to the same matter Signature Date Signature Date Signature Date We strongly advise that you keep a copy of this form for your records. 956A (Design date 04/16 - Page 6 COMMONWEALTH OF AUSTRALIA, 2016

21 Additional details 30 Question number Additional information COMMONWEALTH OF AUSTRALIA, A (Design date 04/16 - Page 7