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

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Application for aResident Return visa (RRV)or replacement evidence of an RRV orBF111 (ATR or RE) visa labelForm1085123Please use a pen, and write neatly in English using BLOCK LETTERS.Tick where applicablePart A – Your detailsTo be completed by all applicantsAre you an Australian citizen?No Yes This is not the correct form. Please read theinformation form 968i Return documents forAustralian citizens and permanent residents.TYPE OF APPLICATION – select one onlyReplacement evidence of a lost, stolen or damagedRRV or BF111 (ATR or RE) visa labelYour full name✓RRV (called a Return (Residence) (Class BB) visa)Provisional RRV (called a Resident Return(Temporary) (Class TP) visa)8Relationship statusMarriedEngagedDe factoSeparatedDivorcedWidowed9 Current residential addressNote: A post office box address is not acceptable as a residentialaddress. Failure to give a residential address will result in your applicationbeing invalid.POSTCODENever married orbeen in a de factorelationship10 Address for correspondence(If the same as your residential address, write ‘AS ABOVE’)Family namePOSTCODEGiven names11Your telephone numbers4Have you been known by any other names?(including name at birth, previous married names, aliases)Office hoursAfter hours(AREA CODE )(AREA CODE )NoYesGive details12Do you agree to the department communicating with you by fax, e-mailor other electronic means?Family nameNoGiven namesYesGive detailsFax number(AREA CODE )Reason forchangeDeed PollMarriageOtherSpecifyE-mail address5If you have changed your name since your first arrival in Australia,please provide documents to evidence your name change(eg. marriage certificate, deed poll or other official documentsshowing use of the name).SexMaleFemale13 Are you presently in Australia?NoYesDate you last departed AustraliaDate of expected departurefrom AustraliaDAY MONTH YEARDAY MONTH YEAR67Date of birthPlace of birthTown/cityCountryDAY MONTH YEAR© COMMONWEALTH OF AUSTRALIA, 20101085 (Design date 11/10) - Page 5
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1085 - Application for a Resident Return visa (RRV) - Fiji - Australian ...

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