1 Your full name
Family name
Given names
2 Other names you are, or have been, known by
(including name at birth, previous married names, aliases)
3 Date of birth
Day
Month
Year
4 Client ID (11 digit number on your visa grant notice)
5 Address for correspondence (in Australia)
Postcode
6 Your telephone numbers
Office hours
( Area code )
After hours
( Area code )
7 Do you agree to the Department communicating with you by email or
other electronic means?
No
Yes
Give details
Email address
8 Details from your travel document
Attach a copy of your travel document (if available). Travel document number
Country of travel document
Date of issue
Day
Month
Year
Date of expiry
Issuing authority/place of issue as shown in your travel document
Family members 9 Give details of ALL members of the family unit who wish to travel with you
(as shown in their travel document) Attach a copy of the travel document (if available) for each member of the family unit. 1. Family name
Given names
Other names family member is, or has been, known by
(including name at birth, previous married names, aliases)
Date of birth
Day
Month
Year
Travel document number
2. Family name
Given names
Other names family member is, or has been, known by
(including name at birth, previous married names, aliases)
Date of birth
Day
Month
Year
Travel document number
If insufficient space, attach additional details
