Fillable Form 1505: Temporary Protection visa or Safe Haven (Department of Home Affairs)

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Form 1505: Temporary Protection visa or Safe Haven (Department of Home Affairs)

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  • 452 other fields

Country of origin: AUSTRALIA
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Form
1505
Department of Home Affairs
Application for a subsequent
Temporary Protection visa or
Safe Haven Enterprise visa
Form
1505
The Department of Home Affairs (the Department) preferred
lodgement method for visas is online through ImmiAccount.
Creating an account is quick and easy – visit
www.homeaffairs.gov.au/immiaccount/
There are a number of benefits to lodging online through
ImmiAccount: you can check the status of your application,
continue a saved application, attach documents to an
application, update personal details, and access a copy of your
online application at any time.
The Department acknowledges that Aboriginal and Torres Strait
Islander peoples are the traditional custodians of the Australian
land.
Life in Australia – Australian values
The Australian Government encourages people to gain an
understanding of Australia, its people and their way of life, before
applying for a visa to live in Australia.
This includes understanding that the English language, as the
national language, is an important unifying element of Australian
society. Australian society is also united through the following
shared values:
• respect for the freedom and dignity of the individual;
• freedom of religion (including the freedom not to follow
a particular religion), freedom of speech, and freedom of
association;
• commitment to the rule of law, which means that all people
are subject to the law and should obey it;
• parliamentary democracy whereby our laws are determined
by parliaments elected by the people, those laws being
paramount and overriding any other inconsistent religious or
secular ‘laws’;
• equality of opportunity for all people, regardless of their
gender, sexual orientation, age, disability, race, or national or
ethnic origin;
• a ‘fair go’ for all that embraces:
– mutual respect;
– tolerance;
– compassion for those in need; and
– equality of opportunity for all.
The Life in Australia booklet provides more information on the
values that Australians share and their way of life. This booklet is
available in a wide range of languages and can be obtained from
www.homeaffairs.gov.au
You are encouraged to read the Life in Australia booklet before
completing this application form. If you have difficulty, or are
unable to read the booklet, you may have the content of it
explained to you, for example, by a friend or relative. This form
contains a statement, that you must sign, that confirms you
understand and will undertake to conduct yourself in accordance
with the values of Australian society (as explained in the booklet)
and will obey the laws of Australia.
This statement must also be signed by each person aged 18 years
or over, who is included in this form.
Information about your subsequent application
Important – Please read this information carefully before you
complete your application. Once you have completed your
application we strongly advise that you keep a copy for your
records.
Complete this application form if you:
• are in Australia;
• hold or have held a Temporary Protection (Class XD) visa
(TPV) or a Safe Haven Enterprise (Class XE) visa (SHEV);
• are applying for a subsequent TPV or SHEV; and
• could not lodge your TPV or SHEV application online.
You must apply for another TPV or SHEV before your
current visa ceases. If you are an Unauthorised Maritime
Arrival (UMA) and your visa ceases before your
subsequent application is received by the Department,
your application will be considered invalid.
Form 1505 is for current and former TPV and SHEV holders
applying for a subsequent TPV or SHEV who cannot lodge an
online application.
This short form allows you to record changes in your personal
circumstances since you were granted your TPV or SHEV. This
form does not require you to provide claims for protection if you
or someone else in your family unit have already provided them
to the Department as part of your previous application. You only
need to provide new details if your previous reasons for claiming
protection have changed. If further information is required, the
Department will contact you after you lodge your application.
A subsequent TPV or SHEV application is a new visa application
that needs a new assessment, even if the Department streamlines
this assessment in some cases.
It is very important that you provide a complete application
including all new or additional information relevant to your
personal circumstances and to your protection claims.
Even if there have been no changes to your personal details and
protection claims since you were last granted a TPV or SHEV, the
Department will still have to assess if you engage Australia’s
protection obligations. This includes checking the current
situation in your home country.
If you were granted your TPV or SHEV as a member of the same
family unit of someone who was claiming protection and you are
no longer a member of that person’s family unit, you can apply
separately. You can provide your own claims for protection and
attach them to this form. If further information is required, the
Department will contact you after you lodge your application.
You may be granted a subsequent TPV or SHEV if you still engage
Australia’s protection obligations and you, and any members of
your family unit included in the application, meet all other
requirements for the grant of a protection visa under the
Migration Act 1958 and the Migration Regulations 1994.
Further information on the process for a subsequent TPV and
SHEV application is available on the Department’s website
www.homeaffairs.gov.au/temporaryprotection
Information on SHEV arrangements and regional Australia is
available on the Department’s website
www.homeaffairs.gov.au/shevpathways
1505 (Design date 05/21) - Page 1© COMMONWEALTH OF AUSTRALIA, 2021
Eligibility to apply for a subsequent TPV or SHEV
Depending on your circumstances you may be eligible for a
subsequent TPV or SHEV.
You will be considered for a TPV if, at the time of lodging your
subsequent application, you:
• hold, or have ever held, either a TPV or a SHEV.
You will be considered for a SHEV if, at the time of lodging your
subsequent SHEV application, you:
• hold, or have ever held either a TPV or a SHEV; and
• sign the Declaration of intention to work and/or study in
regional Australia on page 5 of this form.
Application bars
If you:
• have previously been refused a protection visa since your last
arrival to Australia; or
• have had a protection visa cancelled since your last arrival to
Australia; or
• are a national of 2 or more countries; or
• are an Unauthorised Maritime Arrival (UMA) and your TPV or
SHEV has already ceased;
you will be prevented from making a valid TPV or SHEV
application (unless you have been notified that the Minister has
lifted any application bar). The Department will advise you if any
application bar affects you.
To make a valid TPV or SHEV application
The Department’s preferred lodgment method is online. You can
lodge this application online through your ImmiAccount at
www.homeaffairs.gov.au/trav/visa/immi
To make a valid TPV or SHEV application you must:
• pay the visa application charge (See ‘Method of payment’
below);
• be in Australia;
• provide your residential address;
• provide personal identifiers if required (eg. digital photograph
and fingerprints);
• not be prevented from lodging an application because of any
application bars; and
• complete this form.
Method of payment
Make your payment electronically through the ‘My Payments’
section of ImmiAccount. Sign into, or create, your ImmiAccount
and select My Payments>Manage Payments>Pre-Pay Paper Service,
at www.homeaffairs.gov.au/immiaccount
How to lodge your application
You can send your completed application form and supporting
evidence to:
Protection Visas
Department of Home Affairs
GPO Box 9984
Sydney NSW 2001
Further information on how to lodge your application is available
on the Department’s website
www.homeaffairs.gov.au/temporaryprotection
Your immigration status
You should make a valid subsequent TPV or SHEV application
before your current TPV or SHEV ceases. If you lodge a valid
application for a protection visa while you still hold your TPV or
SHEV, your visa will remain in effect until your subsequent
application is decided.
If your current TPV or SHEV ceases, and you have not made a
valid application for another TPV or SHEV, you will become
unlawful in Australia.
If you are unlawful when you lodge this application, you will
need to lodge a separate application for a Bridging visa E to
remain lawful while your application is being processed.
Form 1008 Application for a Bridging visa E – subclass 050 is
available from the Department’s website
www.homeaffairs.gov.au/allforms/
Members of the family unit
A member of the family unit of someone making claims for
protection can include a partner, dependent children and certain
other dependants. More information on who is a member of the
family unit is available on the Department’s website
www.homeaffairs.gov.au/protectionvisas
Members of the family unit may apply together on the same form
and must all be in Australia at the time of application.
Changes to your family composition
If your family composition has changed since the grant of your
TPV or SHEV, you should provide certified copies of any
documents/evidence to support the relationship between each
person in the application. This includes birth certificates, notarial
certificates, marriage certificates, financial documents and
undertakings for de facto relationships, financial documents to
evidence that dependants over the age of 18 are dependent on
you and any other evidence to support relationships between
each applicant.
If a child is born to a visa holder after visa grant the child will be
taken to have the same visa status as that of their parent(s).
If a child is born to an applicant after an application is lodged and
before a primary decision is made on that application, the child
will be taken to be included in that application. You should
include any child born after the grant of your current TPV or
SHEV in this application.
You should promptly notify the Department of the birth of your
child and provide a certified copy of their birth certificate.
Who can certify my documents?
For a full list of people who can certify documents please see the
Statutory Declarations Regulations 1993, available from the
Attorney-General’s website www.ag.gov.au
Help with your application
Information to assist you with your application is available on the
Department’s website www.homeaffairs.gov.au/protectionvisas
1505 (Design date 05/21) - Page 2
© COMMONWEALTH OF AUSTRALIA, 2021
What is immigration assistance?
A person gives immigration assistance if he or she uses, or
purports to use, his or her knowledge or experience in migration
procedure to assist a person with matters related under the
Migration Act 1958.
The most common times assistance is provided is during visa
application processes, visa cancellation processes or sponsorship
processes (including monitoring or sanctions).
Note: Immigration assistance does not include simply filling in
an application form, translating or interpreting or passing on
information about an application without comment or
explanation.
Registered migration agents
A registered migration agent is a person who is registered with
the Office of the Migration Agents Registration Authority
(OMARA) to provide immigration assistance.
If operating in Australia, migration agents must be registered with
the OMARA.
Information on registered migration agents, including how to
find one, is available on the OMARA website www.mara.gov.au
Legal practitioners
A legal practitioner is a lawyer who holds an Australian legal
practising certificate (whether restricted or unrestricted) granted
under a law of an Australian state or territory.
Legal practitioners can provide immigration assistance in
connection with legal practice.
Information on legal practitioners, including how to find one, is
available on the Law Council of Australia website.
Information on legal practitioners can also be sought from the
relevant state or territory legal professional bodies.
Exempt persons
The following people do not have to be a registered migration
agent or legal practitioner in order to provide immigration
assistance:
• a close family member (spouse, child, adopted child, parent,
brother or sister of a visa applicant);
• a sponsor or nominator for a visa applicant;
• a member of parliament or their staff;
• a member of a diplomatic mission, consular post or
international organisation.
An exempt person must not charge a fee for their assistance.
In Australia, if they do charge a fee they are committing an
offence and penalties of up to 10 years jail can apply.
Appointing a registered migration agent/legal practitioner/exempt
person
To appoint a registered migration agent/legal practitioner/exempt
person you should complete Question 14 Options for receiving
written communications.
Your
registered
migration agent/
legal practitioner/
exempt person
should complete form 956 Appointment of a registered
migration agent, legal practitioner or exempt person.
Form 956 is available from the Department’s website
www.homeaffairs.gov.au/allforms/
Warning: Some visa applicants have been victims of scams,
paying large sums of money to fraudulent immigration advisors
who promise guaranteed visas.
No one can guarantee that you will receive a protection
visa, or the timeframe in which your application will be
processed.
Options for receiving written communications
If you do not appoint a migration agent/legal practitioner/exempt
person you may still authorise another person, in writing, to
receive written communications on your behalf. This person is
called the authorised recipient.
Authorised recipient information
All written communication about your application will be sent to
your authorised recipient, unless you indicate that you wish to
have health and/or character information sent directly to you.
The Department will communicate with the most recently
appointed authorised recipient as you may only appoint one
authorised recipient at any time for a particular application.
You will be taken to have received any documents sent to that
person as if they had been sent to you.
To appoint an authorised recipient you should complete:
• Question 14 Options for receiving written communications;
and
• form 956A Appointment or withdrawal of an authorised
recipient.
Note: Migration agents/legal practitioners/exempt persons do
not need to complete form 956A.
Form 956A is available from the Department’s website
www.homeaffairs.gov.au/allforms/
Consent to communicate electronically
The Department may use a range of means to communicate with
you. However, electronic means such as email will only be used if
you indicate your agreement to receiving communication in this
way.
To process your application the Department may need to
communicate with you about sensitive information, for example
health, police checks, financial viability and personal relationships.
Electronic communications, unless adequately encrypted, are not
secure and may be viewed by others or interfered with.
The Australian Government accepts no responsibility for the
security or integrity of any information sent to the Department
over the internet or by other electronic means.
If you agree to the Department communicating with you by
electronic means, the details you provide will only be used by the
Department for the purpose for which you have provided them,
unless there is a legal obligation or necessity to use them for
another purpose, or you have consented to use for another
purpose. They will not be added to any mailing list.
If you authorise another person to receive documents on your
behalf and they wish to be contacted electronically, their
signature is required on form 956 or 956A to indicate their
consent to this form of communication.
1505 (Design date 05/21) - Page 3
© COMMONWEALTH OF AUSTRALIA, 2021
Please keep these information pages for your reference
Accessing your personal information
If you are seeking access to your personal records in order to
prepare your subsequent application, visit the Department’s
website at www.homeaffairs.gov.au/access-and-
accountability/freedom-of-information/access-to-
information/how-to-make-a-request
Click on the link ‘Access to information’ and select ‘Accessing my
records for a Temporary Protection Visa (TPV) or a Safe Haven
Enterprise Visa (SHEV)’.
The Department will process your request and release to you a
set of records created after the lodgement of your last TPV or
SHEV application. These records will be released to you under
the Privacy Act 1988.
In preparing for your subsequent TPV or SHEV application you
are encouraged to submit your request to access your personal
records 6–8 weeks prior to your lodgement date.
Note: Information you have submitted online can be accessed
via your ImmiAccount.
Important information about privacy
The Privacy Act 1988 contains 13 Australian Privacy Principles
which regulate the way that the Department collects and handles
personal information. Information about how the Department
collects, uses and discloses personal information for its key
functions can be found in form 1442i Privacy notice. More
information about the Department’s general information handling
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
For SHEV applicants: If you are granted a SHEV and later make an
application for a prescribed visa, the Department may disclose
your personal information to Services Australia, the Department
of Social Services, the Department of Education, Skills and
Employment, and other government agencies and third parties
where required, in order to determine whether you meet the
requirements to make a valid application for a further prescribed
visa.
Home page
www.homeaffairs.gov.au
General
enquiry line
Telephone 131 881 during business hours in Australia
to speak to an operator (recorded information available
outside these hours). If you are outside Australia, please
contact your nearest Australian mission.
ImmiAccount
www.homeaffairs.gov.au/immiaccount
For online lodgements and to update your personal
information.
1505 (Design date 05/21) - Page 4
© COMMONWEALTH OF AUSTRALIA, 2021
Form
1505
Department of Home Affairs
Application for a subsequent
Temporary Protection visa or
Safe Haven Enterprise visa
Please open this form using Adobe Acrobat Reader.
Either type (in English) in the fields provided or print this form
and complete it (in English) using a pen and BLOCK LETTERS.
Tick where applicable
3
You must answer ALL questions. If any question is not applicable,
write ‘N/A’. Failure to do so may lead to your application being
considered invalid.
If you need more space to answer any questions, attach a sheet of
paper giving the required details and include the question number to
which the information refers.
Note: This form is for current and former TPV and SHEV holders
applying for a subsequent TPV or SHEV who cannot lodge an
online application.
Visa eligibility
1 Do you hold, or have ever held, either a TPV or a SHEV?
No
If you do not hold, or have never held, a TPV or a SHEV and
wish to apply for a TPV or SHEV you cannot use this form.
You will need to complete form 866 Application for a
Protection visa instead.
Yes
2 Is this an application for a Class XE subclass 790 (Safe Haven
Enterprise) visa?
No
This application will be taken to be an application for a TPV
and not a SHEV. Go to Question 4
Yes
This application will be taken to be an application for a SHEV
and not a TPV
.
Read and sign the declaration at Question 3
before completing this form.
Declaration of intention to work and/or
study in regional Australia
Note: Only SHEV applicants must complete this declaration.
3 You must indicate in writing that you, or one or more member(s) of the
same family unit included in this application, intend to work or study
while accessing minimal social security benefits in regional Australia
to lodge a valid application for a Class XE subclass 790 (Safe Haven
Enterprise) visa. Please sign this declaration before lodging your
application.
You must sign this declaration if you are aged 18 years or over. A parent
or legal guardian must sign on behalf of any applicant who is under 15
years of age, or who lacks the legal capacity to sign on their own behalf
(applicants who are 15 years of age or older, but have not yet turned 18,
may sign for themselves or have a parent or legal guardian sign on their
behalf).
WARNING: Giving false or misleading information is a serious offence.
Declaration
• I understand which areas of Australia are designated as regional
Australia.
• I understand that it is my responsibility to find work or study
opportunities in regional Australia.
• I, or a member of the same family unit as me and who is also an
applicant for a Class XE subclass 790 (Safe Haven Enterprise) visa,
intends to work or study in regional Australia while accessing
minimum social security benefits.
Your name
Your signature
-
Date
Day Month Year
Form
1505
1505 (Design date 05/21) - Page 5© COMMONWEALTH OF AUSTRALIA, 2021
Details of persons included in this
application
4 Give details of ALL persons included in this application (those who
presented claims in their previous TPV or SHEV application and those
who are ‘members of the same family unit’. Members of the same
family unit include partner (spouse or de facto), dependent children and
other dependants).
These persons must be in Australia at the time of application.
Applicant 1 should be the person you want the Department to contact about
this application (although you may wish to authorise another person, your
migration agent or legal practitioner to receive written communications, see
Question 14).
Applicant 1 (main applicant)
Family name
Given names
Date of birth
Day Month Year
Sex Male Female
Indeterminate /
Intersex / Unspecified
Current residential address
Postcode
Postal address
(If the same as residential address, write ‘AS ABOVE’)
Postcode
Mobile/cell
Telephone
(Area code )
Do you agree to the Department communicating with you via email?
Yes
Email address
No
TPV or SHEV Grant number (if known)
Client ID (if known)
Did you raise your own claims for protection in the previous
TPV or SHEV application?
No If you were granted a TPV or SHEV on the basis of
being a member of the same family unit of someone
else who presented claims, and you now want to apply
separately and present your own claims for protection,
attach details of your claims to this application.
Yes
Were you included in the
previous TPV or SHEV application?
No
Yes
Applicant 2
Family name
Given names
Date of birth
Day Month Year
Sex Male Female
Indeterminate /
Intersex / Unspecified
Relationship to applicant 1
(eg. mother, father, partner, son, daughter)
Members of the same family unit must attach evidence of their
relationship to applicant 1.
Current residential address
Postcode
Postal address
(If the same as residential address, write ‘AS ABOVE’)
Postcode
Mobile/cell
Telephone
(Area code )
Does this applicant agree to the Department communicating with
them via email?
Yes Email address
No
TPV or SHEV Grant number (if known)
Client ID (if known)
Did
this applicant
raise their own claims for protection in the
previous TPV or SHEV application?
No If
this applicant was
granted a TPV or SHEV on the
basis of being a member of the same family unit of
someone else who presented claims, and they now
want to apply separately and present their own claims
for protection, attach details of their claims to this
application.
Yes
Was this applicant included in the
previous TPV or SHEV application?
No
Yes
1505 (Design date 05/21) - Page 6
© COMMONWEALTH OF AUSTRALIA, 2021
Applicant 3
Family name
Given names
Date of birth
Day Month Year
Sex Male Female
Indeterminate /
Intersex / Unspecified
Relationship to applicant 1
(eg. mother, father, partner, son, daughter)
Members of the same family unit must attach evidence of their
relationship to applicant 1.
Current residential address
Postcode
Postal address
(If the same as residential address, write ‘AS ABOVE’)
Postcode
Mobile/cell
Telephone
(Area code )
Does this applicant agree to the Department communicating with
them via email?
Yes
Email address
No
TPV or SHEV Grant number (if known)
Client ID (if known)
Did
this applicant
raise their own claims for protection in the
previous TPV or SHEV application?
No
If
this applicant was
granted a TPV or SHEV on the
basis of being a member of the same family unit of
someone else who presented claims, and they now
want to apply separately and present their own claims
for protection, attach details of their claims to this
application.
Yes
Was this applicant included in the
previous TPV or SHEV application?
No
Yes
Applicant 4
Family name
Given names
Date of birth
Day Month Year
Sex Male Female
Indeterminate /
Intersex / Unspecified
Relationship to applicant 1
(eg. mother, father, partner, son, daughter)
Members of the same family unit must attach evidence of their
relationship to applicant 1.
Current residential address
Postcode
Postal address
(If the same as residential address, write ‘AS ABOVE’)
Postcode
Mobile/cell
Telephone
(Area code )
Does this applicant agree to the Department communicating with
them via email?
Yes
Email address
No
TPV or SHEV Grant number (if known)
Client ID (if known)
Did
this applicant
raise their own claims for protection in the
previous TPV or SHEV application?
No
If
this applicant was
granted a TPV or SHEV on the
basis of being a member of the same family unit of
someone else who presented claims, and they now
want to apply separately and present their own claims
for protection, attach details of their claims to this
application.
Yes
Was this applicant included in the
previous TPV or SHEV application?
No
Yes
If insufficient space, attach additional details
1505 (Design date 05/21) - Page 7
© COMMONWEALTH OF AUSTRALIA, 2021
Character
5
Have you, or any other persons included in this
application, ever:
• been charged with any offence that is
currently awaiting legal action? No Yes
• been convicted of an offence in any country
(including any conviction which is now
removed from official records)? No
Yes
• been charged or convicted of family or
domestic violence offences or similar related
offences? No Yes
• been the subject of a domestic or family
violence order, or any other order, of a tribunal
or court or other similar authority, for the
personal protection of another person? No
Yes
• been the subject of an arrest warrant or
Interpol notice? No Yes
• been found guilty of a sexually based offence
involving a child (including where no
conviction was recorded)? No
Yes
• been named on a sex offender register?
No
Yes
• been acquitted of any offence on the grounds
of unsoundness of mind or insanity? No Yes
• been found by a court not fit to plead?
No
Yes
• been directly or indirectly involved in, or
associated with, activities which would
represent a risk to national security in
Australia or any other country? No Yes
• 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? No Yes
• been associated with a person, group or
organisation that has been/is involved in
criminal conduct? No Yes
• been associated with an organisation engaged
in violence or engaged in acts of violence
(including war, insurgency, freedom fighting,
terrorism, protest) either overseas or in
Australia? No Yes
• served in a military force, police force, state
sponsored/private militia or intelligence
agency (including secret police)? No
Yes
• undergone any military/paramilitary training,
been trained in weapons/explosives or in the
manufacture of chemical/biological products? No Yes
• been involved in people smuggling or people
trafficking offences? No Yes
• been removed, deported or excluded from any
country (including Australia)? No Yes
• overstayed a visa in any country (including
Australia)? No Yes
• had any outstanding debts to the Australian
Government or any public authority in
Australia? No Yes
If you answered ‘Yes’ to any question at Question 5, give details,
including the date of the charge, the outcome and any penalty imposed.
Also attach court documents (for example sentencing remarks or court
transcripts).
Where relevant, provide a copy of all declared orders (for example, any
domestic or family violence orders, child protection orders, or orders that
prohibit the applicant from having contact with another person for their
personal protection). You are only requested to declare an order where
the applicant is the respondent or subject of the order. You are not asked
to declare an order where the applicant is the person requiring personal
protection.
Applicant
number
Details
If insufficient space, attach additional details
1505 (Design date 05/21) - Page 8
© COMMONWEALTH OF AUSTRALIA, 2021
Members of the same family unit NOT
included in this application
6 Are there any members of the same family unit who are IN AUSTRALIA
but are NOT included in this application?
No
Yes
Give details
1. Family name
Given names
Date of birth
Day Month Year
Sex Male Female
Indeterminate /
Intersex / Unspecified
Place of birth (including town/city, province/state, country)
Citizenship
Relationship status
Married Separated
Never married or
been in a de facto
relationship
Engaged
Divorced
De facto
Widowed
Relationship to applicant 1
(eg. mother, father, partner, son, daughter)
Contact details
Address
Postcode
Mobile/cell
Telephone
(Area code )
Does this person agree to the Department communicating with
them via email?
Yes
Email address
No
Reason for not including in this application
2. Family name
Given names
Date of birth
Day Month Year
Sex Male Female
Indeterminate /
Intersex / Unspecified
Place of birth (including town/city, province/state, country)
Citizenship
Relationship status
Married Separated
Never married or
been in a de facto
relationship
Engaged
Divorced
De facto
Widowed
Relationship to applicant 1
(eg. mother, father, partner, son, daughter)
Contact details
Address
Postcode
Mobile/cell
Telephone
(Area code )
Does this person agree to the Department communicating with
them via email?
Yes
Email address
No
Reason for not including in this application
If insufficient space, attach additional details
1505 (Design date 05/21) - Page 9
© COMMONWEALTH OF AUSTRALIA, 2021
Travel history
7 Have you, or any other persons included in this application, travelled outside Australia since the grant of the TPV or SHEV?
Include:
• travel in transit to another country
• work or study
• holiday/leisure trips
• visiting relatives
• business
• visits back to own country.
No
Yes
Give details in chronological order
Applicant 1
Date from Date to
Reason for visit City/province/country
Day Month Year Day Month Year
If insufficient space, attach additional details
Applicant 2
Date from Date to
Reason for visit City/province/country
Day Month Year Day Month Year
If insufficient space, attach additional details
Applicant 3
Date from Date to
Reason for visit City/province/country
Day Month Year Day Month Year
If insufficient space, attach additional details
Applicant 4
Date from Date to
Reason for visit City/province/country
Day Month Year Day Month Year
If insufficient space, attach additional details
1505 (Design date 05/21) - Page 10
© COMMONWEALTH OF AUSTRALIA, 2021
Previous addresses
8
Give details of all residential addresses where you, and any other persons
included in this application, have lived for the past 5 years.
Include:
• addresses inside and outside Australia
• places resided for study/work
• any other place resided such as share houses, university residences
and temporary accommodation.
Applicant 1
Date from Date to
Full residential address (including house
number, street name, suburb, town/city,
state/province, postcode and country).
Do NOT provide a PO Box
Month Year Month Year
CURRENT
If insufficient space, attach additional details
Applicant 2
Date from Date to
Full residential address (including house
number, street name, suburb, town/city,
state/province, postcode and country).
Do NOT provide a PO Box
Month Year Month Year
CURRENT
If insufficient space, attach additional details
Applicant 3
Date from Date to
Full residential address (including house
number, street name, suburb, town/city,
state/province, postcode and country).
Do NOT provide a PO Box
Month Year Month Year
CURRENT
If insufficient space, attach additional details
Applicant 4
Date from Date to
Full residential address (including house
number, street name, suburb, town/city,
state/province, postcode and country).
Do NOT provide a PO Box
Month Year Month Year
CURRENT
If insufficient space, attach additional details
1505 (Design date 05/21) - Page 11
© COMMONWEALTH OF AUSTRALIA, 2021
Changes in reasons for claiming protection
9 Have the reasons for claiming protection changed for you, or any other
persons included in this application, since the grant of the TPV or SHEV?
No
Yes
Give details
Note: If the change relates to a particular applicant indicate
the applicant number.
If insufficient space, attach additional details
Changes in personal circumstances
10 Have there been any changes in personal circumstances for you, or any
other persons included in this application, since the grant of the TPV or
SHEV?
Include any changes to personal circumstances such as religion,
financial situation and family unit composition, including deceased
family members and new family members.
No
Yes
Give details
Note: If the change relates to a particular applicant indicate
the applicant number.
If insufficient space, attach additional details
1505 (Design date 05/21) - Page 12
© COMMONWEALTH OF AUSTRALIA, 2021
Assistance with this form
11 Did you receive assistance in completing this form?
No
Go to Question 14
Yes
Please give details of the person who assisted you
Title: Mr Mrs Miss Ms Other
Family name
Given names
Address
Postcode
Telephone number or daytime contact
Office hours
( ) ( )
Country code Area code Number
Mobile/cell
12 Is person a registered migration agent, Australian legal practitioner or an
exempt person?
No
Yes
Go to Question 14
13 Did you pay the person and/or give a gift for this assistance?
No
Yes
Options for receiving written
communications
For more information refer to page 3
14 All written communications about this application should be sent to:
(Tick one box only)
Myself
OR
Authorised
recipient
OR
You should complete form 956A Appointment
or withdrawal of an authorised recipient
Migration agent
OR
Legal
practitioner
OR
Exempt person
Your migration agent/legal practitioner/
exempt person should complete form 956
Appointment of a registered migration agent,
legal practitioner or exempt person
Payment details
15 Method of payment
Make your payment electronically through the ‘My Payments’ section of
ImmiAccount. Sign into, or create, your ImmiAccount and select
My Payments>Manage Payments>Pre-Pay Paper Service, at
www.homeaffairs.gov.au/immiaccount
Do not provide credit card details on this form. Make your credit card
payment electronically through the ‘My Payments’ section of
ImmiAccount.
Payment receipt number from the ‘My Payments’ section of ImmiAccount
Attach a copy of your printed receipt.
1505 (Design date 05/21) - Page 13
© COMMONWEALTH OF AUSTRALIA, 2021
Applicant’s declarations
16 AUSTRALIAN VALUES STATEMENT
This statement must be signed by the main applicant and each person
aged 18 years or over who is included in this application.
I confirm that I have read, or had explained to me, information provided
by the Australian Government on Australian society and values.
I understand that Australian society values:
• respect for the freedom and dignity of the individual;
• freedom of religion (including the freedom not to follow a particular
religion), freedom of speech, and freedom of association;
• commitment to the rule of law, which means that all people are
subject to the law and should obey it;
• parliamentary democracy whereby our laws are determined by
parliaments elected by the people, those laws being paramount and
overriding any other inconsistent religious or secular ‘laws’;
• equality of opportunity for all people, regardless of their gender,
sexual orientation, age, disability, race, or national or ethnic origin;
• a ‘fair go’ for all that embraces:
– mutual respect;
– tolerance;
– compassion for those in need;
– equality of opportunity for all;
• the English language as the national language, and as an important
unifying element of Australian society.
I undertake to conduct myself in accordance with these values of
Australian society during my stay in Australia and to obey the laws of
Australia.
Signature of
applicant 1
(main applicant)
-
Date
Day Month Year
Signature of
applicant 2
-
Date
Day Month Year
Signature of
applicant 3
-
Date
Day Month Year
Signature of
applicant 4
-
Date
Day Month Year
17 DECLARATION
This declaration must be signed by the main applicant and each person
aged 18 years or over who is included in this application.
A parent or legal guardian must sign on behalf of any applicant who is
under 15 years of age, or who lacks the legal capacity to sign on their
own behalf (applicants who are 15 years of age or older, but have not
yet turned 18, may sign for themselves or have a parent or legal
guardian sign on their behalf).
WARNING: Giving false or misleading information is a serious offence.
A person who is found to have provided false or misleading information
in a visa application may face penalties of AUD210,000, 10 years
imprisonment or both. Individuals who provide false or misleading
information in relation to the visa applications of 5 or more people face
penalties of AUD420,000, 20 years imprisonment or both.
I declare that:
• the information I will provide in this application is truthful and honest
in every way.
• the information in Question 5 about me, or any other persons
included in this application, is complete, correct and up-to-date in
every detail.
• the information I have supplied or caused to be supplied on or with
this form is complete, correct and up-to-date in every detail.
• I understand that if I have given false or misleading information, my
application may be refused, and any visa issued may be cancelled.
• I understand that if this application is approved, any person not
included in this application will not have automatic right of entry to
Australia because I am the holder of a protection visa.
• I have read and understood the information supplied to me in this
application.
• (For applicants who received assistance from an interpreter to
complete this application) the interpreter has read this application
and my responses back to me in my own language.
• in accordance with the Migration Act 1958, I undertake to inform the
Department of any changes to my personal circumstances
(eg. relationship status, changes to the family composition including
the birth of a child and change of name) while my application is being
considered.
• I undertake to inform the Department if I intend to change my address
for more than 14 days while my application is being considered.
• Except as shown in Question 5 of this form
:
– I am not aware of any investigation into my affairs that has the
potential to lead to criminal charges.
– I have not been found guilty of, nor had a charge proven against
me for, a sexually based offence involving a child.
– I have not been involved in conduct constituting the crime of
genocide, a crime against humanity, a war crime, a crime
involving torture or slavery or a crime that is otherwise of serious
international concern.
– to the best of my knowledge I do not have any matters which are
either unresolved or in which I have been, or am involved, that
would bring into question whether I pass the character test as
defined at section 501 of the Migration Act 1958.
Consent to collect, use and disclose information
• I authorise the Australian Government to make any enquiries necessary
to determine my eligibility for grant of a protection visa in Australia, and
to use any information supplied in this application for that purpose.
• I consent to the Department disclosing my personal information
(including sensitive information) to other Australian Government
agencies for the purposes of their functions and activities, including (but
not limited to) international and diplomatic relations, law enforcement
(including the National Police Checking Service) and the administration
of Australian Government services and programmes relating to me.
1505 (Design date 05/21) - Page 14
© COMMONWEALTH OF AUSTRALIA, 2021
• I consent to the Department conducting Australian police history
checks on my behalf with the Australian Criminal Intelligence
Commission (ACIC).
• I consent to the Department obtaining my information from other
government agencies that is relevant to the application.
• I consent to the Department disclosing my personal information to
the United Nations. I understand that the United Nations is not
subject to the Privacy Act 1988 in relation to the handling of
information received from the Department.
• I consent to the Australian Government disclosing my identifying
information for the purpose of making inquiries with the relevant
authorities regarding my immigration status in those countries, in
which the Australian Government suspects that I may have the right
to temporarily or permanently reside in, other than the
country/countries I have claimed protection from.
• I understand the Australian Government may disclose my personal
information and/or personal identifiers to countries where I may have
the right to temporarily or permanently reside, other than the
country/countries I have claimed protection from.
• I understand that my personal identifiers and my biographical
information held by the Department may be given to Australian law
enforcement agencies to help identify me, to help determine my
eligibility for grant of a protection visa and for law enforcement
purposes. I consent to:
– Australian law enforcement agencies disclosing my personal
identifiers and biographical and criminal record information to the
Department for any of the purposes outlined above; and
– the Department using the information obtained for the purposes
of the Migration Act 1958 or the Australian Citizenship Act 2007.
• I have read the information contained in form 1442i Privacy notice.
• I understand the Department may collect, use and disclose my
personal information (including biometric information and other
sensitive information) as outlined in form 1442i Privacy notice.
Signature of
applicant 1
(main applicant)
-
Date
Day Month Year
Signature of
applicant 2
-
Date
Day Month Year
Signature of
applicant 3
-
Date
Day Month Year
Signature of
applicant 4
-
Date
Day Month Year
1505 (Design date 05/21) - Page 15
© COMMONWEALTH OF AUSTRALIA, 2021
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Form 1505: Temporary Protection visa or Safe Haven (Department of Home Affairs)

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Completed 11 December 2021

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