Declaration Form Paying for

visa sponsorship
Note: You must print and sign this declaration, and attach as a supporting document to the
associated visa application. Electronic signatures will not be accepted.

I have read and understood Paying for visa sponsorship Declaration Requirement as provided
in the document checklist relevant to this application, that sets out section 245AS of the Migration Act
1958 (the Act) which prohibits offering to provide or providing a benefit in return for the occurrence
of a sponsorship-related event, and the definition of sponsorship related event in s 245AQ of that
Act.

I declare that I have engaged in conduct in relation to this application that constitutes a
contravention of subsection 245AS(1) of the Migration Act 1958.

I declare that I have not engaged in conduct in relation to this application that
constitutes a contravention of subsection 245AS(1) of the Migration Act 1958.

I declare that the declaration I have made, as the primary applicant for this application,
also extends to any person who is identified as a person that has made this combined
application with me.

Yes No Not Applicable (no dependents making a combined application)

Signed: ______________________________________________________________________________________

Full Name: _______________________________________________________________________________________

Date: _______________________________________________________________________________________

Additional Information

Nominator: ______________________________________________________________________________
(Name of nominating business)
Nomination TRN: ______________________________________________________________________________