Part A - Main Visa Applicant's Details: Details of Child or Other Dependent Family Member Aged 18 Years or Over
Part A - Main Visa Applicant's Details: Details of Child or Other Dependent Family Member Aged 18 Years or Over
Part A - Main Visa Applicant's Details: Details of Child or Other Dependent Family Member Aged 18 Years or Over
A separate form 47A must be completed for each member of the 7 Other names the member of the family unit is, or has been, known by
family unit aged 18 years or older whether migrating or not. (including name at birth, previous married names, aliases)
If there is insufficient space to answer, provide details under ‘Additional
information’ at the end of this form.
Please open this form using Adobe Acrobat Reader.
Either type (in English) in the fields provided or print this form For other names, provide required details at Part E – Additional
and complete it (in English) using a pen and BLOCK LETTERS. information
Tick where applicable 3
8 Member of the family unit’s sex
Indeterminate /
Male Female ✔
Part A – Main visa applicant’s details Intersex / Unspecified
3 Main visa applicant’s file number 11 Of which countries is the member of the family unit a citizen?
Brazil
Part B – Member of the family unit’s details 12 Member of the family unit’s country of current residence
Brazil
4 Full name of the member of the family unit
(as shown in the member of the family unit’s passport or travel document)
Family name 13 Details from the member of the family unit’s passport
Wierzynski Passport number GC488679
SR/DPF/RS
6 Other ways you spell the name of the member of the family unit
Family name
14 If applicable, details of identity card or identity number issued to the
member of the family unit by their government eg. National identity card.
Given names Note: If the member of the family unit is the holder of multiple identity
numbers because they are a citizen of more than one country, provide
the identity number on the card from the country the member of the
family unit is a permanent resident of, or resides in.
Identity number 6111609308
2. Country
Type of ID
16 Member of the family unit’s current relationship status 20 Member of the family unit’s main language
Never married or ✔ Portuguese
been in a de facto
relationship
21 How well does this member of the family unit communicate in English?
Widowed
Better than functional Functional ✔
Divorced Limited Not at all
Separated
Engaged to Name of intended spouse 22 Other languages this member of the family unit reads, understands,
be married speaks and writes fluently
Spanish
Date of intended marriage 23 Give full details of the member of the family unit’s education including
Day Month Year details of qualifications
Please enclose evidence of qualifications obtained by the member of the
family unit
Married or in a Name of partner
1. Name of institution
de facto
relationship Colégio Leonardo da Vinci
Postcode Qualification
Yes ✔
Language(s) of institution
Portuguese/English/Spanish
Commencement date
Finish date
Qualification
Language(s) of institution Yes Name and address of the member of the family unit’s
employer
3. Name of institution
Postcode
Date commenced
Day Month Year
Location
Commencement date
Finish date
Qualification
Language(s) of institution
24 Give details of the member of the family unit’s previous employment history (list most recent experience first)
Period Name and address of employer Type of business Occupation
Month Year
From
To
From
To
From
To
From
To
Any dependent children of this member of the family unit (including from previous marriages/relationships)
Country Brazil
Country Brazil
Country Brazil
4. From to
Country
Address
Postcode
If you do not have enough space to give all the necessary information,
attach a separate sheet to this form with further details