This form is used apply for Defence certification through the Afghan Locally Engaged Employee (LEE)

Program.

The Afghan LEE Program provides LEE certification for eligible Afghans who are at risk of harm as a
result of their employment with Australia in Afghanistan.

If you were employed in Afghanistan with the Australian Defence Force (ADF), and you want to apply
for certification under the Afghan LEE Program, please complete this form.

Once completed, this form will contain personal information including information which you may wish
to protect from third parties. Please take precautions when sending or receiving sensitive information
when connected to public Wi-Fi networks. Before submitting this form to Defence, visit the Australian
Cyber Security Centre to seek guidance on security precautions to take when connecting to the internet
and Wi-Fi.

Defence will assess your application against the certification criteria in the Public Guidelines
[https://www.defence.gov.au/sites/default/files/2023-05/lee-public-guidelines.pdf].

Certification under the Afghan LEE Program does not grant you a humanitarian visa and you must apply
separately for a humanitarian visa if you want to resettle in Australia. Applying for a humanitarian visa
is a separate application through the Department of Home Affairs (Home Affairs). Information about
humanitarian visas is provided at: Home Affairs - Resettle in Australia.

If you are certified as an Afghan LEE, Home Affairs will prioritise the processing of your
humanitarian visa application. 

If you are not certified under the Afghan LEE Program, Home Affairs will still process your
application for a humanitarian visa but Home Affairs will not prioritise the processing of your
application.

Instructions to applicant
 This form must be completed in English.
 At the end of this form there is a declaration which requires your signature.
 There is a Privacy Notice attached. If you want to consent to the Privacy Notice, please
complete and return the Privacy Notice. You do not have to consent to the Privacy Notice.
Consenting to the Privacy Notice may assist Defence to verify the employment information in
your application. Your application may be rejected if Defence is unable to verify that
information.
 If you are unable to print, sign and scan the declaration and/or Privacy Notice, Defence will
accept an electronic signature on either document. An electronic signature includes typing a
name in electronic format, or scanning and pasting a physical signature into an electronic
document, or your name appearing in the ‘from’ field in an email. Once completed, you may
submit this form to afghan.lee@defence.gov.au.

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Part A – Personal Details

Family Name:

All Given Names:

Former / Other Names (official):

Common or informal name (name ADF or other people may know you as):

_____________________________________________________________________

Sex: Date of Birth (dd/mm/yy):

Place of Birth: (Town/City) (Country)

Father’s Name:

Mother’s Name:

Marital Status: ____

Identity Card Number (Taskera):

Please provide a copy of your Identity Card (Taskera) with this form. Is it attached?

☐ Yes or ☐ No

Current Home Address:

(Street name and number) ____

(Town/City) (Province)

(Country)

How long have you lived there? ______

All current email addresses: _

_____________________________________________________________________

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Current telephone numbers:

(Mobile) (Home)

(Work)

Do you have a passport/travel document?

☐ Yes or ☐ No

If yes, please provide details:

Passport/travel document number:

Country issuing passport/travel document:

Date of issue: Date of expiry:

Place of issue:

Please provide a copy of your passport/travel document with this form. Is it attached?

☐ Yes or ☐ No

Are you currently a national or citizen of a country other than Afghanistan (including dual
citizenship)?
☐ Yes or ☐ No

If yes, which other country or countries are you a national or citizen of?

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PART B – Employment with the Australian Government

Have you been employed with an Australian government agency in Afghanistan?

☐ Yes or ☐ No

If yes, which Australian Government agency did you work with?

___________________ _

Which organisation directly employed you? (if applicable):

Work type or position you worked in:

Average number of hours you worked with the Australian Government per week:

Name of your supervisor or commanding officer:

Where did you work? ( Building site or military base):

(Town/City) (Province) _

Date you started employment (dd/mm/yy): _

Date you finished employment (dd/mm/yy):

Role / duties performed during your employment, including details of any direct
support you provided to the ADF:

_____________________________________________________________________
Do you have an ADF or other Australian Government referee who Defence can contact to
confirm your working relationship?

☐ Yes or ☐ No

If yes, please provide the name of your referee:

__________________________________________________

Referee contact details (if known): ________________________________________________

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Did you have a public profile in this role? Did you engage with the public or appear
regularly with the ADF while undertaking this role?

☐ Yes or ☐ No

If yes, provide details:

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Have you provided any documents with this form as evidence of your employment with an
Australian agency?

☐ Yes or ☐ No

If yes, please provide details: ____________________________________________________

______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Part C – Current risk of harm as a result of employment with the Australian

Government
Are you currently at risk of harm as a result of your employment with the Australian
Government in Afghanistan?
☐ Yes or ☐ No
If yes, please provide details _
___ ______
_____
_____
_____
_____
_____
_____
_____
_____

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 _____
Have you or any members of your family, ever been threatened with any form of
reprisal as a result of your employment with the Australian Government in Afghanistan?
☐ Yes or ☐ No
If yes, please provide details _____
_____
_____
_____
_____
_____
_____
_____

Part D – Other information

Have you applied for LEE certification before?

If you have applied before, this will not impact your new application. On 1 June 2023
the legislative instrument (IMMI 12/127), which Defence uses to assess applications,
was amended. This means some applicants who were previously assessed as ineligible
may now be eligible for certification. Knowing if you have previously applied will
assist Defence’s process for re-assessing previous applications that were in-eligible for
LEE certification.

Have you applied for LEE certification before?

☐ Yes or ☐ No

If yes, when did you apply? ____________________________________________

Please provide any additional information to support your application to the Afghan
LEE Program

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Please attach copies of evidence to support your application. This may include a letter
from your employer verifying the information you have provided, a copy of your
employment contract, and/or your work pass.

Part E – Declaration

WARNING: Giving false or misleading information is a serious offence.

I declare the information I have given in this form is true and correct.

I understand and accept that:

 completing this form does not guarantee me a visa to Australia; and
 if I provide false or misleading information this may result in processing delays or my
application being refused.

Signature of applicant: __________________

Date (dd/mm/yy): _____________________

Full name: __________________________

Taskera number: ________________________

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 Passport/travel document number: ____________
If you are unable to print and sign this declaration, Defence will accept an electronic
signature. An electronic signature includes typing a name in electronic format, scanning and
pasting a physical signature into an electronic document, or a name appearing in the ‘from’ field
in an email.

Part F – Privacy Notice and Consent Request

Defence asks you to consent to the Defence Afghan LEE Program Privacy Notice. This helps
Defence to assess your application for LEE certification. It means Defence can seek verification
of information you provide from third parties (including former employers or referees),

The Privacy Notice is attached. Please read it carefully. If you consent, tick the applicable boxes,
sign it and return the signed copy with your application form. If you do not complete and sign the
Privacy Notice your application will still be assessed, but Defence may be unable to verify some
of your information with third parties including individuals located overseas.

Defence will not liaise with, or share information about you with, the government of Islamic
Emirate of Afghanistan. If you do not want Defence to contact any other particular foreign
government, international organisation or overseas individual (for example, because you have
concerns for your safety) please let us know. Your application will still be assessed on the
information provided, but Defence may be unable to verify some of your information with relevant
overseas persons.
This may impact Defence’s ability to assess all information provided by you in support of your
application.

Have you signed the Privacy Notice:

☐ Yes or ☐ No

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