Fillable Home Affairs form 956A - Appointment or withdrawal of an authorised recipient

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Home Affairs form 956A - Appointment or withdrawal of an authorised recipient

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Country of origin: AUSTRALIA
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956A (Design date 03/18) - Page 1© COMMONWEALTH OF AUSTRALIA, 2018
Appointment or withdrawal of
an authorised recipient
Form
956A
Department of Home Affairs
Who should use this form?
This form should be used to notify the Department of Home
Affairs (the Department) that you are:
• appointing an authorised recipient to receive documents
that the Department would otherwise have sent to you; or
• withdrawing the appointment of your authorised
recipient.
Return the completed form to the office where you lodged
your application or for any other matter (eg. proposed
visa cancellation), to the office of the Department that is
responsible for that matter. If you are unsure which office is
responsible for your matter, this form may be submitted to the
nearest office of the Department.
Do not use this form if:
• you are appointing a migration agent or exempt
person to provide you with immigration assistance and
they will also be your authorised recipient.
In this case the migration agent or exempt person should
complete form 956 Advice by a migration agent/exempt
person of providing immigration assistance.
Who is an exempt person?
The following people do not have to be registered as
migration agents in order to provide immigration assistance:
• a close family member (spouse, child, adopted child,
parent, brother or sister);
• a sponsor or nominator of a visa applicant;
• a member of parliament or their staff;
• an official whose duties include providing immigration
assistance;
• a member of a diplomatic mission, consular post or
international organisation.
An exempt person must not charge a fee for their service. It is
an offence for an exempt person to charge a fee for providing
immigration assistance and penalties of up to 10 years jail can
apply.
Authorised recipient
An authorised recipient is a person appointed to receive
documents from the Department relating to matters arising
under the Migration Act 1958 (the Act) or the Migration
Regulations 1994 on behalf of another person.
The most common times an authorised recipient would
be appointed is during visa application processes, visa
cancellation processes, sponsorship processes (including
monitoring or sanctions) or ministerial intervention requests.
The Department cannot discuss matters relating to you with
the authorised recipient unless they are also acting on your
behalf as your migration agent/exempt person, or you have
separately provided the Department with consent to disclose
your personal information to them.
You may only appoint one authorised recipient at any time
for a particular application or matter. The Department will
send documents to the most recently appointed authorised
recipient.
The Department is required under the Act to send your
authorised recipient any documents relating to your matter
(eg. visa application or cancellation of a visa), that would
otherwise have been sent to you. Under most circumstances,
you will not receive a separate copy of the documents. You are
taken to have received any documents sent to your authorised
recipients as if they had been sent to you.
You should be aware that the documents sent to your
authorised recipient might include sensitive information about
matters such as your health and character.
If you change your authorised recipient or end their
appointment you must promptly advise the Department. You
may use this form for that purpose.
Dependent applicants
All persons listed on this form will be considered to have
appointed the same authorised recipient.
If a person 16 years of age or older wants to appoint a
different authorised recipient they should complete a separate
form 956A.
956A (Design date 03/18) - Page 2 © COMMONWEALTH OF AUSTRALIA, 2018
Consent to communicate electronically
The Department may use a range of means to send
documents to your authorised recipient. However, electronic
means such as fax or email will only be used if your authorised
recipient indicates their agreement to receiving documents on
your behalf in this way.
To process your matter with the Department (such as visa
application or visa cancellation action), the Department may
need to communicate with you about sensitive information,
for example, health, police checks, financial viability and
personal relationships. This means the information may be
contained in the documents that are sent to your authorised
recipient. Electronic communications, unless adequately
encrypted, are not secure, and any information about you sent
electronically to your authorised recipient may be viewed by
others or interfered with. If your authorised recipient agrees
to the Department sending your documents to them by
electronic means, the details they provide will only be used by
the Department for the purpose of sending documents. They
will not be added to any mailing list.
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.
Important information about privacy
Your personal information is protected by law, including the
Privacy Act 1988. Important information about the collection,
use and disclosure (to other agencies and third parties,
including overseas entities) of your personal information,
including sensitive information, is contained in form 1442i
Privacy notice. Form 1442i is available from the Department’s
website www.homeaffairs.gov.au/allforms/ or offices of the
Department. You should ensure that you read and understand
form 1442i before completing this form.
www.homeaffairs.gov.au
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.
Home page
General
enquiry line
Please keep these information pages for your reference
956A (Design date 03/18) - Page 3© COMMONWEALTH OF AUSTRALIA, 2018
Appointment or withdrawal of
an authorised recipient
Form
956A
Department of Home Affairs
Your details
Family name
Family name
Note: Your migration agent/exempt person should complete form 956
Advice by a migration agent/exempt person of providing immigration
assistance
Given names
Given names
4
3
Full name (For an organisation, provide the name of the contact person)
Do you have a Home Affairs (HA) Client ID number (CID)?
6
7
Organisation name (if applicable)
Business or residential address
8
Address for correspondence
(If the same as business or residential address, write
‘AS ABOVE’)
POSTCODE
POSTCODE
Office hours
Telephone numbers
9
Mobile/cell
( ) ( )
COUNTRY CODE AREA CODE NUMBER
1
Are you using this form to notify the Department that you are:
Complete Part B and Part C
You do not need to complete Part A
Complete Part A and Part C
You do not need to complete Part B
appointing an
authorised recipient
withdrawing the
appointment of an
authorised recipient
Title: Mr Mrs Miss Ms Other
Part A – New appointment
2
Are you a:
(tick one only)
visa applicant
sponsor or sponsor applicant
nominator or nominator applicant
proposer or proposer applicant
visa holder whose visa is being considered for
cancellation or has been cancelled
person requesting ministerial intervention
Family name
Given names
1.
Family name
Family name
Given names
Given names
2.
3.
10
Names of other persons 16 years of age or older who are appointing
the same authorised recipient in relation to the same matter
5
Date of birth
DAY MONTH YEAR
Give details of the migration agent/exempt person
HA Client ID
number (CID)
11
Have you appointed a migration agent or exempt person to provide you
with immigration assistance?
No
No
Yes
Yes
: : : : :
7 DIGITS
Migration Agent Registration
Number (MARN)
If applicable:
Offshore Agent ID Number
If there are more than 3 other persons, give details at Question 30
3
Tick where applicable
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.
956A (Design date 03/18) - Page 4 © COMMONWEALTH OF AUSTRALIA, 2018
Authorised recipient’s detailsAppointment details
Family name
Given names
14
Full name
16
Business or residential address
17
Address for correspondence
(If the same as business or residential address, write
‘AS ABOVE’)
POSTCODE
POSTCODE
Title: Mr Mrs Miss Ms Other
Office hours
Telephone numbers
18
Mobile/cell
( ) ( )
COUNTRY CODE AREA CODE NUMBER
19
Does this person agree to the Department communicating with
them by fax, email or other electronic means?
Give details
Go to Part C
No
Yes
Fax number
Email address
( ) ( )
COUNTRY CODE AREA CODE NUMBER
12
Are you appointing an authorised recipient in relation to an application
process, a cancellation process or another matter (eg. a sponsorship
monitoring and sanction activity by the Department, or only one stage
of a two stage visa application, or ministerial intervention)?
Application process
Cancellation process
Another matter – give details
Not yet lodged
Date lodged
Date visa granted
Type of application
Subclass of visa
DAY MONTH YEAR
DAY MONTH YEAR
15
Date of birth
DAY MONTH YEAR
13
Provide the HA ID number (if known) attached to the matter listed in
Question 12 in relation to which you are appointing an authorised
recipient
HA Request ID number (RID)
HA Transaction Reference
Number (TRN)
Go to Part C
If insufficient space, give details at Question 30
956A (Design date 03/18) - Page 5© COMMONWEALTH OF AUSTRALIA, 2018
Family name Family name
Full name (For an organisation, provide the name of the contact person) Full name
Given names Given names
20
Your details
Date of birth
DAY MONTH YEAR
Organisation name (if applicable)
Part B – Withdrawing an appointment
25
Authorised recipient’s details
Office hours
Telephone numbers
Mobile/cell
( ) ( )
COUNTRY CODE AREA CODE NUMBER
HA Client ID number (CID)
(if known)
Family name
Given names
1.
Family name
Family name
Given names
Given names
2.
3.
21
Names of other persons 16 years of age or older who are
withdrawing the appointment of the same authorised recipient in
relation to the same matter
26
Are you withdrawing the appointment of an authorised recipient in
relation to an application process, a cancellation process or another
matter (eg. sponsorship monitoring and sanction activity by the
Department, or only one stage of a two stage visa application, or
ministerial intervention)?
Application process
Cancellation process
Another matter – give details
Date lodged
Date visa granted
Type of application
Subclass of visa
DAY MONTH YEAR
DAY MONTH YEAR
27
Provide the HA ID number (if known) attached to the matter in relation
to which you are withdrawing your appointment of the authorised
recipient
HA Request ID number (RID)
HA Transaction Reference
Number (TRN)
If insufficient space, give details at Question 30
Your contact details
22
Business or residential address
23
Address for correspondence
(If the same as business or residential address, write
‘AS ABOVE’)
POSTCODE
POSTCODE
Office hours
Telephone number
( ) ( )
COUNTRY CODE AREA CODE NUMBER
24
Do you agree to the Department communicating with you by fax,
email or other electronic means?
Give details
No
Yes
Fax number
Email address
( ) ( )
COUNTRY CODE AREA CODE NUMBER
956A (Design date 03/18) - Page 6 © COMMONWEALTH OF AUSTRALIA, 2018
Part C – Declarations
28 29
Authorised recipient declaration Your declaration
Tick one onlyTick one only
Appointment
I declare that I have appointed the authorised recipient named in
Question 14 of this form to receive all documents relating to the
matter indicated in Question 12 on my behalf.
Appointment
I understand that:
• I have been appointed by the persons named in Part A of this
form to be their authorised recipient; and
• as the authorised recipient all documents that would otherwise
be sent to the persons named in Part A will be sent to me,
including by electronic means as indicated in Question 19 (if
applicable).
Withdrawal of appointment
I declare that the authorised recipient named in Question 25 of this
form is no longer authorised to receive documents relating to the
matter indicated in Question 26 on my behalf.
I understand that future correspondence from the Department will be
sent to the last address that I have provided in Question 22, 23 or 24.
I will inform the Department of any changes to my address for
correspondence.
Withdrawal of appointment
I understand that I am no longer acting as authorised recipient
for the persons named in Part B of this form in relation to the
matter indicated in Part B of this form.
Signature of
authorised
recipient
Date
DAY MONTH YEAR
Your
signature
Signatures of other persons 16 years of age or older who are
appointing or withdrawing the appointment of the same authorised
recipient in relation to the same matter
Signature
Signature
Signature
Date
Date
Date
Date
DAY MONTH YEAR
DAY MONTH YEAR
DAY MONTH YEAR
DAY MONTH YEAR
We strongly advise that you keep a copy of this form for
your records.
-
-
-
-
-
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.
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956A (Design date 03/18) - Page 7© COMMONWEALTH OF AUSTRALIA, 2018
Additional details
Question number Additional information
30
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Home Affairs form 956A - Appointment or withdrawal of an authorised recipient

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Completed 16 September 2019

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