Declaration 21 WARNING : Giving false or misleading information or documents is a
serious offence.
I declare that:
• the information I have supplied in this application is complete, correct
and up-to-date in every detail.
• I have read the information contained in form 1442i
Privacy notice. • I understand the Department may collect, use and disclose my
personal information (including biometric information and other
sensitive information) as outlined in form 1442i
Privacy notice. Your signature -
Date
Day
Month
Year
We strongly advise that you keep a copy of your request and
all attachments for your records.
