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Australian Passport Renewal Application

Visit the Departments website

www.smartraveller.gov.au

to view the latest travel advice

Passport website

www.passports.gov.au
Finda participating

AustraliaPost

retailoutlet
www.auspost.com.au

137 678
Protect your identity
Lost or stolen passports
cause inconvenience and
may be used by others
to assume your identity
for illegal activities.

Keep your passport

safe at all times.

APIS

Australian Passport
Information Service

131 232
www.passports.gov.au
If you have any questions
about this form or about
how to get anAustralian
passport, or if you wish
to comment about our
service, offer suggestions
for improvement, or register
a complaint, contact us by
phone, visit our website
orwrite tothis address:
Director
Passport Policy and
Operations Section
Department of Foreign
Affairs and Trade
R.G. Casey Building
John McEwen Crescent
BARTON ACT 0221
Online form PC7_0414

Only use this form if:

you are lodging this form before the date printed at the top of page 2 next to the arrow
you are able to present the passport with the number printed at the top of page 2
your current personal details are the same as those printed in section 2.

If you cannot use this form:

apply for a passport online at www.passports.gov.au, or
call the Australian Passport Information Service (APIS) on 131 232, or
collect an Application for Australian Passport: Adult form from a participating Australia Post retail outlet.

Fees: The current fee schedule is available on our website or you can call APIS. Methods of payment include
EFTPOS, MasterCard, Visa or cash. Cheques, AMEX and Diners are not accepted.

Processing times: Please allow for a turnaround time of three weeks. If you need your passport in a hurry,
askAPISabout our Priority Processing Service. An additional fee applies.

Lodgement: Lodge this form in person at a participating Australia Post retail outlet if you are in Australia.
Anappointment may be required. Ifrenewing overseas contact your nearest Australian diplomatic mission
orconsulate for advice.

Providing two identical photographs of yourself

Photographic requirements:

Width: 35mm40mm

Height: 45mm50mm

Before you travel

The chin to crown measurement

mustbe between 32mm and 36mm
(the crown is where the top of the
head/skull would be ifit was visible).

NOTE:

Due to security printing requirements,

images reproduced in passports
will not be of photographic quality
and will appear different from the
photographs supplied.

Youmust provide two identical colour

photographs that are not more than six
months old and meet Australian Passport
Photographic requirements. For full details
of our requirements visit our website,
or refer to our Photographic guidelines
brochure available from a participating
Australia Post retail outlet, or contact
APIS. Photographs that do not meet our
requirements will berejected and this
will delay the issue ofyourpassport.

Notice about the collection, use and disclosure of personal information

The Australian Passports Act 2005 authorises the Australian Passport Office of the Department of Foreign Affairs
and Trade to collect the personal information provided with this application for an Australian passport, including
supporting documents and photographs, to determine the applicants eligibility. Without this information we are
unable to process your application.
We may also collect personal information from third parties such as law enforcement or security agencies,
wherethosethird parties provide us with information which is relevant to this application for a passport.
We may disclose your personal information for the provision of consular services; and to other entities or
individualswho are specified in the Australian Passports Act 2005, such as:
the immigration department, civil registries and licencing authorities that can verify information and assist
toestablish your identity and eligibility
Interpol and its member countries and other countries with which we have an agreement for purposes such
as advising about the status of a passport; to law enforcement authorities; to Australian border authorities to
facilitateinternational travel; and to law courts for the operation of family law and related matters.
We are authorised by law to disclose your personal information to foreign border authorities:
if we suspect there is unlawful activity relating to the passport
for law enforcement purposes
in countries with which Australia participates in the Regional Movement Alert system.
We may also use your current and past information for testing, training and research purposes (phone APIS if you object).
For information on how to access or correct personal information and how to complain about a breach of privacy,
please refer to the Protecting your Privacy brochure available on our website, from a participating Australia Post
retailoutlet or by phoning APIS; or the Departments Privacy Policy available at www.dfat.gov.au.

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Department of Foreign Affairs and Trade

Australian Passport Renewal Application

Your Australian
passport number:

Lodge
this form
before

Use BLACKINK

05 DEC 2016

Use CROSSES in boxes

Your passport will be sent to the address shown below. If the address shown below is not
current, write the address beside the old one. This address must be a residential address, not a
business address or a PO Box.

L ETTE RS

Contact details and date of travel

Preferred contact number

0 8 9 4 3 8 2 1 2 3

JOHN HOOGLAND
4A KENT ST
BICTON WA 6157

Email address (must be written clearly in BLOCK LETTERS)

J H OOG 6 @GM A I L . C O
M
Date of travel

2 7

(dd/mm/yyyy)

0 7

2 0 1 6

Please check your personal detailsIf your current details differ from those printed below DO NOT use this form. Fields marked*will appear on your passport

Family name*

Given names*

HOOGLAND

JOHN JOHANAS

Town or city of birth*

Country of birth

ALLAMAR

NETHERLANDS

Date of birth* (dd/mm/yyyy)

06 NOV 1948

Family name on birth certificate

Given names on birth certificate

HOOGLAND

JOHN JOHANAS

Family name on Australian citizenship certificate

Given names on Australian citizenship certificate

HOOGLAND

JOHN

Type of passport required

Ordinary passport
(32 visa pages)

Frequent traveller passport (64

visa pages) A higher fee applies

Senior** passport
a lower fee applies

Sex*

Online form PC7_0414

and print within

B LOC K

the boxes in

05 DEC 2019

Please bring the passport with the number printed above when lodging this form.
Please complete sections1,3,4,and 5.

NOTE:

*778 39797888 P*

E3028750

Passport expiry date:

*778 39797888 P*

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Senior** frequent
traveller passport

** A senior passport is available to applicants 75 years of age or over and has 5 years validity.

4 Emergency contact detailsif there is someone we can contact in the event of an emergency, please give their details
Name of contact
Relationship to you
Address of contact

GABRIELE HOOGLAND

WIFE

4AKENT ST BICTON 6157

Daytime telephone number

Evening telephone number

( 04 ) 38135302

( 08 ) 94382123
PHOTOFACE UP

Applicants declarationcannot be more than six months old

WARNING

I understand that:
My photograph will be used for biometric
matching purposes (biometric matching
allows the passport photograph to be
electronically compared with other facial
images to confirm identity).

It is a criminal offence under the Australian

Passports Act 2005 to make false or
misleading statements (there are penalties
of up to 10 years imprisonment or a fine of
1000 penalty units or both). This Act applies
outside Australia to all persons, irrespective
of their nationality or citizenship.

PHOTOFACE DOWN

Applicant must
write full name
on back of one
photo

45mm

I declare that:

I am an Australian citizen
The statements that I have made and

theinformation that I have given in, or

inconnection with, this application are
trueandcorrect
I have read and understood the Notice about
the collection, use and disclosure of personal
information on page 1.

Signature of applicant

35mm
Date signed (dd/mm/yyyy)

OFFICE USE ONLY Use CROSSES in circles

Method of delivery
Registered Post
Passport Office

Typed details
altered
Priority fee paid
Prev. PPT
cancelled
Interviewed

Emergency passport

35mm

Office use only

OAO

Signature of interviewing officer

Work Centre Code

Interviewers declaration
I declare that: I have checked the passport number of the applicants
previous passport; the photo appearing therein and the attached
photo are of the applicant; I have/have not conducted an applicant
interview; I have/have not cancelled the applicants passport;
I understand it is an offence under the Australian Passports Act
2005 to make a false or misleading statement.

User ID
Date signed (dd/mm/yyyy)