Form

Application for further stay as a visitor

601

Please read these notes carefully It should be noted, however, under Australia’s migration
regulations, decision-makers may grant a Tourist visa permitting
Important – Please read this information carefully before you
the visa holder to travel to and to remain in Australia for a
complete your application. Once you have completed your
specified period that they see as appropriate. In some
application we strongly advise that you keep a copy for your
circumstances the stay period granted may be less than the stay
records.
period requested by the applicant.
Complete the attached form if you are in Australia temporarily
For more detailed information check the department’s website
and want to apply for further stay for tourism or medical
www.immi.gov.au/e_visa/
treatment. Include on this form any dependants who are in
Australia with you and who are in your passport. Those on a
separate passport must complete a separate form. (B) Medical treatment (class UB)
A visitor visa will be granted where it is considered that: This class is for medical treatment which is either elective or
emergency, and includes the following subclasses:
• you have complied and will continue to comply with the
675 Medical treatment (short stay)
conditions of your entry to Australia;
685 Medical treatment (long stay).
• you meet the criteria in the class applied for;
Note: If your current visa is a Sponsored Family Visitor
• you are of good character, do not have a dangerous or visa, the 8531 ‘Must leave before visa expiry’ condition means
contagious disease and are in good health (unless applying that you MUST leave Australia before the expiry of your
for a medical treatment visa). Sponsored Family Visitor visa. If for ANY reason you do not
depart before your Sponsored Family Visitor visa expires,
Integrity of application penalties will be imposed upon your sponsor. If a security bond
has been lodged in support of your application, normally the
The Department of Immigration and Citizenship (the bond will be forfeited.
department) is committed to maintaining the integrity of the
visa and citizenship programs. Please be aware that if you The 8503 ‘No Further Stay’ condition prevents you from lodging
provide us with fraudulent documents or claims, this may result an application for further stay in Australia. If you need to remain
in processing delays and possibly your application being refused. in Australia because compelling and compassionate
circumstances over which you have no control and that resulted
in a major change in your circumstances have developed since
When to apply for a new visa the visa that had the condition imposed was granted, you may
You must apply for a new visa before your current visa expires. request a waiver of the 8503 ‘No Further Stay’ condition.
The best time to apply for a new visitor visa is about 2 weeks If you request a waiver of the 8503 ‘No Further Stay’ condition
before the expiry of your current visa. Please bear in mind that and this results in your remaining in Australia after your
the grant of a new visa will cease any visa currently held and the Sponsored Family Visitor visa expires, you will be taken to have
entitlements attached to that visa. If, for example, you currently breached the 8531 ‘Must leave before the expiry of the
have work rights or formal study entitlements, those sponsored visitor’ condition, and the penalties will be imposed
entitlements will cease when a visitor visa is granted. upon your sponsor, even if the 8503 is waived and a further visa
is granted. If your sponsor lodges a security bond in support of
Class of visa your application, normally the security bond will be forfeited.
In your application you will need to indicate the class of visa
you currently hold and the class of visa you want. How to apply
Your current visa class is shown on your visa. A list of all the • Applications for a further stay in Australia as a tourist may be
visitor classes follows. You can apply for one class only. made via the internet or at an office of the department or by
mail depending on the length of the total stay period.
(A) Tourist visa, class TR, subclass 676 • An application for a total stay of up to 6 months from the
This visa can be applied for from outside Australia (offshore) or date the applicant last entered Australia on an Electronic
in Australia. Travel Authority (Visitor) or a Tourist visa (subclass 676) can
be made over the internet. Further information is available
on the department’s website www.immi.gov.au/e_visa/
Visa validity
• An application for a total stay of more than 6 months can be
This visa generally allows stays of 3 or 6 months in Australia, made at an office of the department.
although a stay of up to 12 months can be granted. A stay
beyond 12 months is ONLY granted where ‘exceptional’
circumstances exist.
It may be granted for a single entry or multiple entries within a
specified period. Generally, this visa allows people to enter
Australia within 12 months from the date of grant.

© COMMONWEALTH OF AUSTRALIA, 2011 601 (Design date 11/11) - Page 1

 For more details on visa lodgement options check the Residential address
department’s website www.immi.gov.au/e_visa/
You must provide the address where you intend to live while
• To apply in person or by mail you will need to complete a your application is being dealt with. Failure to give a residential
paper application form. Please note that false or misleading address in your application will result in your application being
information may lead to refusal or cancellation of your visa, invalid. A post office box address will not be accepted as your
or penalties while in Australia. residential address.
• You may arrange for another person to help you complete
this application form, but you must sign it. If another person Health insurance
does help you complete the form, you should only sign the
Medical treatment in Australia can be expensive. It is
declaration if the information in it is true and correct.
recommended that you take out health insurance for you and
• Lodge your application form, the application charge, your your family for the period of stay in Australia. You will not be
passport and any attachments at the nearest departmental covered by Australia’s national health scheme, unless you are
office. Your application may be lodged personally, by your covered by a reciprocal health care agreement.
representative or sent by mail.
• Please follow any directions given by the visa processing officer If you are 75 years of age or over
as to medical or x-ray examinations that may be required. In order to satisfy the financial requirements for these visas,
• On the return of your passport, carefully check the details you may be asked to provide evidence with your application
and conditions on your visa label or on the letter advising you that you have health insurance to cover your stay in Australia.
of the grant of your visa. If you have any concerns or questions More information about Australian private health insurance is
about the requirements or limitations of your visa, you should available from the department’s website
contact the office that granted the visa immediately. www.immi.gov.au/visitors/

The following documents should be provided with this Vaccinations

form: If it is your intention to enrol your child in an Australian school
or childcare centre (creche or preschool) during your visit to
• your passport or travel document; Australia, you are strongly encouraged to carry certification of
• document/statements supporting your application. your child’s vaccination status.
Examples include: Vaccination is recommended against polio, tetanus, measles,
– evidence that you have enough funds, or access to funds, mumps, rubella, diphtheria, pertussis (whooping cough),
to support yourself for the duration of your stay in Australia. Haemophilus influenzae hypo (Hib), and Hepatitis B.
Proof of funds – current bank or credit card statement Certification may be sought at time of enrolment.
showing the balance in Australian dollars, and/or evidence
of sufficient funds to purchase a return ticket; Note: Vaccination against rubella is also recommended for
women of child bearing age.
– a plane ticket (if you have one) detailing your departure
dates;
Medical treatment
– an itinerary of travel plans, if available;
If you are applying for a visa for medical treatment, you will
– written documents/statements supporting your request for need to meet the criteria and present evidence that:
extension of stay if applying for a visa for medical treatment
purposes or permission to work; (i) arrangements have been made with the doctor and/or
hospital to provide you with medical and/or hospital care,
– other evidence requested by the decision-maker. ie. a firm date for treatment has been made;
Do not supply original documents with your application, unless (ii) arrangements have been made to pay the full cost of that
requested by the department. You should provide certified treatment and you can demonstrate you have the means
copies of original documents. Documents in languages other to pay; and
than English must be accompanied by a certified English
translation. (iii) if the treatment is in a public hospital, that the
state/territory medical authorities have agreed to your
admission and treatment.
Visa Application Charge
If you are providing comfort and support to a person who seeks
Fees may be subject to adjustment at any time. Visa Application medical treatment, and that is the purpose of your further stay
Charges may be subject to adjustment on 1 July each year. This in Australia, then you too should apply for a medical treatment
may increase the cost of a visa. visa.
To check the Visa Application Charge (VAC), see form 990i Special provisions apply to:
Charges available from the department’s website
www.immi.gov.au/allforms/990i.htm or check with the • persons who have sought permanent residence and have
nearest office of the department. met all criteria except the health criterion.
• citizens of Papua New Guinea in the Western Province who
Method of payment have been medically evacuated to a hospital in Queensland
and require further medical treatment.
To make a payment, please pay by credit card, debit card, bank
cheque or money order made payable to the Department of More information about medical treatment visas is available
Immigration and Citizenship. Debit card and credit card are the from the department’s website
preferred methods of payment. www.immi.gov.au/visitors/medical-treatment/

601 (Design date 11/11) - Page 2 © COMMONWEALTH OF AUSTRALIA, 2011

Permission to work Migration agents in Australia
Provision exists, under strict criteria, for a visitor to be granted Migration agents in Australia must be registered with the Office
work rights. But it will only be granted to visitors who are of the Migration Agents Registration Authority (Office of the
prevented from leaving Australia and who can demonstrate MARA) unless they are exempt from registration.
compelling personal reasons and financial hardship as a result
of changed circumstances after arrival in Australia. Visitors Migration agents outside Australia
seeking permission to work need to apply for a new visa and Migration agents who operate outside Australia do not have to
attach a statement outlining their circumstances and reasons be registered. The department may give some overseas agents
for needing to work. If approved, the application charge for the an ID number. This number does not mean that they are
new visa will be refunded. registered.
Note: Some Australian registered migration agents operate
Conditions for a tourist visa in Australia overseas.
Visitors to Australia must be willing and able to abide by the Migration agent information
conditions listed below while in Australia. If you are unwilling
or unable to abide by these conditions you should not apply for A migration agent is someone who can:
a visa. If you do not abide by these conditions, your visa may be • advise you on the visa that may best suit you;
cancelled or you may be subject to other penalties. If you have • tell you the documents you need to submit with your
any questions or concerns about the conditions, you should ask application;
for more information from a regional office of the department. • help you fill in the application and submit it; and
Conditions • communicate with the department on your behalf.
8101 – You must NOT work while in Australia. If you appoint a migration agent, the department will assume
8201 – You must NOT study for more than 3 months that your migration agent will be your authorised recipient,
while in Australia. unless you indicate otherwise.
8503 – No Further Stay. Your migration agent will be the person with whom the
Following an assessment of your application, a visa officer may department will discuss your application and from whom it will
decide to apply the 8503 condition on your visa. The 8503 (or seek further information when required.
No Further Stay) condition means that the holder of the visa You are not required to use a migration agent. However, if you
on which the condition has been imposed will not, after use a migration agent, the department encourages you to use
entering Australia, be entitled to be granted any other visa1, a registered migration agent. Registered agents are bound by
while the holder remains in Australia. the Migration Agents Code of Conduct, which requires them to
The effect of this visa condition is that it will not be possible for act professionally in their clients’ lawful best interests.
you to apply to remain in Australia beyond the authorised Information on migration agents, including a list of registered
period of stay shown on your visa label. It is particularly migration agents, is available on the Office of the MARA website
important, if your visit to Australia is to attend a specific event, www.mara.gov.au
that you organise your travel so that you can attend these events You can also access information about migration agents on the
within your authorised period of stay as you will not be able to department’s website www.immi.gov.au
extend your period of stay in Australia.
If the 8503 condition is imposed on your visa, it will be indicated Exempt persons
on the visa label or on the letter advising you of the grant of The following people do not have to be a registered migration
your visa, with the words 8503 – NO FURTHER STAY. agent in order to provide immigration assistance, but they must
There may be other conditions depending on the purpose of not charge a fee for their service:
your visit. • a close family member (spouse, de facto partner, child,
parent, brother or sister);
Immigration assistance • a member of parliament or their staff;
A person gives immigration assistance to you if he or she uses, • an official whose duties include providing immigration
or claims to use, his or her knowledge or experience in assistance (eg. a Legal Aid provider);
migration procedure to assist you with your visa application, • a member of a diplomatic mission, consular post or
request for ministerial intervention, cancellation review international organisation.
application, sponsorship or nomination.
Appointing a migration agent/exempt person
In Australia a person may only lawfully give immigration
assistance if he or she is a registered migration agent or is To appoint a migration agent/exempt person you should
exempt from being registered. Only registered migration agents complete Question 33 Options for receiving written
may receive a fee or reward for providing immigration communications.
assistance. Your migration agent/exempt person should complete form 956
If an unregistered person in Australia, who is not exempt from Advice by a migration agent/exempt person of providing
registration, gives you immigration assistance they are immigration assistance.
committing a criminal offence and may be prosecuted. Form 956 is available from the department’s website
www.immi.gov.au/allforms/

Options for receiving written communications

If you do not appoint a migration agent/exempt person you
1 may still authorise another person, in writing, to receive written
Except in extremely limited circumstances which are outside your control,
or to engage Australia’s protection obligation under the 1951 UN convention
communications on your behalf. This person is called the
relating to the status of refugees. authorised recipient.

© COMMONWEALTH OF AUSTRALIA, 2011 601 (Design date 11/11) - Page 3

 Authorised recipient information The information provided2 might also be disclosed to agencies
All written communication about your application will be sent who are authorised to receive information relating to adoption,
to your authorised recipient, unless you indicate that you wish border control, business skills, citizenship, education, health
to have health and/or character information sent directly to you. assessment, health insurance, health services, law enforcement,
payment of pensions and benefits, taxation, superannuation,
The department will communicate with the most recently review of decisions and registration of migration agents.
appointed authorised recipient as you may only appoint one
authorised recipient at any time for a particular application. Relevant information about you will be disclosed to federal, state
and territory police to assist in your location and possible detention
You will be taken to have received any documents sent to that in the event that you become an unlawful non-citizen. You will
person as if they had been sent to you. become an unlawful non-citizen if your visa ceases (by cancellation
To appoint an authorised recipient you should complete: for breach of visa condition for example) or expires and you do
not hold another visa authorising you to remain in Australia.
• Question 33 Options for receiving written
communications; and If your application for a visitor visa has also been supported by
an Australian Member of Parliament or a Community Leader
• form 956A Appointment or withdrawal of an authorised
based in Australia, information on the outcome of your application
recipient.
and of your compliance with visa conditions, if your visa is
Note: Migration agents/exempt persons do not need to granted, may be provided to the Member of Parliament or the
complete form 956A. Community Leader.
Form 956A is available from the department’s website The collection, access, storage, use and disclosure by the
www.immi.gov.au/allforms/ department of the information you provide in this form is
governed by the Privacy Act 1988 and, in particular, by the
Consent to communicate electronically 11 Information Privacy Principles. The information form 993i
Safeguarding your personal information, available from the
The department may use a range of means to communicate department’s offices, gives details of agencies to which your
with you. However, electronic means such as fax or e-mail will personal information might be disclosed.
only be used if you indicate your agreement to receiving
communication in this way. The department is authorised under the Migration Act 1958, in
certain circumstances, to collect a range of personal identifiers
To process your application the department may need to including a facial image, fingerprints and a signature from
communicate with you about sensitive information, for example, non-citizens, including from visa applicants. The department
health, police checks, financial viability and personal requires personal identifiers to assist in assessing your identity.
relationships. Electronic communications, unless adequately The department is authorised to disclose your personal
encrypted, are not secure and may be viewed by others or identifiers and information relating to your name and other
interfered with. relevant biographical data to a number of agencies including
If you agree to the department communicating with you by law enforcement and health agencies and to other agencies
electronic means, the details you provide will only be used by who may need to check your identity with this department.
the department for the purpose for which you have provided Where the department obtains personal identifiers they will
them, unless there is a legal obligation or necessity to use them become part of your official record with the department.
for another purpose, or you have consented to use for another The department is involved in international information
purpose. They will not be added to any mailing list. exchanges with a number of countries, including the United
The Australian Government accepts no responsibility for the Kingdom, the United States of America, Canada and New
security or integrity of any information sent to the department Zealand. These international information exchanges may involve
over the internet or by other electronic means. the sharing of personal identifiers, including facial images and
If you authorise another person to receive documents on your fingerprint data, collected by immigration agencies such as this
behalf and they wish to be contacted electronically, their department. If, as a result of this sharing between countries,
signature is required on form 956 or 956A to indicate their there is a match with your personal identifiers, the department
consent to this form of communication. will disclose your biographical data, copies of travel and other
identity documents or information from such documents, your
Note: Electronic communication is the fastest means of immigration status and immigration history (which may include
communication available and the department prefers to any immigration abuse and offences) and any criminal history
communicate electronically because this results in faster information relevant to immigration purposes. The purpose of
processing. such disclosure would be to help confirm your identity and
determine if you have presented to the department and the
About the information you give other agency under the same identity and with similar claims.
The department is authorised to collect information provided For more detailed information you should read information
on this form under Part 2 of the Migration Act 1958 ‘Control of form 1243i Your personal identifying information, which is
Arrival and Presence of Non-Citizens’. The information provided available from the department’s website
will be used by the department for assessing your eligibility for www.immi.gov.au/allforms/ or from any office of the
a visa to travel, enter and remain in Australia and for other department or Australian mission overseas.
purposes relating to the administration of the Migration Act, for
example, to monitor the conduct of migration agents, or for
ensuring compliance with the Migration Act. Home page www.immi.gov.au
General Telephone 131 881 during business hours
2
Including the information provided in relation to health on this form, and enquiry line in Australia to speak to an operator (recorded
the results of any tests for Human Immunodeficiency Virus (HIV), will be information available outside these hours).
used to assess your health for an Australian visa. A positive HIV or other test If you are outside Australia, please contact
result will not necessarily lead to a visa being denied. Your results may be
your nearest Australian mission.
disclosed to the relevant Commonwealth, state and territory health agencies.

Please keep these information pages for your reference

601 (Design date 11/11) - Page 4 © COMMONWEALTH OF AUSTRALIA, 2011
 Form

Application for further stay as a visitor

601

Please use a pen, and write neatly in English using BLOCK LETTERS.
Your details
Tick where applicable 
5 Name(s) as shown in your passport

1 What type of visa are you applying for? Family name

Tourist visa Go to Question 3 Given names
Medical treatment visa Please attach evidence that
arrangements for medical treatment have 6 Sex Male Female
been made (for further information on
medical treatment visas, read the
DAY MONTH YEAR
information on page 2 of this form).
7 Date of birth
Go to Question 2
Note: If you are 75 years or over, you will be asked to undergo a health
Permission to work Permission to work may only be granted assessment and may be asked to show that you have medical insurance
in extenuating circumstances. Please to cover your intended stay in Australia. Please contact your nearest
attach a statement outlining your reasons office of the department for further advice before lodging your application.
for seeking permission to work (for further If additional medical consultations are required, a decision on your visa
information on permission to work, read application will be delayed.
the information on page 3 of this form).
Go to Question 3 8 Relationship status

2 Please indicate the reason you are applying for a medical treatment visa. Married Separated Never married or
been in a de facto
I am applying as: Engaged Divorced
relationship
A person who will undergo medical treatment or De facto Widowed
attend a medical consultation
A person who will be receiving an organ 9 Details from your passport

A person who will be donating an organ Passport number

A person who will be accompanying one of the above people Country of passport
DAY MONTH YEAR
A citizen of Papua New Guinea from the Western Province Date of issue
A person who will be accompanying a citizen of Papua New Guinea
from the Western Province Date of expiry
Issuing authority/
A person who is over 50 and has been refused a permanent visa Place of issue as
on health grounds shown in your
A person who is a member of the family unit of the above person passport
Make sure your passport is valid for the period of stay you are applying
DAY MONTH YEAR for.
3 Specify the date you wish to extend Note: If you hold an APEC Business Travel Card (ABTC) the Australian
your stay to
visa associated with your ABTC will cease if this application is approved.

4 Provide brief reasons for requesting this further stay

(additional space is provided at Question 28 if required) 10 Details of identity card or identity number issued to you by your
government (if applicable) eg. National identity card.
Note: 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.
Identity number

Country of issue

11 Country of usual residence

© COMMONWEALTH OF AUSTRALIA, 2011 601 (Design date 11/11) - Page 5

 12 Your current residential address in Australia Health and character
Note: A post office box address is not acceptable as a residential
address. Failure to give a residential address will result in your application 17 In the last 5 years, have you, or any other person included in this
being invalid. application, visited, or lived, outside your country of passport for more
than 3 consecutive months?
No
Yes Give details
POSTCODE
1. Name
13 Address for correspondence Country(s)
(If the same as your residential address, write ‘AS ABOVE’)
DAY MONTH YEAR DAY MONTH YEAR

Date from to

POSTCODE
2. Name

14 Your telephone numbers Country(s)

DAY MONTH YEAR DAY MONTH YEAR
Home (AREA CODE )
Date from to
Mobile/cell
3. Name
15 Do you agree to the department communicating with you by fax,
e-mail or other electronic means? Country(s)
DAY MONTH YEAR DAY MONTH YEAR
No
Date from to
Yes Give details

Fax number (AREA CODE ) 18 Do you, or any other person included in this application, intend to enter
a hospital or a health care facility (including nursing homes) while in
E-mail address Australia?
No
Children included Yes Give details
If a child under 18 years of age is staying in Australia with someone other
than a parent, legal guardian or relative, a declaration signed by the person
responsible for that child in Australia, is required to be completed. See
form 1257 Undertaking declaration.

16 Details of any accompanying family members who are included

in your passport
1. Full name 19 Do you, or any other person included in this application, intend to work
as, or study to be, a doctor, dentist, nurse or paramedic during your stay
Relationship in Australia?
DAY MONTH YEAR No
Date of birth Yes Give details

2. Full name

Relationship
DAY MONTH YEAR

Date of birth

3. Full name

Relationship
DAY MONTH YEAR

Date of birth

4. Full name

Relationship
DAY MONTH YEAR

Date of birth

601 (Design date 11/11) - Page 6 © COMMONWEALTH OF AUSTRALIA, 2011

20 Have you, or any other person included in this application: 23 Have you, or any other person included in this
• ever had, or currently have, tuberculosis? application, ever:
• been in close contact with a family member that has active • been convicted of a crime or offence in any
tuberculosis? country (including any conviction which is
now removed from official records)? No Yes
• ever had a chest x-ray which showed an abnormality?
No • been charged with any offence that is
currently awaiting legal action? No Yes
Yes Give details
• been acquitted of any criminal offence or
other offence on the grounds of mental
illness, insanity or unsoundness of mind? No Yes

• been removed or deported from any

country (including Australia)? No Yes

• left any country to avoid being removed or

deported? No Yes
21 During your proposed visit to Australia, do you, or any other person
included in this application, expect to incur medical costs, or require • been excluded from or asked to leave any
country (including Australia)? No Yes
treatment or medical follow up for:
• blood disorder; • committed, or been involved in the
• cancer; commission of war crimes or crimes
• heart disease; against humanity or human rights? No Yes
• hepatitis B or C and/or liver disease; • been involved in any activities that would
• HIV infection, including AIDS; represent a risk to Australian national
• kidney disease, including dialysis; security? No Yes
• mental illness;
• pregnancy; • had any outstanding debts to the Australian
• respiratory disease that has required Government or any public authority in
Australia? No Yes
hospital admission or oxygen therapy;
• other? • been involved in any activity, or been
convicted of any offence, relating to the
No illegal movement of people to any country
Yes Give details (including Australia)? No Yes

• served in a military force or state

sponsored/private militia, undergone any
military/paramilitary training, or been
trained in weapons/explosives use
(however described)? No Yes

If you answered ‘Yes’ to any of the above questions, provide all the
22 Do you, or any other person included in this application, require assistance relevant details. If insufficient space, attach an additional statement.
with mobility or care due to a medical condition?

No
Yes Give details

© COMMONWEALTH OF AUSTRALIA, 2011 601 (Design date 11/11) - Page 7

 Previous applications Additional information supporting your
24 Is any person included in this application currently being held in application
immigration detention or other form of custody?
28 Use this space for additional information to support your application
No
Yes Give details
Name

Type of detention

25 Have you held, or do you currently hold a Bridging visa E?

No
Yes

26 Have you previously applied for a further stay in Australia and been
rejected?
No
Yes Please attach details

Evidence of funds
All visitors to Australia must be able to demonstrate that they have
adequate funds to cover all costs associated with their visit. Providing
evidence of funds with a completed application will often help expedite
the processing of a visitor visa application. Examples include showing
personal bank statements, pay slips, audited accounts, taxation records.
If someone else is offering to help meet the cost associated with your
visit, they may be asked to provide evidence of their ability to provide
such support, including the nature of their relationship with you.

27 How will you be maintaining yourself financially while you are in

Australia?
Using your own funds – give details

Someone else will be providing support – give details

Full name
Relationship
to you
DAY MONTH YEAR

Date of birth

Address

POSTCODE

What support are they providing?

Financial Accommodation
Other Give details

If insufficient space, attach additional details.

601 (Design date 11/11) - Page 8 © COMMONWEALTH OF AUSTRALIA, 2011

 Assistance with this form Payment details
29 Did you receive assistance in completing this form? 34 How will you pay your application charge?
No Go to Question 33 Note: In Australia, debit card or credit card are the preferred methods
Yes Please give details of the person who assisted you of payment. Debit cards cannot be used for applications lodged by mail.

Title: Mr Mrs Miss Ms Other Bank cheque Please make payable to:
Money order Department of Immigration and Citizenship
Family name
Debit card Cannot be used for applications lodged by mail
Given names
Address Credit card Give details below

Payment by (tick one box) Australian Dollars

MasterCard Diners Club

POSTCODE
American Express JCB AUD
Telephone number or daytime contact Visa
COUNTRY CODE AREA CODE NUMBER

Office hours ( ) ( )
Credit card number
: : : : : : : : : : : : : : : : : :
Mobile/cell
MONTH YEAR

Expiry date : :
30 Is the person an agent registered with the Office of the Migration Agents
Registration Authority (Office of the MARA)? Cardholder’s name
No
Yes Go to Question 33 Telephone (AREA CODE )
number
31 Is the person/agent in Australia? Address

No Go to Question 33
POSTCODE
Yes

Signature of
32 Did you pay the person/agent and/or give a gift for this assistance? cardholder
No
Yes Credit card information will be used for charge paying purposes only.

Options for receiving written

communications
33 All written communications about this application should be sent to:
(Tick one box only)
Myself

OR
Authorised You should complete form 956A Appointment
recipient
or withdrawal of an authorised recipient
OR
Migration agent Your migration agent/exempt person should
complete form 956 Advice by a migration
OR agent/exempt person of providing
Exempt person immigration assistance

© COMMONWEALTH OF AUSTRALIA, 2011 601 (Design date 11/11) - Page 9

 Declaration Office use only
WARNING: Giving false or misleading information is a serious offence. If the visa has been issued manually, please complete the following
and forward a copy of this form to:
35 I declare that: Data maintenance and Reporting Section, National Office Canberra
• the information I have given on this form is complete and correct.
Facsimile of visa stamp
• I have not and will not work unless authorised.
• I have enough funds to meet all costs during my visit to Australia, and
for travel out of Australia.
• I have never been convicted of a crime or any offence in any country;
I have not been charged with any offence that is awaiting legal action;
I do not have an outstanding debt to the Australian government or
any public authority in Australia; otherwise I attach details.
Having read the ‘Conditions for a tourist visa in Australia’ on page 3 of
this form: Signature of issuing
officer
• I understand that the effect of the 8503 visa condition is that it will
not be possible for me to apply to remain in Australia beyond the
authorised period of stay of my visa. I agree to having this condition Office file number
included on any visa issued to me as a result of this application.
• I acknowledge that I understand that if the 8503 visa condition is Decision (0 = not approved, 1 = approved)
imposed on my visa, it will be indicated in documents given to me by
the Department of Immigration and Citizenship about the grant of my Expiry date
visa, by the condition code ‘8503’ and by the short description ‘No
Further Stay’. I acknowledge that this means that the 8503 condition Conditions/class
has been imposed on my visa, that I am required to depart Australia
before the end of the period of stay authorised by my visa and that I Date of issue
understand the restriction that condition 8503 places on me.
• I declare that the information as set down in this form is true and Visa number
correct and has been included with my full knowledge, consent and
understanding, including those parts that have been completed with Name
the assistance of another person.
Date

Your signature
Interviewed? No Yes

DAY MONTH YEAR Charge paid? No Yes

Date
Approved Not approved

We strongly advise that you keep a copy of your application Comments

and all attachments for your records.

Name

Signature of
authorised
officer

Date

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