1454 Request for approval to travel under condition 8570

Travel details
10 
Give details of ALL countries you intend to enter when you travel on this occasion (including transit countries)
Country
Address
Intended travel dates
Is this a country you or 
a member of your family 
unit claimed protection 
from?
Day Month Year
From
No
Yes
To
From
No
Yes
To
From
No
Yes
To
From
No
Yes
To
From
No
Yes
To
From
No
Yes
To
From
No
Yes
To
If insufficient space, attach additional details
11 
Date of intended departure from Australia
If you do not have a specific departure date, state the month and year.
Day
Month
Year
12 
Date of intended return to Australia 
If you do not have a specific return date, state the month and year.
Day
Month
Year

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1454 (Design date 11/22) - Page 7
© COMMONWEALTH OF AUSTRALIA, 2022
13 
Give details of reasons for your travel including whether you intend to 
enter a declared area as defined under section 119.3 of the 
Criminal 
Code Act 1995.
Attach additional documents to this form if necessary.
If insufficient space, attach additional details
14 
Give details of all persons you intend to visit in the country of intended 
travel
1. Family name 
Given names 
Date of birth 
Day
Month
Year
Nationality 
Relationship
to you
Address 
Postcode
Migration status of the person (above) in the country you intend to enter
2. Family name 
Given names 
Date of birth 
Day
Month
Year
Nationality 
Relationship
to you
Address 
Postcode
Migration status of the person (above) in the country you intend to enter
If insufficient space, attach additional details

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1454 (Design date 11/22) - Page 8
© COMMONWEALTH OF AUSTRALIA, 2022