Application for a New Zealand Citizen Family Relationship (subclass 461) visa

Part E – New Zealand citizen’s details

Provide details of the New Zealand citizen with whom you claim a family relationship for the purpose of this application

Family name Given names

Other names the New Zealand citizen is known by or has been known by (include name at birth, previous married names, aliases

Family name Given names

Reason for name change

Sex

Male
Female
Indeterminate / Intersex / Unspecified

Date of birth

Day

Month

Year

Place of birth Town/city

City State / Province / Region Country

Current citizenship

Current residential address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

(If the same as your residential address, write ‘AS ABOVE’)

Telephone number

New Zealand citizen’s passport number

Date of issue

Day

Month

Year

Date of expiry

Day

Month

Year

Issuing authority/place of issue as shown in passport

Part F – Your relationship with the New Zealand citizen

Is the New Zealand citizen your parent or step parent?

No
Yes

Relationship status

Married

Date of marriage

De facto

Date relationship began

Separated
Divorced
Widowed

Date of marriage

Note: You must provide evidence to demonstrate that your relationship is genuine and continuing (including a marriage certificate if you are married). See Booklet 1 Partner Migration, for information on what evidence may be provided.

2 If you are married or in a de facto relationship with the New Zealand citizen, have you lived separately or apart for any period of time?

Not applicable
No
Yes

Give details of the period of separation and the reasons

Part G – Health

Do you hold health insurance cover?

No
Yes

Type of health insurance cover

Name of health insurer

Period covered by health insurance

From

To

In the last 5 years, have you, or any other person included in this application, visited, or lived, outside your country of passport for more than 3 consecutive months?

No
Yes

List

Person’s name	Country visited/lived in	Date from	Date To

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 Australia?

No
Yes

Give details

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 in Australia?

No
Yes

Give details

Do you, or any other person included in this application, intend to work, or be a trainee, at a child care centre (including preschools and creches) while in Australia?

No
Yes

Give details

Have you, or any other person included in this application: • ever had, or currently have, tuberculosis? • been in close contact with a family member that has active tuberculosis? • ever had a chest x-ray which showed an abnormality?

No
Yes

Give details

During your proposed stay in Australia, do you, or any other person included in this application, expect to incur medical costs, or require treatment or medical follow up for: • blood disorder; • cancer; • heart disease; • hepatitis B or C and/or liver disease; • HIV infection, including AIDS; • kidney disease, including dialysis; • mental illness; • pregnancy; • respiratory disease that has required hospital admission or oxygen therapy; • other?

No
Yes

Give details

Do you, or any other person included in this application, require assistance with mobility or care due to a medical condition?

No
Yes

Give details

Have you, or any other person included in this application, underta

No
Yes

Give details (including HAP ID if available)

Part H – Character

Have you, or any of the secondary applicants included in this application, ever:

been charged with any offence that is currently awaiting legal action?

No
Yes

been convicted of an offence in any country (including any conviction which is now removed from official records)?

No
Yes

been charged or convicted of family or domestic violence offences or similar related offences?

No
Yes

been the subject of a domestic or family violence order, or any other order, of a tribunal or court or other similar authority, for the personal protection of another person?

No
Yes

been the subject of an arrest warrant or Interpol notice?

No
Yes

been found guilty of a sexually based offence involving a child (including where no conviction was recorded)?

No
Yes

been named on a sex offender register?

No
Yes

been acquitted of any offence on the grounds of unsoundness of mind or insanity?

No
Yes

been found by a court not fit to plead?

No
Yes

been directly or indirectly involved in, or associated with, activities which would represent a risk to national security in Australia or any other country?

No
Yes

been charged with, or indicted for: genocide, war crimes, crimes against humanity, torture, slavery, or any other crime that is otherwise of a serious international concern?

No
Yes

been associated with a person, group or organisation that has been/is involved in criminal conduct?

No
Yes

been associated with an organisation engaged in violence or engaged in acts of violence (including war, insurgency, freedom fighting, terrorism, protest) either overseas or in Australia?

No
Yes

served in a military force, police force, state sponsored/private militia or intelligence agency (including secret police)?

No
Yes

undergone any military/paramilitary training, been trained in weapons/explosives or in the manufacture of chemical/biological products?

No
Yes

been involved in people smuggling or people trafficking offences?

No
Yes

been removed, deported or excluded from any country (including Australia)?

No
Yes

overstayed a visa in any country (including Australia)?

No
Yes

had any outstanding debts to the Australian Government or any public authority in Australia?

No
Yes

If you answered ‘Yes’ to any question at Question 32, give details, including the date of the charge, the outcome and any penalty imposed. Also attach court documents (for example sentencing remarks or court transcripts). Where relevant, provide a copy of all declared orders (for example, any domestic or family violence orders, child protection orders, or orders that prohibit the applicant from having contact with another person for their personal protection). You are only requested to declare an order where the applicant is the respondent or subject of the order. You are not asked to declare an order where the applicant is the person requiring personal protection. (If you need more space to answer, attach a signed and dated sheet giving the required details)

Part I – Assistance with this form

Did you receive assistance in completing this form?

No
Yes

Title

Mr
Mrs
Miss
Ms

Other

Family name Given names

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone number or daytime contact

Office hours

Mobile/cell

Is the person an agent registered with the Office of the Migration Agents Registration Authority (Office of the MARA)?

No
Yes

Is the person/agent in Australia?

No
Yes

Did you pay the person/agent and/or give a gift for this assistance?

No
Yes

Part J – Options for receiving written communications

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

Myself

OR

Authorised recipient

You should complete form 956A Appointment or withdrawal of an authorised recipient

OR

Migration agent

OR

Exempt person

Your migration agent/exempt person should complete form 956 Advice by a registered migration agent/exempt person of providing immigration assistance

Part K – Payment details

IMPORTANT: You must refer to the Department’s website at https://immi.homeaffairs.gov.au/visas/getting-a-visa/fees-and-charges/current-visa-pricing/live to complete this part of your application. The website shows reference tables with the Visa Application Charges applicable to each visa subclass.

Visa subclass you are applying for

1.Base Application Charge

Write the amount shown on the reference table for your visa subclass

2.Non-internet Application Charge (if applicable)

Additional Applicant Charge aged 18 years or over at the time your application is lodged

Write the amount shown on the reference table for your visa subclass

Number of additional applicants aged 18 years or over

3. Total AUD

4.Additional Applicant Charge under 18 years of age at the time your application is lodged

Write the amount shown on the reference table for your visa subclass

Number of additional applicants under 18 years of age

4. Total AUD

5.Subsequent Temporary Application Charge (if applicable)

Write the amount shown on the reference table for your visa subclass

Number of applicants

5. Total AUD

{Write the amount shown on the reference table for your visa subclass AUD:204} * {Number of applicants:206}

Total (1) + (2) + (3) + (4) + (5)

You must pay the total amount or your visa application will not be valid. Note: A second instalment of the Visa Application Charge must also be paid before we can grant some visas.

Make your payment electronically through the ‘My Payments’ section of ImmiAccount. Sign into, or create, your ImmiAccount and select My Payments>Manage Payments>Pre-Pay Paper Service, at www.homeaffairs.gov.au/immiaccount Do not provide credit card details on this form. Make your credit card payment electronically through the ‘My Payments’ section of ImmiAccount. If you are outside Australia and cannot pay online in ImmiAccount check the Department’s website for alternative payment methods for your location www.homeaffairs.gov.au/locations

Payment receipt number from the ‘My Payments’ section of ImmiAccount

Attach a copy of your printed receipt

Max. file size: 256 MB.

Part L – Documentation to be attached to this application

This document checklist details the information and supporting documents (personal, health and character) required to assist with the lodgement of a complete application. You may also need to provide additional information and documentation after you have made your application, if the Department requires it, however, a decision on the visa application may be made solely on the information provided at the time of application. Original documents should NOT be provided unless requested. Please provide certified copies of original documentation. Documents not in English must be accompanied by accredited English translations.

Tick when completed

Forms, fees and charges

A completed form 147
Evidence the correct Visa Application Charge has been paid (if applicable).

Evidence of your relationship with the New Zealand citizen

Evidence of your relationship with the New Zealand citizen. This can include: • certified copies of birth certificates for each person claiming a relationship with the New Zealand citizen • marriage certificates • death certificates • adoption certificates • family status certificates or family books (if these documents are officially issued and maintained).
Evidence that the New Zealand citizen holds or is eligible for a Special Category visa. This can include: • certified copy of the New Zealand citizen’s birth certificate • New Zealand passport.
A family tree/diagram of your relationship to the New Zealand citizen.

Personal documents

Part M – Signatures

This declaration and consent must be signed by the main applicant and each accompanying person aged 16 years or over. If I am requested or required to provide my fingerprints and facial image: I consent to: • the collection of my fingerprints and facial image; and • if applicable, the collection of the fingerprints and facial image of each accompanying person under 16 years of age. I declare that: • I understand that my fingerprints and facial image and my biographical information (and those of each accompanying person under 16 years of age) held by the Department may be given to Australian law enforcement agencies to help identify me and each accompanying person, to help determine my eligibility and the eligibility of each accompanying person for grant of the visa applied for, and for law enforcement purposes. I consent to: • Australian law enforcement agencies disclosing my biometric, biographical and criminal record information (and that of each accompanying person under 16 years of age) to the Department for any of the purposes outlined above; and • the Department using the information obtained for the purposes of the Migration Act 1958 or the Australian Citizenship Act 2007.

Signature of primary applicant

Date

Day

Month

Year

Signatures of secondary applicants

Signature

Name

Signature

Name

Signature

Name

Signature

Name

Signature

Name

: Giving false or misleading information or documents is a serious offence. This declaration and consent must be signed by the main applicant and each accompanying person over 18. I declare that: • the information that has been provided on this form, and on any attachments to it, is complete, correct and up-to-date. • I acknowledge that I have read the notes at the front of this application. I am aware of the conditions that may apply and that I am required to abide by them. • any registration or licensing that is required before I can begin employment in Australia will be my responsibility. • I am aware that I must advise the Department immediately I am aware of a change in circumstances relating to any information I have provided in or with this application. • I understand that if condition 8501 is imposed on my visa, it will be indicated on the visa label or in documents given to me by the Department about the grant of my visa by the condition code ‘8501’. • I understand that if my visa is granted it may be subject to condition 8501. • 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. • I understand that if any fraudulent documents or false or misleading information has been provided with this application, or if I fail to satisfy the Minister of my identity, my application may be refused and I, and any other member of my family unit, may become unable to be granted a visa for specified periods of time. • if documents are found to be fraudulent or information to be incorrect after the grant of a visa, the visa may subsequently be cancelled. • I have read and understood that I am liable for the cost of any health related services that I receive while in Australia. This does not include costs otherwise covered, such as by health insurance, Medicare (if eligible), or treatment for certain community health risks such as tuberculosis.

I confirm that I have read, or had explained to me, information provided by the Australian Government on Australian society and values. I understand that Australian society values: • respect for the freedom and dignity of the individual; • freedom of religion (including the freedom not to follow a particular religion), freedom of speech, and freedom of association; • commitment to the rule of law, which means that all people are subject to the law and should obey it; • parliamentary democracy whereby our laws are determined by parliaments elected by the people, those laws being paramount and overriding any other inconsistent religious or secular ‘laws’; • equality of opportunity for all people, regardless of their gender, sexual orientation, age, disability, race, or national or ethnic origin; • a ‘fair go’ for all that embraces: – mutual respect; – tolerance; – compassion for those in need; – equality of opportunity for all; • the English language as the national language, and as an important unifying element of Australian society. I undertake to conduct myself in accordance with these values of Australian society during my stay in Australia and to obey the laws of Australia

Signature of primary applicant

Date

Day

Month

Year

Signatures of secondary applicants

Signature

Name

Signature

Name

Signature

Name

Signature

Name

Signature

Name

Office use only

Decision

Approved
Rejected

Reasons for refusal/comment

Subclass

Class

Entry

Single
Multiple

Conditions

Date of birth

validity

Length of stay

Signature of authorised officer

Date

Day

Month

Year

Email

Full Name	Sex	Date of birth	Country of birth	Citizenship(s)	Relationship to you	Other names they have been known by	Passport number	Country of issue	Date of issue	Date of expiry	Issuing authority/place of issue as shown in passport	Actions

There are no Entries.

Application for a New Zealand Citizen Family Relationship (subclass 461) visa

Application for a New Zealand Citizen Family Relationship (subclass 461) visa