Beruflich Dokumente
Kultur Dokumente
Given names
Part B – About you
2 Your full name (as shown in your passport or travel document)
8 Child’s name in own language or script (if applicable)
Family name
Given names
9 Other ways used to spell the child’s name
Family name
3 Sex Male Female
Given names
DAY MONTH YEAR
4 Date of birth
Grandchild Go to Part G
Other Please specify
Go to Part F
Part F – Orphan relative
17 Are the child’s parents both either dead, of unknown whereabouts or
Part D – Adopted child permanently incapacitated?
No
15 When did you adopt the child?
Yes Give details
Before I became an Attach a certified copy of the
Australian citizen, permanent child’s adoption certificate Parent’s full name
resident or eligible New or, if applicable, an adoption
Zealand citizen compliance certificate made
under the Adoption Convention. Sex Male Female
Go to Part G Unknown Permanently
Dead
whereabouts incapacitated
After I became an Australian Attach a certified copy of the
citizen, permanent resident or child’s adoption certificate Parent’s full name
eligible New Zealand citizen or, if applicable, an adoption
compliance certificate made
under the Adoption Convention.
Sex Male Female
Go to Part H
Dead Unknown Permanently
whereabouts incapacitated
I have not yet adopted the Attach an official letter from
child but the child has been the relevant Australian state Attach evidence to support this claim (eg. parent’s death certificate or
allocated to me for adoption or territory adoption authority report from a qualified medical practitioner, which shows that the child’s
which shows that you have been parent has a disability that stops them from looking after the child)
allocated the child for adoption.
Go to Part H
No Give details of ALL other people who have parental Yes Give details
responsibility (custody), access or guardianship rights in
relation to the child 1. Full name
You must attach either a completed form 1229 Consent to Sex Male Female
grant an Australian visa to a child under the age of
DAY MONTH YEAR
18 years or a statutory declaration from each of these
people giving permission for the child to migrate. Date of birth
Note: Form 1229 or the statutory declaration must be Country of current
accompanied by a certified copy of the other person’s residence
identification (eg. passport or driver’s licence). Citizenship
1. Full name Relationship to child*
Relationship to child*
POSTCODE
Telephone number * Siblings who wish to migrate together must make separate
COUNTRY CODE AREA CODE NUMBER applications and have separate sponsorships.
( ) ( )
Yes Attach a certified copy of the court order giving you sole
legal right to determine where the child shall live or the
right to permanently remove the child from the country
Does this document give permission for the child to migrate
permanently?
No Yes
POSTCODE
From to
23 Do you agree to the Department communicating with you by fax, email
or other electronic means? Your occupation
No 3. Name of employer
Yes Give details
COUNTRY CODE AREA CODE NUMBER
DAY MONTH YEAR DAY MONTH YEAR
Fax number ( ) ( )
From to
Email address Your occupation
Note: If this sponsorship is refused, you will be notified in writing. 4. Name of employer
24 Relationship status
DAY MONTH YEAR DAY MONTH YEAR
Married Separated Never married or
been in a de facto From to
Engaged Divorced
relationship
De facto Widowed Your occupation
25 What is your current employment status? You should provide certified photocopies of one of the following
documents to show your employment during the last 2 years:
In paid employment
• Australian income and/or overseas tax assessment notices*; or
Not in paid Give details • letter from employer confirming length of employment and annual
employment
Home duties salary; or
Seeking • payslips; or
employment • business documents or letter from your accountant if self-employed,
Go to
Retired Question 27 or self-funded from other sources.
Receiving pension * The Department does not require your Tax File Number (TFN). If your
Full-time student TFN is shown on your tax assessment notice, you may wish to remove
or obscure it before you attach the copy of the assessment notice to
Other Give details this form.
Now go to Question 27
DAY MONTH YEAR DAY MONTH YEAR DAY MONTH YEAR DAY MONTH YEAR
From to From to
29 Are you currently receiving any other form of social security benefit, 4. City/town
pension or allowance (including any benefits received from a country
POSTCODE
outside Australia)?
DAY MONTH YEAR DAY MONTH YEAR
No
From to
Yes Give details
31 Do you have any other children or relatives (in and outside of Australia) who are dependent on you?
No
Yes Give details
Relationship to you Are they
Relative’s full name Sex (eg. your child, father, sister, residing with
(FAMILY name in CAPITALS) Date of birth or Age M/F aunt, cousin) you?
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
• specifically, been charged with any offence that is currently awaiting legal action,
in any country, relating to persons under 18 years of age, including but not limited
to: child abuse, child sex, endangering a child, indecent dealings with a child, or
possession of child pornography? No Yes
If you answered ‘Yes’ to either of these questions, you must give ALL relevant details. If the matter relates to a criminal conviction, please
give the nature of the offence, full details of sentence and dates of any period of imprisonment or other detention.
34 In which countries have you lived for 12 months or more during the last 10 years?
Dates lived there
Country MONTH YEAR Last permanent address in that country
FROM
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
1. Type of payment
From to
2. Type of payment
If insufficient space, attach additional details
44 Your partner’s current residential address DAY MONTH YEAR DAY MONTH YEAR
From to
3. Type of payment
POSTCODE
DAY MONTH YEAR DAY MONTH YEAR
POSTCODE
Email address
1. Name of employer
From to
2. Name of employer
From to
3. Name of employer
From to
• specifically, been charged with any offence that is currently awaiting legal action,
in any country, relating to persons under 18 years of age, including but not limited
to: child abuse, child sex, endangering a child, indecent dealings with a child, or
possession of child pornography? No Yes
If you answered ‘Yes’ to either of these questions, you must give ALL relevant details. If the matter relates to a criminal conviction,
please give the nature of the offence, full details of sentence and dates of any period of imprisonment or other detention.
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
FROM
TO
Occupation
Separately list the relationship of each person (eg. high school student, university student, retired,
in your dwelling (eg. child, father, sister, aunt, cousin) Date of birth or Age part-time waitress, unemployed)
Address
60 Will the child you are sponsoring be living with you
in the same dwelling?
No
POSTCODE
Yes Go to Part L
Telephone number or daytime contact
61 Provide reason(s) why the child you are sponsoring COUNTRY CODE AREA CODE NUMBER
will not be living with you in the same dwelling Office hours ( ) ( )
Mobile/cell
67 Did you pay the person/agent and/or give a gift for this assistance?
No
Yes
69 Undertaking
WARNING: Giving false or misleading information or documents is a
serious offence.
I agree to: I declare that:
• provide information and advice to help the person(s) I am • the information I have supplied in this form is complete, correct and
sponsoring settle in Australia; up-to-date in every detail;
• ensure that adequate accommodation is available to them on arrival • I understand that if this application is approved, any person not
in Australia or, to provide accommodation for up to 2 years from included in this application will not have automatic right of entry to
arrival in Australia, or the 2 years following the grant of your child’s Australia by way of this application and whether they can migrate
visa if your child is applying in Australia; will depend on the migration settings at the time they apply, their
• if sponsoring an orphan relative, provide support (including circumstances and their ability to meet visa requirements, including
accommodation and financial assistance required to meet the the health requirement;
child’s reasonable needs) until the orphan relative turns 18 years • I have read the information contained in form 1442i Privacy notice;
of age or, if this period is less than 2 years after entry to Australia and
for the first time on the Orphan Relative visa or less than 2 years • I understand the Department may collect, use and disclose my
following the grant of the Orphan Relative visa if granted in Australia, personal information (including biometric information and other
during the child’s first 2 years in Australia; sensitive information) as outlined in form 1442i Privacy Notice.
• provide support as required to enable them to attend appropriate
English language courses; Signature
of sponsor
• attend an interview (if requested by the Department) in relation to
the child’s application; and
-
DAY MONTH YEAR
• inform the Department in writing if I withdraw my support for the
child before this application is finalised. Date