Application for a Temporary Form

Business (Long Stay) visa

(Subclass 457)
1066

Important Charges and method of payment

You can also lodge this application on the Department You will be required to pay the prescribed charge when you
of Immigration and Multicultural and Indigenous Affairs lodge this application. See form 990i Charges for current fees
(the department) website and charges.
www.immi.gov.au/e_visa/business.htm
Payment must accompany your application and is generally not
Before completing this form you should read the refunded if the application is unsuccessful. To make a payment
detailed information in the department’s booklet 1154 in Australia, please pay by credit card, debit card or by bank
Sponsoring a temporary overseas employee to cheque or money order made payable to the Department of
Australia. All booklets and forms can be found on the Immigration and Multicultural and Indigenous Affairs. Please
department’s website do not pay by cash or personal cheque.
www.immi.gov.au/allforms/index.htm
If you are applying outside Australia, before you make your
Medical doctors completing this form can find detailed payment, please contact the nearest Australian mission overseas
information about the entry requirements at to find out what methods of payment can be accepted at that
www.immi.gov.au/doctors/index.htm office.
You should also read the following instructions carefully.
Please ensure that all questions on this form are
Who can be included in this application?
answered and any requested information attached. The At no extra charge, you can include in this application form
department may decide your application on the basis of your spouse and any dependants who will accompany you to,
the information provided in your application form. or remain with you in Australia. Dependants include children
under 18 years of age AND children and other relatives 18 or
This form should only be used by persons seeking to work in
over who are wholly or substantially reliant on you for financial
Australia on a long-stay temporary basis (ie. up to 4 years) as
support for their basic needs. Persons 18 or over must also
a temporary business entrant.
show that they have been reliant on you for a substantial period
and that they are more reliant on you than on any other person
Who should use this form? or source. A person may also be considered dependent on you
Use this form if you: if they rely on you for financial support because of a disability.
• have been sponsored to work in Australia and you have been
advised by your sponsor to apply for your visa; Residential address
• will be working in Australia under a Labour Agreement (LA) You must provide the address of where you intend to live during
and you have been advised by your sponsor to apply for the period that your application is being considered. Failure to
your visa; give your residential address may result in this application being
• will be working in Australia on the basis of a transfer within invalid. A post office box address will not be accepted as your
your company; residential address.
• will be working in Australia under a Regional Headquarters
agreement (RHQ) or an Invest Australia Supported Skills Let the department know if you change your address
agreement (IASS); If you change your residential address for more than 14 days
• have established a business in Australia as the holder of an while your application is being processed, you must tell the
independent executive visa and you are applying for a second department your new address and how long you will be there.
independent executive visa; The department will send communication about your
• will be a representative of a supplier of services located application to the latest address for correspondence you have
outside Australia; provided.
• are a person recommended for entry by the Australian Communication about your application can be sent to another
Minister for Foreign Affairs; or person that you have authorised, but you will be taken to have
• are a family member of a person currently holding a received the communication that the department sends to that
Temporary Business (Long Stay) visa in Australia and you are person. The department must be informed (in writing) of any
applying to join them as their dependant. address change for either you or your authorised person.

Medical and x-ray examinations

Please enquire about health checking procedures and forms at
the office where you intend to lodge this application. If
examinations are required, you will need to submit 2 additional
passport-sized photographs for attachment to the health
examination form.

Continued on the next page

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 1

 How to apply Your application can be lodged personally or by your
representative, or sent by mail.
Step 1 If you want to change any details after you lodge your application,
To make a valid application for a Temporary Business (Long or if you want to withdraw it, please contact the office where
Stay) visa (Subclass 457), you must lodge your visa application you lodged your application.
at the same time as, or after the sponsorship application is You should also advise that office if any of the information you
lodged. If the sponsorship and nomination have been approved, gave in your application changes while your application is being
your sponsor will provide you with a copy of the sponsorship considered.
and nomination approval letter and other documents needed
to assist in deciding your visa application. What happens then?
Note: The sponsor at the time you lodge your visa application Your application will be considered and you may be asked to
must be the same sponsor at the time of visa grant. provide additional information to enable a decision to be made.
To make a valid application for a Temporary Business (Long You will be advised in writing whether your application has
Stay) visa (Subclass 457), in relation to a Labour Agreement been approved or not.
(LA), Regional Headquarters agreement (RHQ) or Invest
Australia Supported Skills agreement (IASS), then the If your application is refused, you will be given a reason for the
agreement must already be in place. Your employer will provide decision as well as information about your review rights.
you with details of the agreement approval.
Applications made by people who are in Australia
Step 2 If you are applying for a visa in Australia this form also serves as
Make sure you and your accompanying family members have an application for any class of bridging visa (classes A, C or E)
passports which are valid. for which you may be able to apply. A bridging visa is granted
If you are already in Australia, and are eligible to apply in to ensure visa applicants retain the legal authority to remain in
Australia, check the expiry date of your current visa. If you can Australia pending a decision on their application, even after the
apply whilst in Australia, you should lodge your visa application visa they held prior to applying has expired.
before your current visa expires. If you need to travel overseas temporarily before the application
Note: If you already have a visa for travel to Australia and you is decided, you should contact the processing office to enquire
are granted another visa, the first visa will cease. if you are eligible for a Bridging visa B to enable you to return
to Australia.
Step 3 If you are seeking to change the work conditions of your existing
Complete the application form. visa before the application is decided, you should apply on
form 1005 Application for a bridging visa.
Please either type or use a pen, and write neatly in English using
BLOCK LETTERS.
Intra-company transfers
If you need more space to answer questions or wish to provide
Streamlined processing arrangements are in place to assist
additional relevant information, attach a signed and dated sheet
executives, managers and specialists on intra-company transfer
giving the details.
(ie. employees of an international business transferred to
Any alterations made before you lodge the form must be Australia to work in the business’ branch or subsidiary). These
initialled and dated. arrangements also assist intra-company transfers between Asia
Pacific Economic Co-operation (APEC) economies [APEC
Step 4 economies are: Australia, Brunei Darrussalam, Canada, Chile,
Where should you lodge your application? China, Hong Kong (China), Indonesia, Japan, Korea, Malaysia,
If you: Mexico, New Zealand, Papua New Guinea, Peru, the Philippines,
Russia, Singapore, Chinese Taipei, Thailand, the United States
• are being sponsored by an Australian business (including of America, and Vietnam].
under an LA, an RHQ or an IASS), you should lodge your
application form, fee and any attachments (including certified Visa condition – 8107
copies of passports), online on the department’s website
www.immi.gov.au/e_visa/business.htm or in Australia at If your visa application is approved, it will be subject to visa
the same office of the department at which your employer’s condition 8107. This requires that a holder of a Temporary
sponsorship and/or nomination applications were lodged; Business (Long Stay) visa (Subclass 457), sponsored to work in
Australia, must not:
• are sponsored by a business that is based outside of Australia,
you should lodge your visa application at an Australian mission • cease to be employed by the employer who sponsored them
overseas and you must be outside of Australia when you lodge (ie. become unemployed or change employer); or
your application; • work in a position or occupation inconsistent with the
• have established a business in Australia as the holder of an nominated position or occupation for this visa subclass; or
independent executive visa and you are applying for a second • work for another person or for themselves while working for
independent executive visa, you should lodge your the sponsoring employer.
application at any of the department’s offices in Australia; If a visa holder wishes to change employer, a new visa
• are applying under service seller arrangements or you are a application is required, together with an approved sponsorship
person recommended for entry by the Australian Minister for and nomination, to allow full consideration against the visa
Foreign Affairs, and you are currently in Australia, you should regulations.
lodge your application at any of the department’s offices in
Australia. If you are currently outside Australia, you should
lodge your application at an Australian mission overseas.

1066 (Design date 07/05a) - Page 2 © COMMONWEALTH OF AUSTRALIA, 2005

Sponsorship undertakings Before claiming an exemption from the Medicare levy in your
income tax return to the Australian Taxation Office, you need
The business employing you in Australia must meet a number
to apply to the Levy Exemption Certification Unit of the Health
of sponsorship undertakings in relation to you and your
Insurance Commission (HIC) for certification that you
accompanying family members, eg. sponsors must comply with
(including any dependants) were not entitled to Medicare
Australian industrial relations laws, Australian levels of
benefits for a particular period. If your application is successful,
remuneration and conditions of employment. These
the letter advising of certification should be submitted in
undertakings are detailed on form 1196 Sponsoring temporary
support of a claim for exemption from the Medicare levy in
overseas employees to Australia. Failure by the business
your income tax return. Such certification is done on an
employing you in Australia to meet its sponsorship obligations
individual basis and must be done retrospectively, ie. you can
may result in: barring the business from sponsoring or
only apply after the end of financial year for certification of any
nominating further sponsored employees for a specified period
period in the financial year just finished.
of time; cancellation of the business’ sponsorship status; and/or
cancellation of your visa, and the visas of any of your family If you are not sure about your entitlement to Medicare benefits,
members. you should check with the Medicare Levy Exemption
Certification Unit of the HIC on telephone number
Further information, including a list of your employer’s
1300 300 271 (for the cost of a local call within Australia). The
sponsorship undertakings, is available in form 1196 Sponsoring
application form for Medicare levy exemption certification and
temporary overseas employees to Australia which is available
further information about procedures can also be obtained by
from the department’s website
phoning this number, or from the internet
www.immi.gov.au/allforms/index.htm
www.hic.gov.au/yourhealth/forms/mf.htm (select the ‘Medicare
Levy Exemption Certification form’ link to download the
Certified regional employment document in Adobe Acrobat format), or by writing to:
If your visa is granted on the basis of a nomination approved
Levy Exemption Certification Unit
under regional sponsored temporary entry arrangements, your
Health Insurance Commission
visa may be cancelled if you are found to be working and/or
GPO Box 9822
living in a non-regional location. These locations are specified
HOBART TAS 7001
in a Gazette Notice, made under the Migration Regulations.
The Gazette Notice is available from the department’s website
About the information you give in this form
www.immi.gov.au/legislation/gazettals/index.htm
The department is authorised to collect information provided
Medical coverage on this form under Part 2 of the Migration Act 1958 ‘Control of
Arrival and Presence of Non-Citizens’. Information provided will
You should discuss health insurance arrangements with your
be used for assessing your visa application, and for other
sponsor as temporary business entrants are generally not
purposes relating to the administration of the Migration Act.
entitled to access Australia’s national health insurance scheme.
Information about your health, including the results of any tests
Medicare Levy Exemption for Human Immunodeficiency Virus (HIV), will be used to
assess your health for an Australian visa. A positive HIV or other
The Medicare Levy is a tax paid through the personal tax system.
test result will not necessarily lead to a visa being denied. Your
The Income Tax Assessment Act 1936 imposes a Medicare levy
result(s) may be disclosed to the relevant Commonwealth, State
on individuals who are considered to be Australian residents
and Territory health agencies.
under the taxation laws. People granted temporary residence
visas by the department are often considered to be Australian Form 1163i Health requirement for temporary entry to
residents under the taxation laws and may be subject to the Australia provides additional information on Australia’s visa
Medicare Levy. The Medicare Levy is based on the taxable health requirements. This form is available at the department’s
income of the individual for each income tax year. offices or via the internet
www.immi.gov.au/allforms/index.htm
Temporary residents who have not been entitled to Medicare
benefits (or Medicare benefits under reciprocal health care The department may disclose information you provide to other
agreements) and have no dependants who are entitled to such government departments or agencies to assist in assessing the
benefits can seek an exemption from the Medicare levy in their application or to ensure Australian laws are complied with.
income tax return at the end of each financial year, provided The information provided might also be disclosed to agencies
their lack of entitlement to Medicare benefits has been certified who are authorised to receive information relating to adoption,
by the Minister for Health. border control, business skills, citizenship, education, health
Temporary residents from countries with which Australia has assessment, health insurance, health services, law enforcement,
reciprocal health care arrangements are eligible for Medicare payment of pensions and benefits, taxation, review of decisions
assistance for immediately necessary treatment. Nationals from and regulation of migration agents.
most of these countries are therefore not exempt from the The department has authority under the Migration Act 1958 to
Medicare levy (applicants for parent visas, New Zealand collect a range of personal identifiers from non-citizens,
residents not residing in Australia and people from Ireland may including visa applicants, in certain circumstances. For more
be able to obtain exemptions via certification). detailed information you should read information form 1243i
Your personal identifying information, which is available from
the department’s website www.immi.gov.au
The collection, access, storage, use and disclosure by the
department of the information you provide in this form is
governed by the Privacy Act 1988 and, in particular, by the
11 Information Privacy Principles. The information form 993i
Safeguarding your personal information, available from the
department’s offices, gives details of agencies to which your
personal information might be disclosed.
Continued on the next page

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 3

 Disclosure of information to your business sponsor If you change your migration agent or end his/her appointment,
after you have lodged this application, you must promptly
Information may be disclosed to your current or former
advise the department in writing, preferably by using form 956
approved sponsor, in the following circumstances:
Appointment of migration agent, which is available on the
• to allow your sponsor to respond to a claim which may lead department’s website or from your migration agent.
to cancellation or barring their approval as a sponsor;
The department will communicate with your agent about your
• to allow your sponsor to meet a liability relating to their application, including your personal information such as health,
sponsorship; and police checks, financial viability and personal relationships. If
• in connection with applications for review of certain decisions. your agent authorises it see Part J, this communication may
Information that may be provided includes: take place by e-mail or fax.
• details of any breaches of your visa conditions; The department will only send your agent information which
• information as to whether you hold a Business (Long Stay) you are entitled to receive. For example, if you are a visa
visa and remain lawfully in Australia; applicant and have a sponsor, your agent will not receive
personal information about your sponsor, unless your sponsor
• information regarding your salary or workplace conditions;
has also appointed the same agent.
• details of any hospital or medical expenses you may have
incurred that the sponsor has to pay; and In some situations, department staff will need to speak with
you directly, rather than with your migration agent - for
• details of any costs to the Commonwealth you may have
example, if you are applying for a visa the department may
incurred.
interview you. In some situations, department staff will also
send documents to you directly (eg. passport) instead of to
Authorisation of a person to only receive written your agent, but it will inform your agent that it has done so.
communications
If you have appointed a migration agent to act for you, you are
You may authorise another person to only receive all written still responsible for the accuracy of information and supporting
communications about your visa application with the documentation that you give to your agent so that your agent
department. That person will be known as your authorised can provide it to the department.
recipient. To do this, you will need to complete Part F Options
for receiving written communications and Part G Authorised When you provide the details of your migration agent, please
recipient details in this form. The authorised recipient will need make sure you include their 7-digit:
to sign at Part H. You can only appoint one authorised recipient • migration agent registration number (if they are a registered
at any time. The department will communicate with the most migration agent); or
recently appointed authorised recipient. • offshore agent ID number (if they have been allocated one
The department is required under section 494D of the by the department).
Migration Act 1958 (the Act) to send your authorised recipient Note: Agents who operate overseas do not need to be
any written communications relating to your application that registered. They may however, have been allocated an ID
would otherwise have been sent to you. The department will number by the department.
only send your authorised recipient information which you are
entitled to receive. For example, if you are a visa applicant and Using a migration agent
have a sponsor, your authorised recipient will not receive
personal information about your sponsor, unless your sponsor You are not required to use a migration agent. However, if you
also appointed the same authorised recipient. use a migration agent, the department encourages you to use
a registered migration agent. Registered agents are bound by
If you decide to change your nominated authorised recipient, the Migration Agents Code of Conduct, which requires them to
after you have lodged this application, you must promptly act in the lawful best interests of their clients and act
advise the department in writing. You may use form 1231 professionally.
Appointment of authorised recipient for this purpose OR form
922 Notification of address or change of address for Business A list of registered migration agents is available from the
Skills visa holders, if you are a Business visa holder. Migration Agents Registration Authority (MARA) website:
www.themara.com.au
Authorisation of a migration agent to act on your behalf You can contact the MARA at:
If you have a migration agent acting on your behalf in relation E-mail: [email protected]
to your visa application, you need to complete Part F Options
PO Box Q1551
for receiving written communications and Part I Agent details.
QVB NSW 1230
The migration agent will need to sign at Part J.
AUSTRALIA
Appointing a migration agent to act on your behalf includes
Telephone: 61 2 9299 5446
authorising the department to:
Fax: 61 2 9299 8448
• discuss your visa application with the agent and seek further
information from them; and The MARA investigates complaints against registered agents and
may take disciplinary action against them. If you have a concern
• send your agent written communications about your visa
about a registered agent, you should contact the MARA. A copy
application that would otherwise have been sent to you.
of the complaint form is available from the MARA website.
Note: Your migration agent will be your authorised recipient
for written communication under section 494D of the Act and
you will be taken to have received any documents sent to them.

1066 (Design date 07/05a) - Page 4 © COMMONWEALTH OF AUSTRALIA, 2005

Restrictions on giving immigration assistance
In Australia, anyone (including a lawyer) who uses knowledge
of migration procedure to offer immigration assistance to a visa
or cancellation review applicant, sponsor or nominator, must
be registered, unless exempted from registration requirements
by law. There are serious criminal penalties under Part 3 of the
Act for breaching the law – including possible imprisonment if
the unregistered person asks for, or receives, a fee or reward
for their services.

Using an agent exempted from registration

Certain people, such as officials, parliamentarians, diplomats,
close family members (ie. only your spouse, child, adopted
child, parent, brother or sister), sponsors and nominators, are
able to provide you with immigration assistance as long as they
do not ask or receive a fee or reward. If you wish to appoint an
‘exempted agent’, you must complete form 956 Appointment
of migration agent and attach it to this application form.

Applications for multiple visas

If you are a dependant applicant (eg. the spouse of a primary
applicant) and you wish to appoint a different migration agent
to the primary applicant, you must fill out a separate form 956
Appointment of migration agent, or advise the department in
writing. Otherwise, the agent appointed by the principal
applicant will have the authority to act for all persons included
in the application.

Notification of giving immigration assistance

Under section 312A of the Act, a registered agent has a duty to
notify the department when lodging an application on behalf
of a client, or within 28 days of commencing to act on behalf of
a visa applicant. This notification can be done by completing,
and your agent signing, the relevant sections of this application
form.

Consent to communicate electronically

The department may use a range of means to communicate
with you. However, electronic means such as fax or e-mail will
only be used if you indicate your agreement to receiving
communication in this way.
To process your application the department may need to
communicate with you about sensitive information, for example,
health, police checks, financial viability and personal
relationships. Electronic communications, unless adequately
encrypted, are not secure and may be viewed by others or
interfered with. If you agree to the department communicating
with you by electronic means, the details you provide will only
be used by the department for the purpose for which you have
provided them, unless there is a legal obligation or necessity to
use them for another purpose, or you have consented to use
for another purpose. They will not be added to any mailing list.
The Commonwealth Government accepts no responsibility for
the security or integrity of any information sent to the
department over the internet or by other electronic means.
If you authorise another person to receive documents on your
behalf and they wish to be contacted electronically, their
signature is required on the form to indicate their consent to
this form of communication.
Home page www.immi.gov.au
DIMIA enquiry line Telephone 131 881 (24 hours a day, 7 days
a week). This number is available only in
Australia. If you are outside Australia, please
contact your nearest Australian mission.

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 5

This page is intentionally blank
 Application for a Temporary Form

Business (Long Stay) visa

(subclass 457)
1066
Please use a pen, and write neatly in English using BLOCK LETTERS.
Tick where required  PHOTOGRAPH

Please attach a recent

Details of the applicant passport photograph of
yourself
1 Your full name
AND
Family name
all family members
Given names included in this
application.

2 Have you been known by any other names? 9 Do you agree to the department communicating with you by fax, e-mail
(including name at birth, previous married names, aliases) or other electronic means?
No No
Yes Give details Yes Give details

Family name Fax number (AREA CODE )

Given names E-mail address

If you have been known by other names, Note: If this visa application is refused, you will be notified by mail
attach a page giving the names
10 Present country of citizenship
3 Sex Male Female

DAY MONTH YEAR

11 Do you hold any other citizenship?
4 Date of birth
No

5 Place of birth Yes Please provide country of citizenship

Town/city

Country

12 National identity number (if applicable)

6 Your current residential address
Note: A post office box address is not acceptable as a residential
address. Failure to give your residential address will result in this
application being invalid. Continued on the next page

POSTCODE

7 Address for correspondence

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

POSTCODE

8 Telephone numbers

Office hours (AREA CODE )

After hours (AREA CODE )

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 7

 13 Details from your passport Details of accompanying family members
Passport number 19 Give details of all family members who will accompany you to Australia
Country of or who are in Australia, who you wish to include as applicants for a
passport subclass 457 visa on this application form.
DAY MONTH YEAR
(If there are more than 6 family members, please copy the next page
Date of issue and attach it to this form with additional details)
Date of expiry 1. Family name
Issuing authority/
Place of issue as Given names
shown in your Have they been known by any other names?
passport (including name at birth, previous married names, aliases)

Please note that most visa applicants will be required to hold a valid No Yes Give details
passport before they can be granted a visa. It is strongly recommended Family name
that the passport be valid for at least 6 months.
If you change your passport after you have been granted the visa you Given names
must notify the nearest Australian mission or office of the department. If they have been known by other names,
If you do not provide us with the details of any new or additional attach a page giving the names
passport you use to travel to Australia, you will experience Sex Male Female
significant delays at the airport and could be denied permission DAY MONTH YEAR

to board your plane. Date of birth

Relationship to
14 Marital status Never married Divorced the applicant
Married Separated Citizenship
De facto Widowed Details from passport
Engaged to be married Passport number

15 If the sponsorship and nomination applications have been lodged Country of

passport
or approved, indicate the Nomination Permission Request Identifier DAY MONTH YEAR
or the nomination approval number Date of issue

Date of expiry

16 If the sponsorship or nomination application is refused or withdrawn, do Issuing authority/

you wish to withdraw your visa application? Place of issue as
shown in passport
No Note: If you do not withdraw your application, a decision
will be made on the application.
Now go to Question 18

Yes Note: If you withdraw your application, the case will be

considered closed and you will forego any review rights to
which you might have been entitled.

17 If you answered ‘Yes’ to Question 16 and you have paid the visa
application charge do you wish to seek a refund of it?
No
Yes Note: If someone paid the visa application charge on your
behalf that person must make the request for a refund. If
that person dies or becomes bankrupt, a new written request
for refund must be made by their legal personal
representative or a trustee of the estate respectively.

18 If you are applying on the basis of being a family member of another

person (the primary applicant), what is that person’s name?

Family name

Given names

Sex Male Female

1066 (Design date 07/05a) - Page 8 © COMMONWEALTH OF AUSTRALIA, 2005

2. Family name 4. Family name

Given names Given names

Have they been known by any other names? Have they been known by any other names?
(including name at birth, previous married names, aliases) (including name at birth, previous married names, aliases)
No Yes Give details No Yes Give details

Family name Family name

Given names Given names

If they have been known by other names, If they have been known by other names,
attach a page giving the names attach a page giving the names
Sex Male Female Sex Male Female
DAY MONTH YEAR DAY MONTH YEAR

Date of birth Date of birth

Relationship to Relationship to
the applicant the applicant
Citizenship Citizenship

Details from passport Details from passport

Passport number Passport number
Country of Country of
passport passport
DAY MONTH YEAR DAY MONTH YEAR

Date of issue Date of issue

Date of expiry Date of expiry

Issuing authority/ Issuing authority/
Place of issue as Place of issue as
shown in passport shown in passport

3. Family name 5. Family name

Given names Given names

Have they been known by any other names? Have they been known by any other names?
(including name at birth, previous married names, aliases) (including name at birth, previous married names, aliases)
No Yes Give details No Yes Give details

Family name Family name

Given names Given names

If they have been known by other names, If they have been known by other names,
attach a page giving the names attach a page giving the names
Sex Male Female Sex Male Female
DAY MONTH YEAR DAY MONTH YEAR

Date of birth Date of birth

Relationship to Relationship to
the applicant the applicant
Citizenship Citizenship

Details from passport Details from passport

Passport number Passport number
Country of Country of
passport passport
DAY MONTH YEAR DAY MONTH YEAR

Date of issue Date of issue

Date of expiry Date of expiry

Issuing authority/ Issuing authority/
Place of issue as Place of issue as
shown in passport shown in passport

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 9

 6. Family name
Health and character
Given names 21 In the last 5 years, have you, or has any family member included in this
application, visited or lived outside your country of usual residence for
Have they been known by any other names? more than 3 consecutive months?
(including name at birth, previous married names, aliases)
No
No Yes Give details
Yes Give details
Family name
Name
Given names
Countries
If they have been known by other names,
DAY MONTH YEAR DAY MONTH YEAR
attach a page giving the names
From to
Sex Male Female
DAY MONTH YEAR

Date of birth Name

Relationship to Countries
the applicant
DAY MONTH YEAR DAY MONTH YEAR
Citizenship
From to
Details from passport
Passport number 22 Do you, or any family member included in this application:
Country of • intend to be in a classroom situation for more
passport than 3 months, as either a student, teacher,
DAY MONTH YEAR
lecturer, or observer etc? No Yes
Date of issue
• intend entering an Australian hospital
Date of expiry (including nursing homes) for work, training,
treatment or visiting? No Yes
Issuing authority/
Place of issue as • intend to work in or attend an Australian
shown in passport preschool-aged child care centre (including
preschools and creches) as an employee, No Yes
trainee or student?
20 Please provide evidence of marriage certificate, birth certificate or other • require assistance with mobility and/or care? No Yes
evidence if de facto spouse. • intend performing medical procedures
If any dependants were not included in the nomination application made (eg. as a practising/trainee doctor, dentist, No Yes
by your employer, you should attach written confirmation from your nurse etc.)?
employer that they will meet the sponsorship undertakings in relation If you answered ‘Yes’ to any of the above questions, you must state who
to those dependants. it applies to and give all the relevant details.

1066 (Design date 07/05a) - Page 10 © COMMONWEALTH OF AUSTRALIA, 2005

23 Have you, or any family member included in this application: 25 Have you, or any family member included in this application, ever:
• ever had, or currently have, tuberculosis? • been convicted of a crime or offence in any
• been in close contact with a person who has, or has had, active country (including any conviction which is
tuberculosis? now removed from official records)? No Yes
• ever had a chest x-ray which showed an abnormality? • been charged with any offence that is
currently awaiting legal action? No Yes
No
• been acquitted of any criminal offence or
Yes Give full details other offence on the grounds of mental
illness, insanity or unsoundness of mind? No Yes
• been removed or deported from any
country (including Australia)? No Yes

• left any country to avoid being removed or

deported? No Yes

• been excluded from or asked to leave any

country (including Australia)? No Yes

• committed, or been involved in the

commission of war crimes or crimes
against humanity or human rights? No Yes

• been involved in any activities that would

represent a risk to Australian national
security? No Yes

• had any outstanding debts to the Australian

24 During your proposed stay in Australia, do you, or any family member Government or any public authority in
included in this application, have, or expect to incur medical costs, or Australia? No Yes
require treatment or medical follow up for: • been involved in any activity, or been
• blood disorder • mental illness convicted of any offence, relating to the
• cancer • pregnancy illegal movement of people to any country
• heart disease • respiratory disease that has (including Australia)? No Yes
• hepatitis B required hospital admission
• HIV infection, including AIDS • any form of surgery • served in a military force or state
• kidney disease, including dialysis • any other health concerns sponsored/private militia, undergone any
• liver disease military/paramilitary training, or been
trained in weapons/explosives use
No (however described)? No Yes

Yes Give full details If you answered ‘Yes’ to any of the above questions, you must give ALL
relevant details. If the matter relates to a criminal conviction, please give
the nature of the offence, full details of sentence and dates of any period
of imprisonment or other detention.

You are strongly advised to carry certification of your vaccination status,

especially for children attending Australian schools and/or child care
centres (including preschools and creches). Vaccination against polio,
tetanus, measles, mumps, rubella, diphtheria, pertussis (whooping
cough), haemophilus influenzae hypo B (Hib), and hepatitis B is
recommended for children. Certification may be sought at time of child
care centre (including preschool and creche) and school enrolment.
Vaccination against rubella is also recommended for women of child
bearing age.

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 11

 Details of the visa 32 Have you ever had an Australian visa refused or cancelled?
26 Proposed period of stay in Australia No
DAY MONTH YEAR DAY MONTH YEAR Yes Give details
From To

DAY MONTH YEAR

27 When do you require your visa?

28 Do you currently hold an Australian visa?

No
Yes Give details

Visa V <
number
Class of visa

Place of issue
DAY MONTH YEAR

Date of expiry
If granted a visa without a label, please provide the visa approval number,
or 13-digit grant number, as shown on the letter notifying you of the
grant of the visa

29 Are you, or any family member included in this application:

• a home government sponsored student?
No Yes

• an AusAID subsidised student or AusAID recipient?

No Yes You must provide a letter of support from
AusAID for the grant of a subclass 457 visa

30 Before this application, have you ever applied for an Australian visa?
No Go to Question 34
Yes Give details of your most recent application
DAY MONTH YEAR

Date of application

Place of application

Class of visa applied for

Was the visa or the application: Granted Refused

Withdrawn Pending

31 Have you ever held a bridging visa E?

No
Yes Give details

Place of issue
DAY MONTH YEAR

Date of issue

Date of expiry

1066 (Design date 07/05a) - Page 12 © COMMONWEALTH OF AUSTRALIA, 2005

33 How are you applying for a visa to enter or remain in Australia?
As a person sponsored by an Australian business Complete Part A and E before
(including Regional Headquarters Agreement (RHQ) signing the Declaration at Part F
or Labour Agreement (LA)) or a person sponsored
by a business outside Australia

As a person sponsored by an Australian Complete Part A and E before

business as an intra-company transfer signing the Declaration at Part F

As the holder of an independent executive visa who Complete Part B and E before
has an established business in Australia signing the Declaration at Part F

As a representative of a supplier of services Complete Part C and E before

located outside Australia signing the Declaration at Part F

As a person accorded certain privileges and Complete Part D and E before

immunities under the International Organisations signing the Declaration at Part F
(Privileges and Immunities) Act 1963 or the Overseas
Missions (Privileges and Immunities) Act 1995

Part A
Note: Only complete this part if you are applying for a visa to enter 35 How are you entering Australia?
Australia after being sponsored by an Australian business (including a
Labour Agreement (LA), Regional Headquarters Agreement (RHQ) or an As a person sponsored by an Australian or overseas business
Invest Australia Supported Skills Agreement (IASS)) or sponsored by a Please attach a copy of the nomination approval letter and other
business outside Australia. documents provided by your sponsor then go to Question 38

34 Details of your sponsoring employer As a person sponsored as an intra-company transfer

Business name Please attach a copy of the nomination approval letter and other
documents provided by your sponsor then go to Question 37

Under a Labour Agreement (LA)

Postal address Labour Agreement name and number

POSTCODE

Please attach a copy of the nomination approval letter to this

application, then complete Questions 38, 39 and 40, then go
to Part E

Under a Regional Headquarters Agreement (RHQ) or an Invest

Australia Supported Skills Agreement (IASS)
RHQ/IASS agreement name and number

Please attach a copy of the nomination approval letter to this

application, then go to Part E

Continued on the next page

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 13

 36 Are you transferring to Australia from a branch or subsidiary of the 39 Details of your employment over the past 3 years
business’ operations elsewhere in the APEC region?
(A list of APEC economies can be found on page 2 of this form.) 1. Employer

No Position

Yes Duration of
employment
Duties of
37 Details of your qualifications, training and skills relevant to your proposed position
activity in Australia
(If you need more space to answer, attach a signed and dated sheet 2. Employer
giving the required details)
Position
Educational qualifications including trade or professional qualifications
Duration of
employment
Duties of
position

3. Employer

Position
Training (including on-the-job training)
Duration of
employment
Duties of
position

You should attach to your application, evidence of any qualifications,

employment references, and a curriculum vitae
Other relevant skills
If you are entering Australia under a Labour Agreement (LA), or Regional
Headquarters Agreement (RHQ) or an Invest Australia Supported Skills
Agreement (IASS), go to Part E

40 Total Remuneration Package A$

(gross per annum)
Base Salary Component A$
(gross per annum)
38 Does your nominated position in Australia require Australian registration (Base salary must be the gross salary paid, excluding any additional
or licensing? payments or allowances such as superannuation, accommodation
allowances, bonuses, commissions, shares, meals, or vehicles. During
No monitoring of your sponsor, the department will be checking that the
Yes Please attach evidence from the relevant Australian base salary stated at this point is being paid to you.)
registration or licensing authority or other relevant evidence You should attach to your application an employment contract or offer of
that you would be eligible for this on arrival in Australia. employment setting out the salary arrangements.

41 If you are nominated by an overseas business to establish or assist to

establish a business activity in Australia, please attach the following
documents to this application.
(Keep a copy of the documents for your own records.)

A statement outlining:
• your previous business experience and expertise

• details of the business to be established including:

– the nature of the proposed business activity
– the name or proposed name of the business
– the proposed location
– local and expatriate employees to be involved
– the capital to be invested
– your proposed function in the business
– a broad outline of any research conducted and
by whom.

Now go to Part E

1066 (Design date 07/05a) - Page 14 © COMMONWEALTH OF AUSTRALIA, 2005

 Part B Your business in Australia
Note: Only complete this part if you are applying for a visa to remain in 43 Have you been involved in a business in Australia as a principal for
Australia as an independent executive. To assist you in lodging a complete 15 months?
application, document checklists are available at No You must provide endorsement from your State/Territory
www.immi.gov.au/migration/business/ government that your business is beneficial to that state.
more_info.htm#dococheck Yes
Details of State/Territory governments is at
www.immi.gov.au/migration/business/
sponsorship.htm
Additional dependants
42 Please list any family members not included in this application 44 Provide details of your business
Family name Note: If you are involved as a principal in more than one business, please
photocopy this page and provide the additional details of each additional
Given names business.
Sex Male Female Business name
DAY MONTH YEAR

Date of birth
Address of business premises
Country of birth

Citizenship
POSTCODE

Family name COUNTRY CODE AREA CODE NUMBER

Given names Telephone ( ) ( )

DAY MONTH YEAR

Sex Male Female Date you began your
DAY MONTH YEAR ownership of the business
Date of birth Your type of ownership/interest in the business
Country of birth Sole proprietorship Partnership

Citizenship Public company Business Trust

Proprietary company

Family name Other

Given names What was/is your % interest in the business for the 15 months prior to
this application?
Sex Male Female Year Year
DAY MONTH YEAR

Date of birth % %

Country of birth What is the major activity of this business?

Citizenship

What is your position/title in the business?

Please attach a statement which outlines your major management

responsibilities and activities in this business over a period of 15 months
prior to this application.

Now go to Part E

Continued on the next page

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 15

 Part C Part E – Assistance with this form
Note: Only complete this part if you are applying for a visa to enter 47 Did you receive assistance in completing this form?
Australia as a representative of a supplier of services located outside No Go to Part F
Australia.
Yes Please give details of the person who assisted you
45 Please attach the following documents to this application. Title: Mr Mrs Miss Ms Other
(Keep a copy of the documents for your own records.)
Family name
An original letter of appointment from the company you
represent outlining the nature of your relationship with Given names
the company and your proposed activities in Australia.
Address
A statement outlining:
• your previous business experience and expertise;
and
POSTCODE
• the name(s) of businesses you propose contacting
in Australia. Telephone number or daytime contact
COUNTRY CODE AREA CODE NUMBER

Now go to Part E Office hours ( ) ( )

Mobile phone
Part D
48 Is your agent registered with the Migration Agents Registration
Note: Only complete this part if you are applying for a visa to enter Authority (MARA)?
Australia as a person accorded certain privileges and immunities under No
the International Organisations (Privileges and Immunities) Act 1963 or
the Overseas Missions (Privileges and Immunities) Act 1995. Yes Go to Part F

46 Please attach the following documents to this application. 49 Is your agent in Australia?
(Keep a copy of the documents for your own records.) No Go to Part F

An original letter from the Australian Minister for Yes

Foreign Affairs recommending the applicant should be
granted the visa. 50 Did you pay the person and/or give a gift for this assistance?
No
Yes How much did you pay?
A$ AND/OR
What kind of gift did you give? (eg. jewellery)

Value of gift (approximately)

A$

1066 (Design date 07/05a) - Page 16 © COMMONWEALTH OF AUSTRALIA, 2005

 Part F – Options for receiving written Part H – Authorised recipient consent
communications 54 As the authorised recipient named on this form, do you agree to the
department communicating with you by fax, e-mail or other electronic
51 All written communications about this application should be sent to: means?
(Tick one box only)
No
Myself All written communications will be sent to
the address for communications that you Yes Give details
have provided in this form. Go to Part K COUNTRY CODE AREA CODE NUMBER

Australian registered Fax number ( ) ( )

migration agent
E-mail address
OR Go to Part I
Offshore agent 55 I understand and accept that I am the person appointed by the
Agent exempted applicant to receive all written communications.
You must complete form 956 Appointment
from registration Signature of
of migration agent and attach it to this
application form. Go to Part K authorised
recipient
Authorised This is a person authorised to only receive
recipient DAY MONTH YEAR
written communications. All written
communications that would otherwise Date
have been sent to you in relation to this
application will be sent to that person. Now go to Part K

52 Do you want the authorised person to receive health and/or character

information about you, your spouse or your dependants, that may arise, Part I – Agent details
or be revealed, in the course of this application (for example, requests
for medical investigation, other health information about you, or the 56 Provide the details requested below about the agent who is
results of criminal history checks)? authorised to act on your behalf and to receive all written
communications about this application.
No 7 DIGITS

Yes Migration Agent Registration : : : : :

Number (MARN)
OR
Part G – Authorised recipient details Offshore Agent ID Number
7 DIGITS

Note: Do NOT complete this section if you are acting as a : : : : :

(if allocated by the department)
migration agent, go to Part I
Title: Mr Mrs Miss Ms Other
53 Provide details of the person who is authorised on your behalf to
receive all written communications about this application. Family name

Title: Mr Mrs Miss Ms Other Given names

Family name Business or

company name
Given names Postal address
Authorised recipient’s postal address

POSTCODE

POSTCODE
Telephone number or daytime contact
Telephone number or daytime contact COUNTRY CODE AREA CODE NUMBER

COUNTRY CODE AREA CODE NUMBER Office hours ( ) ( )

Office hours ( ) ( )
Mobile phone
Mobile phone
Continued on the next page

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 17

 Part J – Agent consent Part K – Declaration
57 As the agent named on this form, do you agree to the department Note: All applicants must complete this part.
communicating with you by fax, e-mail or other electronic means?
No 59 This declaration must be read and signed by the applicant and any family
members included in this application who are aged
Yes Give details 18 years or over
COUNTRY CODE AREA CODE NUMBER

Fax number ( ) ( )
• The information on this form is correct.
• I will abide by the conditions of the visa.
E-mail address
Signature
58 I understand and accept that I am the person appointed by the applicant of main
to receive all written communications and act as his/her agent. applicant
DAY MONTH YEAR
Signature of
agent Date

DAY MONTH YEAR Signatures of partner and dependants over the age of 18
Date
Signature

Name
DAY MONTH YEAR

Date

Signature

Name
DAY MONTH YEAR

Date

Signature

Name
DAY MONTH YEAR

Date

Signature

Name
DAY MONTH YEAR

Date

60 Declaration by custodial parent/guardian

Where the visa applicant is under 18 years of age, I am not aware of
any reason why the visa applicant should not travel to Australia (the
custody/access/guardianship rights of another person are not affected).

Signature of
custodial
parent/guardian
DAY MONTH YEAR

Date

1066 (Design date 07/05a) - Page 18 © COMMONWEALTH OF AUSTRALIA, 2005

Credit card details
If you wish to pay by credit card, please give details below.
Payment by (tick one box) Australian Dollars

MasterCard Visa
Bankcard Diners Club A$
American Express JCB

Credit card number

: : : : : : : : : : : : : : : : : :
MONTH YEAR

Expiry date : :
Cardholder’s name

COUNTRY CODE AREA CODE NUMBER

Telephone ( ) ( )

Address

POSTCODE

Signature of
cardholder

Credit card information will be used for charge paying purposes only.

© COMMONWEALTH OF AUSTRALIA, 2005 1066 (Design date 07/05a) - Page 19