A Papua New Guinea traditional inhabitant from the PNG area of jurisdiction of the Protected Zone who is now an
Australian citizen and resides in the Protected Zone or adjacent coastal area of Australia who was granted
permanent residency status under the 1978/79 Immigration Taskforce Amnesty List. Or is a descendent of such a
person.
NOTE: The applicant must attach either a letter of confirmation from the Department of Immigration and
Border Protection, OR if the applicant is a descendant of such a person, they must attach a letter from the
Department of Immigration and Border Protection for their parent and a copy of their birth certificate as
evidence that they are related to the person named in the letter.
I confirm that any required preliminary evidence is attached.
Councillor’s Signature:………………………………………………………………. Date: ……/……/……
I, ……………………………………………, the Mayor^ of …………………………………………Council, having:
(insert name) (insert council name)
(tick the appropriate description below)
known the applicant for …………… years,
OR
sighted supporting documentation which is attached
#
,
agree with Councillor ………………………………………… that the applicant is:
(insert Councillor’s name)
(tick the appropriate description below)
A Torres Strait Islander who lives in the Protected Zone or adjacent coastal area of Australia and is an Australian
citizen who maintains traditional customary associations with the area in relation to subsistence or livelihood or
social, cultural or religious activities.
OR
An Aboriginal traditional inhabitant of the Torres Strait or the northern peninsula area as defined under the Torres
Strait Treaty and who is resident of that area.
OR
A Papua New Guinea traditional inhabitant from the PNG area of jurisdiction of the Protected Zone who is now an
Australian citizen and resides in the Protected Zone or adjacent coastal area of Australia who was granted
permanent residency status under the 1978/79 Immigration Taskforce Amnesty List. Or is a descendent of such a
person.
I confirm that any required preliminary evidence is attached.
Mayor’s signature:……………………………………………………………………. Date: ……/……/……
(^ - Note that the Councillor and Mayor signing this identification form must be from the same Council.)
(
#
- Note that the first identifying person’s declaration is insufficient supporting documentation for the second
identifying person to independently determine whether the applicant meets the described criteria.)