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1276 - Application for general skilled migration to Australia

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102<br />

DECLARATION FOR ALL APPLICANTS<br />

WARNING: Giving false or misleading in<strong>for</strong>mation is a serious offence.<br />

• I declare that the in<strong>for</strong>mation I have supplied in this application is<br />

complete, correct and up-<strong>to</strong>-date in every detail.<br />

• I understand that if I, or third parties acting on my behalf, provide<br />

false or misleading in<strong>for</strong>mation or bogus documents either<br />

knowingly or otherwise my visa application will be refused or any<br />

visa granted may be cancelled.<br />

• I understand that if this application is approved, any person not<br />

included in this application will not have au<strong>to</strong>matic right of entry <strong>to</strong><br />

<strong>Australia</strong> by way of this application.<br />

• I will in<strong>for</strong>m the department of any changes <strong>to</strong> my personal<br />

circumstances (including change of address) while my application<br />

is being considered.<br />

• I authorise the <strong>Australia</strong>n Government <strong>to</strong> make any enquiries<br />

necessary <strong>to</strong> determine my eligibility <strong>for</strong> permanent stay in <strong>Australia</strong>,<br />

and <strong>to</strong> use any in<strong>for</strong>mation supplied in this application <strong>for</strong> that<br />

purpose. The agencies/organisations <strong>to</strong> which in<strong>for</strong>mation may be<br />

disclosed include:<br />

– federal, state or terri<strong>to</strong>ry government agencies;<br />

– federal, state or terri<strong>to</strong>ry law en<strong>for</strong>cement agencies;<br />

– state or terri<strong>to</strong>ry housing authorities (including private landlords);<br />

– local government authorities;<br />

– financial institutions;<br />

– educational institutions; and<br />

– private businesses (including telecommunication and internet<br />

service providers, insurance companies).<br />

• I have read and unders<strong>to</strong>od the in<strong>for</strong>mation supplied <strong>to</strong> me in this<br />

application.<br />

• I consent <strong>to</strong> my details and in<strong>for</strong>mation about my visa application<br />

being provided <strong>to</strong> employers, Commonwealth and state/terri<strong>to</strong>ry<br />

governments and regional organisations in <strong>Australia</strong>, who may<br />

facilitate skill matching (if applicable).<br />

• I consent <strong>to</strong> in<strong>for</strong>mation about my visa application being provided<br />

<strong>to</strong> my nominating state/terri<strong>to</strong>ry or Regional Certifying Body (if<br />

applicable).<br />

Have you completed the visa specific checklist from the department’s<br />

website www.immi.gov.au/<strong>skilled</strong>/<br />

No<br />

Yes<br />

Please complete the checklist<br />

Include it with your application<br />

Signature<br />

of primary<br />

applicant<br />

Date<br />

DAY MONTH YEAR<br />

When lodging your application do NOT place the application in<br />

any binder, folder or plastic sleeve.<br />

We strongly advise that you keep a copy of your application<br />

and all attachments <strong>for</strong> your records.<br />

© COMMONWEALTH OF AUSTRALIA, 2010 <strong>1276</strong> (Design date 07/10) - Page 39

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