1085 - Application for a Resident Return visa (RRV) - Fiji - Australian ...

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Part G – Payment detailsPart H – Declaration43Do you have the application charge to include with your application?(Check with the department or an Australian mission for the currentcharges, or refer to the latest form 990i Charges available fromwww.immi.gov.au/allforms/990i.htm)NoApplication will be returned unassessed45WARNING: Giving false or misleading information is a serious offence.• I declare that the information I have supplied in this application iscomplete, correct and up-to-date in every detail.• I understand that if I give false or misleading information, myapplication may be refused, or any visa granted may be cancelled.44YesHow will you pay your application charge?• I understand that if this application is approved, any person notincluded in this application will not have automatic right of entry toAustralia by way of this application.If applying in Australia, debit card or credit card are the preferredmethods of payment. Debit cards cannot be used for applications lodgedby mail. If paying by bank cheque or money order please make payableto the Department of Immigration and Citizenship.If applying outside Australia, please check with the AustralianGovernment office where you intend to lodge your application as to whatmethods of payment and currencies they can accept and to whom thepayment should be made payable.• I will inform the Department of Immigration and Citizenship of anychanges to my personal circumstances (including change of address)while my application is being considered.• I authorise the Australian Government to make any enquiries necessaryto determine my eligibility for permanent stay in Australia, and to useany information supplied in this application for that purpose.• I have read and understood the information supplied to me in thisapplication.Bank chequeMoney orderDebit cardCannot be used for applications lodged by mailSignatureof primaryapplicantCredit cardPayment by (tick one box)Give details belowAustralian DollarsDateDAY MONTH YEARMasterCardAmerican ExpressDiners ClubJCBAUDWhen lodging your application do NOT place the application inany binder, folder or plastic sleeve.VisaCredit card numberWe strongly advise that you keep a copy of your applicationand all attachments for your records.: : : : : : : : : : : : : : : : : :Expiry dateMONTH:YEAR:Cardholder’s nameTelephonenumberAddressCOUNTRY CODE AREA CODE( ) ( )NUMBERPOSTCODESignature ofcardholderCredit card information will be used for charge paying purposes only.1085 (Design date 11/10) - Page 10 © COMMONWEALTH OF AUSTRALIA, 2010
Office use onlyCharge paid? No YesExpiry date of passportClass / subclass of visa issuedDAY MONTH YEARComments (if applicable)Previous visa number (if applicable)Passport numberVIT / visa numberExpiry date of visaIssued atDate of issueSignature ofissuing officerPassportHeld for collectionSignature ofapplicant/authorisedrepresentativeReturned by mailSignatureof returningofficer© COMMONWEALTH OF AUSTRALIA, 20101085 (Design date 11/10) - Page 11
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