Department of Home Affairs
COVID-19 Impacted Students
Who should use this form?
You should use this form if you are an Education Provider (as per
the definition in the Education Services for Overseas Students
Act 2000) supporting a COVID-19 impacted student who is:
eligible for a nil visa application charge for a new Student
(Subclass 500) visa application if they are unable to complete
their approved course of study within the original visa validity
due to COVID-19, or
seeking to have online study undertaken outside Australia as
a result of COVID-19 travel restrictions counted towards the
Australian Study Requirement.
Information on eligibility is available from the Department of Home
Affairs (the Department) website
Important – Please read this information carefully before you
complete this form. Once you have completed this form we
strongly advise that you keep a copy for your records.
Integrity of information
The Department is committed to maintaining the integrity of the
visa and citizenship programs. Please be aware that if you provide
us with fraudulent documents or claims, this may result in
processing delays and possibly the arrangement being refused.
If documents are found to be fraudulent or information to be
incorrect after the grant of a visa, the visa may subsequently be
Completing this form
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.
In order to complete this form you must first read these notes
and the information available from the Department’s website
Lodging this form
Education providers should provide this completed and signed
form to the impacted student who must include this form
together with either:
form 157A (internet) Application for a student visa if the
student is applying for a Student (Subclass 500) visa, or
form 1409 (internet) Application for a temporary graduate
visa if the graduate is applying for a Temporary Gradate
(Subclass 485) visa.
This form will only be accepted as part of a visa application and
must be provided at time of online lodgement.
If the student does not meet COVID-19 impacted eligibility or
fails to submit this form at the time of lodgement, the application
could be invalidated. The student would be required to submit a
new application.
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
Home page
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.
1545 (Design date 07/20) - Page 1© COMMONWEALTH OF AUSTRALIA, 2020
Department of Home Affairs
COVID-19 Impacted Students
Please open this form using Adobe Acrobat Reader.
Either type in the fields provided or print this form and complete it using
a pen and BLOCK LETTERS.
Tick where applicable
Part A – Education Provider details
1 Registered provider name
Cricos registration number
Part B – Student details
2 The student’s full name in English
Family name
Given names
3 Date of birth
Day Month Year
4 Details from the student’s passport
Passport number
Country of passport
5 Which visa is the student applying for?
Student (Subclass 500) visa
Go to Part C
Temporary Graduate (Subclass 485) visa
Go to Part D
Part C – Student (Subclass 500) visa
6 Course deferral commencement date
Day Month Year
7 Course deferral end date
8 Reason for deferral
9 New course completion date
10 CoE number
Go to Part E
Part D – Temporary Graduate
(Subclass 485) visa applicant
11 Online study commencement date
Day Month Year
12 Online study end date
13 Name of course
14 CoE number
Part E – Declaration
This section to be completed by the Education Provider.
15 I declare that:
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.
of provider
Day Month Year
Full name
Title/position at the education institution
Telephone number
1545 (Design date 07/20) - Page 2© COMMONWEALTH OF AUSTRALIA, 2020