Professional Documents
Culture Documents
Important – Please read this information carefully before you Please open this form using Adobe Acrobat Reader.
complete this form. Once you have completed this form we Either type (in English) in the fields provided or print this form
strongly advise that you keep a copy for your records. and complete it (in English) using a pen and BLOCK LETTERS.
This form is to be completed in English by applicants who are Tick where applicable 3
16 years of age or over, as requested by the office processing the
application. If you need more space for any answers, give details at Part T –
Additional information
Integrity of application
The Department of Home Affairs (the Department) is committed
to maintaining the integrity of the visa and citizenship programs.
Please be aware that if you provide us with fraudulent documents Part A – Applicant details
or claims, this may result in processing delays and possibly your
application being refused. 1 Please provide your details as they appear in your official documents.
For example, passport, identity document, travel document, birth
Important information about privacy certificate.
The Privacy Act 1988 contains 13 Australian Privacy Principles Note: If you have one name only, please write it in the ‘Family name’
which regulate the way that the Department collects and handles field.
personal information. Information about how the Department Family name
collects, uses and discloses personal information for its key
functions can be found in form 1442i Privacy notice. More LASHKARI
information about the Department’s general information handling
All given names
practices (including form 1442i) can be found in the Department’s
Privacy policy at https://www.homeaffairs.gov.au/access-and-
accountability/our-commitments/privacy SEFATULLAH
Indeterminate /
Sex Male Female Intersex / Unspecified
Day Month Year
Day, month and year
Date of birth 07-02-1996 MUST be provided
Suburb of birth
Country Afghanistan
2 Do you ever use a Chinese Commercial Code Number for your names
shown in the passport/travel document at Question 1?
No
Yes Chinese Commercial Code Number (in full)
5 Have you ever had a different date of birth to the one shown at
Question 1? Yes
No Day Month Year Day Month Year
7 Do you hold or have you held citizenship from any other country
(including dual citizenships and all previous citizenships)?
No
Yes Country
From to
Note: If you still have the citizenship, write ‘CURRENT’.
If more than one country, give details at Part T – Additional
information
Iran
Nationality Nationality
Place of issue/issuing authority Place of issue/issuing authority
Name on the document (if the same as Question 1, write ‘SAME AS Name on the document (if the same as Question 1, write ‘SAME AS
QUESTION 1’) QUESTION 1’)
Family name Family name
Primary sefatoolahlashkari@gmail.com
Home ( +98 ) ( (933 ) 4824594
Other fmsana9@gmail.com Mobile/cell
Other
Afghanistan
Jan-2001 CURRENT District 7, Chelston Bagh Raes, Kabul Afghanistan
26 List the towns/cities you will visit during your further stay in Australia
23 Do you have any proposed or booked travel dates for your journey to
Australia? N/A
No
Yes Give details of proposed arrival in Australia
Day Month Year 27 Give details of your arrival in Australia
Arrival date Day Month Year
Arrival date
Flight number or vessel details (if known)
City of arrival N/A
City of arrival
28 Are you applying for a temporary visa?
Give details of countries you will visit on your way to Australia No Go to Part I
(write ‘N/A’ if not applicable)
Yes
N/A
29 Do you have any proposed or booked travel for your departure from
Australia?
List the towns/cities you will visit during your time in Australia No
N/A Yes Give details
Day Month Year
Departure date
24 Are you applying for a temporary visa? Flight number or vessel details (if known)
No Go to Part I N/A
Yes Give details of proposed final departure from Australia
Day Month Year City of departure N/A
Departure date Give details of countries you will visit after your departure from Australia
(write ‘N/A’ if not applicable)
Flight number or vessel details (if known)
N/A N/A
N/A
Now go to Part I
Mobile/cell
If you will stay at any other address(es), give details at Part T –
Additional information.
Now go to Part J
Child 1
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Child 2
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Child 4
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Child 5
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Child 6
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Parent 2
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Mother LASHKARI BIBI AYSHA N/A F N/A
Parent 3
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Brother LASHKARI KARIM N/A M N/A
Parent 4
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Brother LASHKARI SUHAIL N/A M N/A
Sibling 1
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Brother LASHKARI RAFI JAN N/A M N/A
Sibling 2
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Brother LASHKARI RAHMAN N/A M N/A
Sibling 3
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Sister LASHKARI NAZANIN JANA N/A F N/A
Sibling 4
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Sister LASHKARI NAJILA N/A F N/A
Family member 1
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
Family member 2
Given names Any other names Sex Date of birth Chinese commercial codes
Relationship to you Family name
(include patronymic name) (eg. maiden or tribal name) M/F/X Day Month Year (If not applicable, write ‘N/A’)
If more than 2 other family members, give details at Part T – Additional information
Date of birth
Nationality
Country Your personal contact’s current residential address
Note: A post office box is not acceptable.
Nationality
Address (including building/unit/house number and street name)
Your personal contact’s current residential address
Note: A post office box is not acceptable.
Address (including building/unit/house number and street name)
Signature of
applicant
Organisation/Business commercial address (including building number -
and street name) Day Month Year
Date
N/A
If you do not have enough space to give all the necessary information, attach a separate statement to this form with further details
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