1436 (Design date 01/18) - Page 5© COMMONWEALTH OF AUSTRALIA, 2018
If you answered ‘Yes’ to any of the questions at Question 19, give ALL
relevant details below.
If the matter relates to a criminal conviction, please give the nature of
the offence, full details of sentence and date of any period of
imprisonment or other detention.
Part D – Additional applicant
Has the additional applicant ever:
• been charged with any offence that is
currently awaiting legal action?
• been convicted of an offence in any country
(including any conviction which is now
removed from official records)?
• been the subject of an arrest warrant or
• been found guilty of a sexually based offence
involving a child (including where no
conviction was recorded)?
• been named on a sex offender register?
• been acquitted of any offence on the grounds
of unsoundness of mind or insanity?
• been found by a court not fit to plead?
• been directly or indirectly involved in, or
associated with, activities which would
represent a risk to national security in
Australia or any other country?
• been charged with, or indicted for: genocide,
war crimes, crimes against humanity, torture,
slavery, or any other crime that is otherwise
of a serious international concern?
• been associated with a person, group or
organisation that has been/is involved in
• been associated with an organisation
engaged in violence or engaged in acts of
violence (including war, insurgency, freedom
fighting, terrorism, protest) either overseas or
• served in a military force, police force, state
sponsored/private militia or intelligence
agency (including secret police)?
• undergone any military/paramilitary training,
been trained in weapons/explosives or in the
manufacture of chemical/biological products?
• been involved in people smuggling or people
• been removed, deported or excluded from
any country (including Australia)?
• overstayed a visa in any country (including
• had any outstanding debts to the Australian
Government or any public authority in