Form

Application for a
Visitor visa – Tourist stream 1419
Department of Home Affairs

About this form Visa validity

Important – Please read this information carefully before you This visa generally allows stays of 3 or 6 months in Australia,
complete your application. Once you have completed your although a stay of up to 12 months can be granted. However,
application we strongly advise that you keep a copy for your the visa period is determined on a case by case basis and may
records. be less than the period you requested. A stay beyond 12 months
All relevant questions on this form should be answered and is ONLY granted where ‘exceptional circumstances exist’.
any requested information attached. The Department of A visa may be granted for a single entry or multiple entries
Home Affairs (the Department) may decide your application within a specified period. Generally, this visa allows people to
on the basis of the information provided on your application. enter Australia within 12 months from the date of grant.
All forms are available from the Department’s website
www.homeaffairs.gov.au/allforms/ Conditions for a Visitor visa to Australia
Visitors to Australia must be willing and able to abide by the
Who should use this form? conditions listed below while in Australia. If you are unwilling
Use this form to apply for a Visitor visa – Tourist stream to or unable to abide by these conditions you should not apply
visit or remain in Australia for tourism or other recreational for a visa. If you do not abide by these conditions, your visa
activities (holiday, sightseeing, social or recreational reasons or may be cancelled or you may be subject to other penalties. If
to visit relatives or friends). you have any questions or concerns about the conditions, you
should ask for more information from an Australian Visa Office
If you intend to: or office of the Department in Australia.
• visit Australia to visit family members, and you have a family If you are granted a visa, carefully check the details and
member who is eligible and willing to sponsor you, you may conditions on the letter advising you of the grant of your visa.
use form 1418 Application for a Visitor visa – Sponsored
Family stream; If you have any concerns or questions about the requirements
or limitations, you should contact the office that granted that
• visit Australia for medical treatment you should use form visa. You should not assume that any changes to your
48ME Application for a Medical Treatment visa; immigration status can be made while in Australia.
• visit Australia for a short business trip, you should use
form 1415 Application for a Visitor visa – Business Visitor Visa conditions
stream;
• study in Australia for more than 3 months you should apply The following conditions will be applied to your visa:
for a student visa. Please contact the nearest Australian
Visa condition 8101
Visa Office or office of the Department for information on
student visa applications, including the correct application You must NOT work in Australia.
form.
Visa condition 8201
Each applicant, including dependent children, must apply on
their own form. You must complete all questions in all You must NOT study for more than 3 months while in Australia.
sections. Failure to answer any question completely and Visa condition 8602
accurately may result in the application being refused, or the
visa may be cancelled at a later date. You must NOT have an outstanding public health debt.

The following conditions may be applied to your visa:

Integrity of application
Visa condition 8503
The Department is committed to maintaining the integrity of
the visa and citizenship programmes. In relation to this No further stay.
application, if you or a member of your family unit: Following an assessment of your application, a visa officer may
• provide, or have provided in a previous application, decide to apply the 8503 condition on your visa. The 8503 (or
fraudulent documents or false or misleading information No Further Stay) condition means that the holder of the visa
(knowingly or not); and/or on which the condition has been imposed will not, after
entering Australia, be entitled to be granted any other visa,
• fail to satisfy, or have failed to satisfy in a previous
while the holder remains in Australia.
application, the Minister of your or their identity;
The effect of this visa condition is that it will not be possible
this visa application may be refused and you, and any
for you to apply to remain in Australia beyond the authorised
members of your family unit, may become unable to be
period of stay of your visa. It is particularly important, if your
granted a visa for specified periods of time, as set out in
visit to Australia is to attend a specific event, that you organise
migration legislation.
your travel so that you can attend these events within your
If documents are found to be fraudulent or information to be authorised period of stay as you will not be able to extend
incorrect after the grant of a visa, the visa may subsequently your period of stay in Australia.
be cancelled.
If the 8503 condition is imposed on your visa, it will be
indicated on the letter advising you of the grant of your visa,
with the words 8503 – NO FURTHER STAY.
© COMMONWEALTH OF AUSTRALIA, 2018 1419 (Design date 06/18) - Page 1
 Visa condition 8531 Ways to apply
You must NOT stay in Australia after your visa expires. You may arrange for another person to help you complete this
application form, but you must sign it. If you have been assisted
Visa condition 8558 in completing the application form, you should only sign the
You must NOT spend more than 12 months in Australia in an declaration(s) if the information in it is true and correct.
18 month period.
Outside Australia
Visa Application Charge If you are applying from outside Australia, you, or your
representative, can submit your application, Visa Application
Refer to Part L – Payment details of this form to calculate the Charge and supporting documents in one of the following
correct charge and make payment. ways:
Refer to www.homeaffairs.gov.au/trav/visa/fees for a • Electronically over the internet if you are eligible. To check
complete and current list of applicable fees and charges. your eligibility please visit the Department’s website
Fees and charges may be subject to change at any time and www.homeaffairs.gov.au/trav/visa-1/600-
this may increase the cost of a visa application. • In person or by mail at the nearest Australian Visa Office or
Generally, Visa Application Charges are reviewed on 1 July office of the Department. If you are lodging in person you
each year, and the exchange rates used to calculate the may require an appointment. To check if an appointment is
amount payable in a foreign country are updated on 1 January required please visit the Department’s website
and 1 July each year. www.homeaffairs.gov.au/about/contact/offices-
If you do not pay the full Visa Application Charge amount, locations or
your visa application will not be valid. • Through a Service Delivery Partner (SDP). SDP’s provide
Charges are generally not refundable, even if the application is visa application services on behalf of the Department in
withdrawn or refused. some countries. For more detailed information, and to
check if an SDP is available in your country, please visit the
Contact Us web page on the Department’s website
Method of payment www.homeaffairs.gov.au/about/contact/offices-
Payment information, including any applicable surcharges, is locations
available at www.homeaffairs.gov.au/trav/visa/fees/how-
to-pay-for-an-application In Australia
If lodging outside Australia, you must check with the If you are applying in Australia, you, or your representative,
Australian Government office where you intend to lodge your can submit your application, Visa Application Charge and
application as to what methods of payment and currencies supporting documents in one of the following ways:
they can accept and to whom the payment should be made • Electronically over the internet
payable. A list of offices of the Department is available at
www.homeaffairs.gov.au/about/contact/offices-locations • By mail (with the correct pre-paid postage):
You can make your payment electronically through the Onshore Visitor Visa Processing
‘My Payments’ section of ImmiAccount, at GPO Box 9984
www.homeaffairs.gov.au/immiaccount SYDNEY NSW 2001
AUSTRALIA
Lodge your application within 30 days of making your
payment online. • By courier:
Onshore Visitor Visa Processing
Level 3
26 Lee Street
SYDNEY NSW 2000
AUSTRALIA

Supporting documents and additional information

Part M – Application checklist on page 15 contains
information about supporting documentation. If you are
lodging your application overseas, you should also check the
website of your nearest Australian Visa Office
www.homeaffairs.gov.au/about/contact/offices-locations

Sponsorship by an eligible relative

You may be asked by the Department to support your
application with an eligible sponsor and payment of a bond as
part of the assessment process.

Extending your stay in Australia

If you are applying for a new visa or extension while in
Australia you must apply for a new visa before your current
visa expires. The best time to apply for a new Visitor visa is
about 2 weeks before the expiry of your current visa. Please
bear in mind that the grant of a new visa will cease any visa
currently held and the entitlements attached to that visa. If, for
example, you currently have work rights or formal study
entitlements, those entitlements will cease when a Visitor visa
is granted.
1419 (Design date 06/18) - Page 2 © COMMONWEALTH OF AUSTRALIA, 2018
Health requirements Immigration assistance
All applicants must meet Australia’s health requirements. You A person gives immigration assistance to you if he or she uses,
may be required to undergo a chest x-ray and medical or claims to use, his or her knowledge or experience in
examination in order to meet the criteria for the grant of a migration procedure to assist you with your visa application,
subclass 600 visa. request for ministerial intervention, cancellation review
Please follow any directions given by the visa processing officer application, sponsorship or nomination.
as to medical or x-ray examinations that may be required. In Australia a person may only lawfully give immigration
Additional information regarding the health requirement assistance if he or she is a registered migration agent or is
for entry into Australia is available on the Department’s website exempt from being registered. Only registered migration
www.homeaffairs.gov.au/trav/visa/heal/meeting-the- agents may receive a fee or reward for providing immigration
health-requirement/health-examinations assistance.
If an unregistered person in Australia, who is not exempt from
Health insurance requirements registration, gives you immigration assistance they are
committing a criminal offence and may be prosecuted.
Medical treatment in Australia can be very expensive. It is
recommended that you take out health insurance for your Sponsors of applicants for Visitor visas – Sponsored
period of stay in Australia. You will not be covered by Family stream are exempt from the requirements to be
Australia’s national health scheme, unless you are covered by a registered as a migration agent in order to assist
reciprocal health care agreement. applicants in relation to Visitor visas – Sponsored
Family stream.
If you are seeking a long stay Visitor visa – Tourist stream or are
75 years of age or over Migration agents in Australia
You may be asked to provide evidence with your application Migration agents in Australia must be registered with the
that you have health insurance to cover your stay in Australia. Office of the Migration Agents Registration Authority (Office of
More information about health insurance is available from the the MARA) unless they are exempt from registration.
Department’s website www.homeaffairs.gov.au/trav/visi/visi Migration agents outside Australia
Migration agents who operate outside Australia do not have to
Vaccinations be registered. The Department may give some overseas agents
If it is your intention to enrol your children in an Australian an ID number. This number does not mean that they are
school or childcare centre (crèche or preschool) during your registered.
visit to Australia, you are strongly encouraged to carry Note: Some Australian registered migration agents operate
certification of your child’s vaccination status. Certification overseas.
may be sought at time of enrolment.
Vaccination is recommended against polio, tetanus, measles, Migration agent information
mumps, rubella, diphtheria, pertussis (whooping cough), A migration agent is someone who can:
Haemophilus influenza hypo (Hib) and Hepatitis B.
• advise you on the visa that may best suit you;
Note: Vaccination against rubella is also recommended for
• tell you the documents you need to submit with your
women of child bearing age.
application;
• help you fill in the application and submit it; and
Passport information
• communicate with the Department on your behalf.
Most visa applicants will be required to hold a valid passport
before they can be granted a visa. It is strongly recommended If you appoint a migration agent, the Department will assume
that the passport be valid for at least 6 months. that your migration agent will be your authorised recipient,
unless you indicate otherwise.
If you change your passport after you have been granted the
visa you must notify the nearest Australian Visa Office or office Your migration agent will be the person with whom the
of the Department. Department will discuss your application and from whom it
will seek further information when required.
If you do not provide us with the details of any new or
additional passport you use to travel to Australia, you You are not required to use a migration agent. However, if you
may experience significant delays at the airport and use a migration agent, the Department encourages you to use
may be denied permission to board your plane. a registered migration agent. Registered agents are bound by
the Migration Agents Code of Conduct, which requires them
to act professionally in their clients’ lawful best interests.
Residential address
Information on migration agents, including a list of registered
You must provide the address of where you intend to live
migration agents, is available on the Office of the MARA
during the period that your application is being considered.
website www.mara.gov.au
Failure to give your residential address will result in this
application being invalid. A post office box address will not be You can also access information about migration agents on the
accepted as your residential address. Department’s website www.homeaffairs.gov.au

Change of address
If you change your residential address for more than 14 days
while your application is being processed, you must tell the
Department your new address and how long you will be there.
The Department will send communication about your
application to the latest address for correspondence you have
provided.

© COMMONWEALTH OF AUSTRALIA, 2018 1419 (Design date 06/18) - Page 3

 Exempt persons Consent to communicate electronically
The following people do not have to be a registered migration The Department may use a range of means to communicate
agent in order to provide immigration assistance, but they with you. However, electronic means such as fax or email will
must not charge a fee for their service: only be used if you indicate your agreement to receiving
• a close family member (spouse, de facto partner, child, communication in this way.
parent, brother or sister); To process your application the Department may need to
• a member of parliament or their staff; communicate with you about sensitive information, for
example, health, police checks, financial viability and personal
• an official whose duties include providing immigration relationships. Electronic communications, unless adequately
assistance (eg. a Legal Aid provider); encrypted, are not secure and may be viewed by others or
• a member of a diplomatic mission, consular post or interfered with.
international organisation. If you agree to the Department communicating with you by
Appointing a migration agent/exempt person electronic means, the details you provide will only be used by
the Department for the purpose for which you have provided
To appoint a migration agent/exempt person you should them, unless there is a legal obligation or necessity to use
complete Part K – Options for receiving written them for another purpose, or you have consented to use for
communications. another purpose. They will not be added to any mailing list.
Your migration agent/exempt person should complete The Australian Government accepts no responsibility for the
form 956 Advice by a migration agent/exempt person of security or integrity of any information sent to the Department
providing immigration assistance. over the internet or by other electronic means.
Form 956 is available from the Department’s website If you authorise another person to receive documents on your
www.homeaffairs.gov.au/allforms/ behalf and they wish to be contacted electronically, their
signature is required on form 956 or 956A to indicate their
Options for receiving written communications consent to this form of communication.
If you do not appoint a migration agent/exempt person you Note: Electronic communication is the fastest means of
may still authorise another person, in writing, to receive communication available and the Department prefers to
written communications on your behalf. This person is called communicate electronically because this results in faster
the authorised recipient. processing.

Authorised recipient information

Important information about privacy
All written communication about your application will be sent to
Your personal information is protected by law, including the
your authorised recipient, unless you indicate that you wish to
Privacy Act 1988. Important information about the collection,
have health and/or character information sent directly to you.
use and disclosure (to other agencies and third parties,
The Department will communicate with the most recently including overseas entities) of your personal information,
appointed authorised recipient as you may only appoint one including sensitive information, is contained in form 1442i
authorised recipient at any time for a particular application. Privacy notice. Form 1442i is available from the Department’s
You will be taken to have received any documents sent to that website www.homeaffairs.gov.au/allforms/ or offices of the
person as if they had been sent to you. Department. You should ensure that you read and understand
form 1442i before completing this form.
To appoint an authorised recipient you should complete:
As sponsorship may be required for your visa subclass, the
• Part K – Options for receiving written communications; and outcome of your application may be made known to the
• form 956A Appointment or withdrawal of an authorised person/organisation who has submitted a sponsorship form
recipient. regarding your application.
Note: Migration agents/exempt persons do not need to
complete form 956A.
Form 956A is available from the Department’s website Home page www.homeaffairs.gov.au
www.homeaffairs.gov.au/allforms/ General Telephone 131 881 during business hours
enquiry line 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

1419 (Design date 06/18) - Page 4 © COMMONWEALTH OF AUSTRALIA, 2018
 Form
Application for a
Visitor visa – Tourist stream 1419
Department of Home Affairs

Please open this form using Adobe Acrobat Reader.

Either type (in English) in the fields provided or print this form PHOTOGRAPH
and complete it (in English) using a pen and BLOCK LETTERS.
Tick where applicable 3
Please attach a
recent passport
size photograph
of yourself.
1 Indicate if you are applying outside Australia or in Australia:
Outside Australia ✔ Go to Question 2
In Australia Go to Question 5

Applicants outside Australia Part A – Your details

2 When do you wish to visit Australia? 7 Give the following details exactly as they appear in your passport
DAY MONTH YEAR DAY MONTH YEAR Make sure your passport is valid for the period of stay you are applying for.
Date from 19-Dec-2019 to 02-Jan-2020
Family name SHUVO
3 How long do you wish to stay in Australia? Given names ANISUZZAMAN
Up to 3 months ✔
Up to 6 months Sex Male ✔ Female
Up to 12 months DAY MONTH YEAR

Note: The stay period granted may be less than the period requested. Date of birth 16-Dec-1983
You should check the terms of any visa granted.
Passport number BW0623812
4 Do you intend to enter Australia on more than one occasion? Country of passport BANGLADESH
No ✔ Go to Question 7 Nationality of BANGLADESHI
passport holder
Yes Give details DAY MONTH YEAR

Date of issue 28-Jun-2018

Date of expiry 27-Jun-2023
Place of issue/
DIP / DHAKA
issuing authority

Go to Question 7
8 Place of birth
Applicants in Australia
Town/city DHAKA
DAY MONTH YEAR
5 Specify the date you wish
to extend your stay to State/province

Country BANGLADESH
6 Provide detailed reasons for requesting this further stay

9 Relationship status
Married Separated Never married or ✔
been in a de facto
Engaged Divorced
relationship
De facto Widowed

© COMMONWEALTH OF AUSTRALIA, 2018 1419 (Design date 06/18) - Page 5

 10 Are you or have you been known by any other name? 18 What is your legal status in your current location?
(including name at birth, previous married names, aliases) Citizen ✔
No ✔ Permanent resident
Yes Give details Visitor
Student
Work visa
No legal status
11 Do you currently hold an Australian visa? Other Give details
No ✔
Yes Note: If this visa application is approved, your current visa
may cease. 19 What is the purpose of your stay in your current location and what is
your visa status?
12 Have you applied for a Parent (subclass 103) visa?
I am a citizen of Bangladesh by born. I live there together
No ✔ DAY MONTH YEAR with my family, relatives & friends. Also, I am an
Yes Please provide your queue date Chemist in CHINA NORTHEAST ELECTRIC POWER
ENGINEERING & SERVICES CO LTD.
13 Do you currently hold, or have you applied for, an APEC Business Travel
Card (ABTC)?
20 Your current residential address
No ✔ Note: A street address is required as a post office box address cannot
Yes Note: If this visa application is approved, the Australian visa be accepted.
associated with your ABTC will cease. 10/H, NAYA PALTAN, DHAKA GPO, DHAKA

14 Are you a citizen of any other country?

No ✔
POSTCODE 1000
Yes List countries
Country Bangladesh

21 Address for correspondence

(If the same as your residential address, write ‘AS ABOVE’)
15 Do you have other current passports? AS ABOVE
No ✔
Yes Give details

Passport number POSTCODE

Country of passport Country Bangladesh

16 Do you hold an identity card or identity number issued to you by your 22 Contact telephone numbers
government (eg. National identity card) (if applicable)? COUNTRY CODE AREA CODE NUMBER

Note: If you are the holder of multiple identity numbers because you Home (            ) (            )
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. Office +88
(            0960
) (            ) 44090005-6

No Mobile/cell +88 01717436322

Yes ✔ Give details
23 Do you agree to the Department communicating with you by email
Family name SHUVO and/or fax?
Given names ANISUZZAMAN This may include receiving notification of the outcome of this application.
Note: We can communicate about this application more quickly using
email and/or fax.
Type of document NID
No
Identity number 6444203712 Yes ✔ Give details
Country of issue BANGLADESH Email address [email protected]
COUNTRY CODE AREA CODE NUMBER
17 In what country are you currently located? Fax number (            ) (            )
BANGLADESH

1419 (Design date 06/18) - Page 6 © COMMONWEALTH OF AUSTRALIA, 2018

 Part B – Family travelling to Australia with you
24 Are you travelling to, or are you currently in, Australia with any family members?
No ✔
Yes Give details of each family member
Make sure all the applications are lodged at the same time.
Full name Relationship to you Name of sponsor (if applicable)

If insufficient space, give details at Part O

Part C – Family NOT travelling to Australia with you

25 Do you have a partner, any children, or fiancé who will NOT be travelling, or has NOT travelled, to Australia with you?
No ✔
Yes Give details

Full name Date of birth Relationship to you Their address while you are in Australia
DAY MONTH YEAR

/ /

/ /

/ /

/ /

If insufficient space, give details at Part O

Part D – Details of your visit to Australia

26 Is it likely you will be travelling from Australia to any other country (eg. New Zealand, Singapore, Papua New Guinea) and back to Australia?
No ✔
Yes Attach itinerary details

27 Do you have any relatives in Australia?

No ✔
Yes Give details

Date of birth Relationship Citizen or permanent

Full name Address
DAY MONTH YEAR to you resident of Australia

/ / No Yes

/ / No Yes

/ / No Yes

/ / No Yes

If insufficient space, give details at Part O

© COMMONWEALTH OF AUSTRALIA, 2018 1419 (Design date 06/18) - Page 7

 28 Do you have any friends or contacts in Australia?
No
Yes Give details

Date of birth Relationship Citizen or permanent

Full name Address
DAY MONTH YEAR to you resident of Australia

/ / No Yes

/ / No Yes

/ / No Yes

/ / No Yes

If insufficient space, give details at Part O

29 Why do you want to visit Australia?

Include details of any dates that are of special significance to your visit.

Basically i will be celebrating the CHRISTMAS & NEW

YEAR in Australia and i will enter through airport of
Melbourne in 19 December 2019 followed by Brisbane,
Cairns & Sydney. Specially, I want to enjoy new year's
fireworks at Sydney Harbor . I have attached my details
15 days tour plan along with my documents.

If insufficient space, give details at Part O

30 Do you intend to do a course of study while in Australia?

No ✔
Yes Give details

Name of the
course

Name of the
institution

How long will the course last?

1419 (Design date 06/18) - Page 8 © COMMONWEALTH OF AUSTRALIA, 2018

 Part E – Health details 35 During your proposed visit to Australia, do you expect to incur medical
costs, or require treatment or medical follow up for:
31 In the last 5 years, have you visited or lived outside your country of
• blood disorder;
passport for more than 3 consecutive months?
• cancer;
Do not include time spent in Australia.
• heart disease;
No ✔ • hepatitis B or C and/or liver disease;
Yes Give details • HIV Infection, including AIDS;
1. Country(s) • kidney disease, including dialysis;
• mental illness;
• pregnancy;
DAY MONTH YEAR DAY MONTH YEAR
• respiratory disease that has required
Date from to
hospital admission or oxygen therapy;
• other?
2. Country(s) No ✔
Yes Give details
DAY MONTH YEAR DAY MONTH YEAR

Date from to

3. Country(s)

DAY MONTH YEAR DAY MONTH YEAR

Date from to 36 Do you require assistance with mobility or care due to a medical
condition?
If insufficient space, give details at Part O No ✔
Yes Give details
32 Do you intend to enter a hospital or health care facility (including
nursing homes) while in Australia?
No ✔
Yes Give details

37 Have you undertaken a health examination for an Australian visa in

the last 12 months?
No ✔
Yes Give details (including HAP ID if available)
33 Do you intend to work as, or study to be, a doctor, dentist, nurse or
paramedic during your stay in Australia?
No ✔
Yes Give details

Note: If you are applying for a long stay Visitor visa or are 75 years
or over, you will be asked to undergo a health assessment and may
be asked to show that you have medical insurance to cover your
intended stay in Australia. Please contact your nearest office of the
Department for further advice before lodging your application. If
34 Have you:
additional medical consultations are required, a decision on your visa
• ever had, or currently have, tuberculosis?
application will be delayed.
• been in close contact with a family member that has active
tuberculosis?
• ever had a chest x-ray which showed an abnormality?
No ✔
Yes Give details

© COMMONWEALTH OF AUSTRALIA, 2018 1419 (Design date 06/18) - Page 9

 Part F – Character details If you answered ‘Yes’ to any of the questions at Question 38, give ALL
relevant details below.
38 Have you ever:
• been charged with any offence that is
currently awaiting legal action? No ✔ Yes
• been convicted of an offence in any country
(including any conviction which is now
removed from official records)? No ✔ Yes
• been the subject of an arrest warrant or
Interpol notice? No ✔ Yes
• been found guilty of a sexually based offence
involving a child (including where no
conviction was recorded)? No ✔ Yes
• been named on a sex offender register? No ✔ Yes
• been acquitted of any offence on the grounds
of unsoundness of mind or insanity? No ✔ Yes
• been found by a court not fit to plead? No ✔ Yes
• been directly or indirectly involved in, or
associated with, activities which would
represent a risk to national security in
Australia or any other country? No ✔ Yes If insufficient space, give details at Part O
• 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? No ✔ Yes
• been associated with a person, group or
organisation that has been/is involved in
criminal conduct? No ✔ Yes
• 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? No ✔ Yes
• served in a military force, police force, state
sponsored/private militia or intelligence
agency (including secret police)? No ✔ Yes
• undergone any military/paramilitary training,
been trained in weapons/explosives or in the
manufacture of chemical/biological products? No ✔ Yes
• been involved in people smuggling or people
trafficking offences? No ✔ Yes
• been removed, deported or excluded from
any country (including Australia)? No ✔ Yes
• overstayed a visa in any country (including
Australia)? No ✔ Yes
• had any outstanding debts to the Australian
Government or any public authority in
Australia? No ✔ Yes

1419 (Design date 06/18) - Page 10 © COMMONWEALTH OF AUSTRALIA, 2018

 Part G – Employment status Part H – Funding for stay
39 What is your employment status? All visitors to Australia must be able to demonstrate they have adequate
Employed/ Give details funds to cover all costs associated with their visit. Providing evidence of
self-employed Employer/business name funds will help expedite the processing of a visitor visa application.
Examples may include personal bank statements showing a financial
CHINA NORTHEAST ELECTRIC P history, pay slips, audited accounts, taxation records or details of funds
Address that visitors will be taking with them or funds that are available to them.
PARKUL, AFRUJGANJ-3203, Relevant factors may also include the number of persons your are
supporting, the type of activities planned and the length of stay sought.
NABIGANJ, HABIGANJ,
BANGLADESH 40 Give details of how you will maintain yourself financially while you are
HABIGANJ POSTCODE 3203 in Australia
Telephone number I have attached my Bank statement along with my
COUNTRY CODE AREA CODE NUMBER
solvency. I already booked hotel .I will have sufficient
+88
(            01717
) (            ) 436322 cash dollar & also use credit card for maintaing all
Position you hold expenses .
ASSISTANT CHEMIST
How long have you
been employed by this
employer/business? 4.6 YEARS

Retired Year of retirement

Student Give details

Your current course

Name of educational institution

How long have you been

studying at this institution?

Other ✔ Give details

Unemployed Explain why you are unemployed and give details

of your last employment (if applicable)

© COMMONWEALTH OF AUSTRALIA, 2018 1419 (Design date 06/18) - Page 11

 41 Is your sponsor or someone else providing support for your visit to Australia?
Note: This includes support from an organisation.
No ✔
Yes Give details

Date of birth Relationship Type of support provided

Full name Their address while you are in Australia
DAY MONTH YEAR to you Financial Accommodation Other

/ /

/ /

/ /

/ /

If insufficient space, give details at Part O

Attach details. The person or people you have listed will need to provide evidence of their ability to provide this support.

Part I – Previous applications

42 Have you ever:
• been in Australia and not complied with
visa conditions or departed Australia
outside your authorised period of stay? No ✔ Yes
• had an application for entry to or further
stay in Australia refused, or had a visa for
Australia cancelled? No ✔ Yes

If you answered ‘Yes’ to any of the above questions, give details

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 Part J – Assistance with this form Part K – Options for receiving written
43 Did you receive assistance in completing this form? communications
No ✔ Go to Part K 47 All written communications about this application should be sent to:
Yes Please give details of the person who assisted you (Tick one box only)

Title: Mr Mrs Miss Ms Other Myself ✔

Family name OR

Given names Authorised You should complete form 956A Appointment

recipient or withdrawal of an authorised recipient
Address
OR

Migration agent Your migration agent/exempt person should

complete form 956 Advice by a migration
POSTCODE OR agent/exempt person of providing
Telephone number or daytime contact Exempt person immigration assistance
COUNTRY CODE AREA CODE NUMBER

Office hours (            ) (            )

Mobile/cell

44 Is the person an agent registered with the Office of the Migration

Agents Registration Authority (Office of the MARA)?
No ✔
Yes Go to Part K

45 Is the person/agent in Australia?

No ✔ Go to Part K
Yes

46 Did you pay the person/agent and/or give a gift for this assistance?
No ✔
Yes

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 Part L – Payment details
48 IMPORTANT: You must refer to the Department’s website at www.homeaffairs.gov.au/trav/visa/fees 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

Write the amount shown on the reference table for your visa subclass AUD (1)

+
Non-internet Application Charge (if applicable) AUD (2)

Additional Applicant Charge aged 18 years or over at the time your application is lodged
+
Write the amount shown on the Number of additional applicants
reference table for your visa subclass aged 18 years or over
AUD X (multiplied by) = AUD (3)

Additional Applicant Charge under 18 years of age at the time your application is lodged
+
Write the amount shown on the Number of additional applicants
reference table for your visa subclass under 18 years of age
AUD X (multiplied by) = AUD (4)

Subsequent Temporary Application Charge (if applicable)

+
Write the amount shown on the
reference table for your visa subclass Number of applicants
AUD X (multiplied by) = AUD (5)

=
Total
Total (1) + (2) + (3) + (4) + (5) AUD
You must pay the total amount or your visa application will not be valid.
Note: A second instalment of the Visa Application Charge must also be
paid before we can grant some visas.

49 Method of payment
Payment information, including any applicable surcharges, is available at www.homeaffairs.gov.au/trav/visa/fees/how-to-pay-for-an-application
If lodging outside Australia, you must 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. A list of offices of the Department is available at
www.homeaffairs.gov.au/about/contact/offices-locations
You can make your payment electronically through the ‘My Payments’ section of ImmiAccount, at www.homeaffairs.gov.au/immiaccount
Lodge your application within 30 days of making your payment online.

How did you make your payment?

Electronically through Payment receipt number
the ‘My Payments’
section of ImmiAccount
Attach a copy of your printed receipt.
Other Provide details

Attach copies of your receipt(s) or evidence of payment(s).

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 Part M – Application checklist Additional documents
50 With your completed and signed application form 1419, Under the Migration Act 1958, decision-makers are not obliged to seek
you must include: additional information from the applicant before making a decision on a
visa application. It is therefore in the your best interest to submit the
• a certified copy of the identity page (showing photo following documentation, if applicable, with your application:
and personal details) of a valid passport and other
pages which provide evidence of travel to any other • �evidence of access to funds to support your stay
countries
• evidence of your medical/travel insurance
• a recent passport photograph (not more than (if requested)
6 months old) of yourself
• medical examination or tests (if requested)
• evidence of payment of the Visa Application Charge
• a letter from your employer confirming your leave
• a completed form 1257 Undertaking declaration, for
applicants under 18 years of age, staying in Australia • evidence of enrolment at school, college or university
with someone other than a parent, legal guardian or
relative (if applicable) If visiting a close family member in Australia (who is a
citizen or permanent resident of Australia):
• a completed form 1229 Consent to grant an
Australian visa to a child under the age of 18 years, • a letter of invitation to visit
for applicants under 18 years of age, travelling alone • other information to show that you have an incentive
or without one or both of their parents or legal and authority to return to your country of residence,
guardians (if applicable) such as property or other significant assets in your
If you authorise another person to receive all written home country
communications about your application with the
Department: Important: Do not provide original documents unless requested.
You should provide ‘certified copies’ of original documentation.
• completed Part K – Options for receiving written
Documents not in English should be accompanied by accredited
communications; and
English translations.
• form 956 Advice by a migration agent/exempt person
of providing immigration assistance; or
• form 956A Appointment or withdrawal of an
authorised recipient

When you have lodged your application, you should

attach your receipt to this sheet.

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 Part N – Signatures 52 DECLARATION
51 BIOMETRICS DECLARATION AND CONSENT WARNING: Giving false or misleading information or documents is a
serious offence.
This declaration and consent is for offshore visa applicants.
Having read the ‘Conditions for a Visitor visa to Australia’ on page 1 of
If I am requested or required to provide my fingerprints and facial image: this form, I declare that:
I consent to:
• the information given is complete, correct and up-to-date;
• the collection of my fingerprints and facial image.
• I understand that the visa I am applying for does not permit me to
I declare that: work in Australia;
• I understand that my fingerprints and facial image and my • I understand that the visa I am applying for does not permit me to
biographical information held by the Department may be given to study for longer than 3 months in Australia;
Australian law enforcement agencies to help identify me, to help
• my intention to visit Australia is genuine and I will abide by the
determine my eligibility for grant of the visa I have applied for, and
conditions and period of stay of the visa;
for law enforcement purposes.
• I have access to adequate funds to meet all costs associated with
I consent to:
the visit to and from Australia;
• Australian law enforcement agencies disclosing my biometric,
• I have never had tuberculosis or any serious condition likely to
biographical and criminal record information to the Department for
endanger or be a cost to Australia (otherwise, I attach details);
any of the purposes outlined above; and
• I have read and understood that I am liable for the cost of any health
• the Department using the information obtained for the purposes of
related services that I receive while in Australia. This does not
the Migration Act 1958 or the Australian Citizenship Act 2007.
include costs otherwise covered, such as by health insurance,
Medicare (if eligible), or treatment for certain community health risks
Signature of such as tuberculosis;
applicant
- • I understand that if a no further stay 8503 condition is imposed on
DAY MONTH YEAR this visa, it will limit my ability to remain in Australia beyond the
Date authorised period of the visa;
• 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;
• if granted a visa, I will advise the Australian Visa Office should my
circumstances change;
• 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. If applicable, my sponsor may also be penalised;
• I have truthfully declared all relevant details requested of me in this
application;
• 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;
• I understand that if any fraudulent documents or false or misleading
information has been provided with this application, or if I fail to
satisfy the Minister of my identity, my application may be refused
and I, and any other member of my family unit, may become unable
to be granted a visa for specified periods of time;
• if documents are found to be fraudulent or information to be incorrect
after the grant of a visa, the visa may subsequently be cancelled.

Signature of
applicant
-
DAY MONTH YEAR

Date

We strongly advise that you keep a copy of your application

and all attachments for your records.

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 Part O – Additional information
53 Question number Additional information

If insufficient space, attach additional details.

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