Application for Bridging visa E – subclass 050 Application for Bridging visa E — subclass 050 Part A – Personal detailsYour full name Family name Given names Date of birth Day Month Year Are you currently in immigration detention? No Yes Are the other applicants included in this application (if any) also being held in immigration detention? No Yes Your current residential address in Australia Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Note: A post office box address is not acceptable as a residential address. Failure to provide your residential address will result in this application being invalid.Part B – Contact detailsAddress for correspondence (If the same as your residential address in Question 4, write ‘AS ABOVE’ Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country If any other applicants are included in this application (see Question 16), is this the address at which the Department may correspond with those other applicants? No Yes Your telephone numbersOffice hoursAfter hoursDo you, and the other applicants included in this application (if any), agree to the Department communicating with you by fax, email or other electronic means? No Yes Fax numberEmail address Part C – Details from your passportDetails from your passportPassport numberCountry of passportDate of issue Day Month Year Date of expiry Day Month Year Issuing authority/place of issue as shown in your passport Part D – Application detailsPlease select the section that is most appropriate to your circumstances: (Additional information may be provided at Question 15 to support your application.) Applicant for a substantive visa Ministerial intervention Judicial review Review of a decision to cancel a visa Making arrangements to depart Australia Applicant for a substantive visaAre you waiting for a decision from the Department or the tribunal on an application for a substantive visa? No Yes Do you intend to apply for a substantive visa (ie. a visa other than a bridging visa)? No Yes Ministerial interventionHave you requested the exercise of the Minister’s powers to intervene to substitute a more favourable decision for a decision of the Administrative Appeals Tribunal? No Yes Judicial reviewHave you commenced judicial proceedings (eg. in the Federal Court) in relation to a decision to refuse or cancel a substantive visa (ie. proceedings in relation to the refusal or cancellation of a visa other than a bridging visa)? No Yes Have those proceedings been completed or withdrawn? No Yes Are you a party to any other proceedings concerning your immigration status? No Yes Has a member of your family unit commenced judicial proceedings in relation to the refusal of an application for a substantive visa (ie. proceedings in relation to the refusal of a visa other than a bridging visa)? No Yes Have those proceedings been completed or withdrawn? No Yes Note: To be eligible for the grant of a bridging visa in association with such proceedings you must have made an application that was combined with the substantive visa application made by the member of your family unit. Review of a decision to cancel a visaDid you hold a visa that has been cancelled? No Yes Have you applied for, or are you applying for, revocation or review of a decision in relation to the cancellation of a visa? No Yes Did you hold a visa that was cancelled because of the cancellation of a visa held by another person? No Yes Has that other person applied for, or is that other person intending to apply for, review of the decision to cancel his or her visa? No Yes Are you making, or are you the subject of, arrangements to depart Australia? No Yes Date of intended departure Day Month Year Method of departure Intended destination What arrangements have been made for your departure? Hold a passport Hold a ticket Other Give details Give details Give details Do you currently have any matters before an Australian court or tribunal? No Yes Give details Are you seeking the waiver of a condition imposed on a previous visa, or a restriction, which currently prevents you from applying for a visa in Australia? No Yes Give details Have you been granted a bridging visa previously on the basis that you were making arrangements to depart Australia? No Yes Why did you not depart? Additional information Please provide any additional information that may be relevant to your application, including details of any outstanding visa application(s), merits review proceedings, judicial review proceedings, ministerial intervention requests and any other steps you are taking to resolve your immigration status. (If necessary, please attach additional pages.) Note: In order to satisfy the criteria for the grant of a Bridging visa E, an applicant must satisfy the Department that he or she will abide by any conditions to be imposed on the visa if granted and, if requested, lodge a security for compliance with those conditions. Part E – Additional applicantsGive details of members of your family who are seeking to satisfy the same criteria for the grant of a Bridging visa E (see Questions 10–14). (If any members of your family are seeking to satisfy different criteria for the grant of a Bridging visa E, they will need to complete a separate form 1008 Application for Bridging visa E – subclass 050.) Note: • A post office box address is not acceptable as a residential address. Failure to give a residential address will result in your application being invalid. • Unless otherwise advised in writing or on form 929 Change of address and/or passport details, the Department will communicate with the additional applicants in the same manner, and at the same address, as has been requested by the main applicant (see Questions 6, 8 and 21).ApplicantFamily nameGiven namesDate of birthCurrent residential address in Australia Part F – Assistance with this formDid 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 AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Telephone number or daytime contactOffice hoursMobile/cellIs the person/agent in Australia? No Yes s the person/agent in Australia? No Yes Did you pay the person/agent and/or give a gift for this assistance? No Yes Part G – Options for receiving written communicationsAll written communications about this application should be sent to: (Tick one box only) Myself Authorised recipient You should complete form 956A Appointment or withdrawal of an authorised recipient Migration agent Exempt person You should complete form 956A Appointment or withdrawal of an authorised recipientPart H – CharacterHave you, or any other person 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 a family or domestic violence offence or any similar related offence? 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 22, 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. Part I – DeclarationThe following declaration must be signed and dated by all applicants aged 18 or over included in this applicationWARNING: Giving false or misleading information is a serious offence. If a Bridging visa E is granted to me I understand that conditions may apply to the visa and that if I fail to abide by these conditions my visa may be cancelled and any security lodged for compliance with the conditions may be forfeited. I declare that: • the information supplied on 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. • I understand that if my visa ceases to be in effect and I do not hold another visa to remain in Australia at that time, I will be an unlawful non-citizen under the Migration Act 1958. As such, I will be expected to depart from Australia, and be subject to removal under the Migration Act 1958.SignatureDate Day Month Year SignatureDate Day Month Year SignatureDate Day Month Year SignatureDate Day Month Year SignatureDate Day Month Year Office use onlyForm 1211 may be completed as the decision record for this application. Form 1212 may be completed to advise applicant of conditions of grantIf the applicant is in detention, has a Detention Review Officer been informed of the application? No Yes Agent Email