Application for a Form

Austrolian Government
Deparrtment of Immigration
Temporary Work (Long Stay Activity) visa 1482
and Border Protection

The Department of Immigration and Border Protection (the have been nominated by a long stay activity sponsor to
department) acknowledges that Aboriginal and Torres Strait undertake full-time domestic duties in the private household
Islander peoples are the traditional custodians of the Australian of an eligible Temporary Work (Skilled) (subclass 457) visa
land. holder or a Temporary Work (International Relations)
(subclass 403) visa holder who has been granted in the
Life in Australia – Australian values
The Australian Government encourages people to gain an privileges and immunities stream; or
understanding of Australia, its people and their way of life, are a family member of a primary applicant or holder of a
before applying for a visa to live in Australia. As part of this Temporary Work (Long Stay Activity) visa, Exchange visa,
application every person aged 18 years or over must declare that Sport visa, Religious Worker visa or Domestic Worker
they will respect Australian values, as outlined below and obey (Executive) visa and you are applying to join them.
the laws of Australia. Who should be included in this application?
Australian values include respect for the freedom and dignity of As the primary person you should include your details as well as
the individual, freedom of religion, commitment to the rule of all family members (secondary persons) who will be
law, Parliamentary democracy, equality of men and women and a accompanying you to Australia.
spirit of egalitarianism that embraces mutual respect, tolerance, Family members include your partner, children under 18 years of
fair play and compassion for those in need and pursuit of the age AND children and other relatives 18 years or over who are
public good. wholly or substantially reliant on you for financial support for
Australian society also values equality of opportunity for their basic needs.
individuals, regardless of their race, religion or ethnic ‘Partner’ means your spouse or de facto partner (including a
background. same-sex partner).
It is also important to understand that English is the national People 18 years or over must show that they have been reliant on
language. you for a substantial period and that they are more reliant on
Further information is contained in the Life in Australia booklet, you than on any other person or source. A person may also be
however, you are not required to read the booklet. The booklet is considered dependent on you if they rely on you for financial
available in a wide range of languages. If you would like a copy of support because of a disability.
the booklet it can be obtained from [Link] Note: A child of any age who is engaged to be married or who
About this form has a partner is not considered dependent
Important – Please read this information carefully before you Family members joining a temporary resident in Australia
complete the application. Once you have completed the If as a family member you intend to join the primary person in
application we strongly advise that you keep a copy for your Australia who holds a Temporary Work (Long Stay Activity)
records. (subclass 401) visa, Exchange (subclass 411) visa, Sport (subclass
All relevant questions on this form should be answered and any 421) visa, Religious Worker (subclass 428) visa or Domestic
requested information attached. The department may decide the Worker (Executive) (subclass 427) visa you will need to make a
application on the basis of the information provided on the separate visa application.
application form. All applicants for this visa must be sponsored. You must show
All forms are available from the department’s website evidence that the organisation in Australia who has sponsored
[Link]/allforms/ the primary visa holder will also accept responsibility for you
Who should use this form? during your stay in Australia.
Use this form if you: Integrity of application
have been nominated by a long stay activity sponsor or The department is committed to maintaining the integrity of the visa
exchange sponsor to work in a skilled position under a staff and citizenship programmes. In relation to this application, if you or
exchange arrangement; a member of your family unit:
provide, or have provided in a previous application, fraudulent
have been nominated by a long stay activity sponsor or sport documents or false or misleading information (knowingly or not);
sponsor to be employed or to undertake an activity in a and/or
sports position in relation to a sporting club, team or event in fail to satisfy, or have failed to satisfy in a previous
Australia; application,the Minister of your or their identity;
have been nominated by a long stay activity sponsor or this visa application may be refused and you, and any members of
religious worker sponsor to undertake full-time religious your family unit, may become unable to be granted a visa for
work in Australia that directly serves an institution’s religious specified periods of time, as set out in migration legislation. If
objectives;ralia; information or documents are found to be fraudulent or misleading
after the grant of a visa, it may subsequently be cancelled
People our business © COMMONWEALTH OF AUSTRALIA, 2025 1482 (Design date 07/14) - Page 1
Sponsorship obligations Health insurance requirements
The sponsor must meet a number of sponsorship obligations in You are required to hold adequate private medical and hospital
relation to the primary person and any secondary persons health insurance for the entire time you are in Australia on a
.Further information about sponsorship obligations is available subclass 401 visa. This insurance does not have to be held with an
[Link]’swebsite Australian insurer – arrangements made in your home country
[Link]/business/pages/temporary-residence- may be assessed as being acceptable.
[Link] To meet this requirement you should attach to this application
If your visa application is approved, it will permit you to work or evidence of your health insurance policy which states the level of
undertake activities for your sponsor in the nominated position, health care provided by the insurance policy. A copy of the
or position in relation to which your visa was granted, for the suggested certification letter and further information on the
visa validity period. Should you cease employment or the minimum level of coverage is available from
activities with your sponsor, or if you believe the sponsor is not [Link]/skilled/
meeting their sponsorship obligations, you should contact your The above does not apply if you have enrolled with Medicare
nearest office of the department. (Australia’s national health cover). Information on entitlements to
To ensure the integrity of temporary sponsored residence visas, Medicare is available from [Link]
the department has a thorough monitoring process to assist in Medicare Levy Exemption
ensuring compliance with programme requirements Subclass 401 visa holders who are not an eligible Australian
resident for Medicare benefit purposes and whose country does
Other obligations
not have a reciprocal health arrangement with Australia may be
The sponsor must also comply with other applicable laws of the
eligible to obtain an exemption of the Medicare levy payment in
Commonwealth, states and territories. If the department believes
their tax return. Please contact Medicare Australia directly for
that the sponsor has breached a law of the Commonwealth or a
further advice on 132 011 or by writing to
state or territory, the department may take action to bar the
: Levy Exemption Certification Unit
sponsor from accessing further overseas people for the specified
Medicare Australia
period or may cancel the sponsorship.
GPO Box 9822
Further information about sponsorship obligations is available
HOBART TAS 7001
from the department’s website Visa conditions
[Link]/business/pages/temporary-residence Visa condition 8107
[Link] If your visa application is approved, it will be subject to visa
Residential address condition 8107.
You must provide the address of where you intend to live during This requires that a primary holder of a subclass 401 visa, must
the period that your application is being considered. Failure to not, during their period of stay:
give your residential address will result in this application being • cease to be employed, or cease to undertake the activity in
invalid. A post office box address will not be accepted as your relation to which the visa was granted;
residential address. • work in a position, or engage in an activity inconsistent with the
Passport information position or activity in relation to which the visa was granted; or
Most visa applicants will be required to hold a valid passport • engage in work for another person or on their own account,
before they can be granted a visa. It is strongly recommended while undertaking the employment or activity in relation to
that the passport be valid for at least 6 months. If you change which the visa was granted.
your passport after you have been granted the visa you must If you wish to work for another organisation which is not your
notify the nearest Australian mission or office of the department. current sponsor you do not need to make a new visa application.
If you do not provide us with the details of any new or Before you can work for another organisation, your new sponsor
additional passport you use to travel to Australia, you may must nominate you to undertake that position. You must not
experience significant delays at the airport and may be commence work for the new sponsor until the nomination is
denied permission to board your plane. approved.
Do NOT send your passport with your visa application. Visa condition – 8501
You must provide with your visa application a certified copy of If your visa application is approved, it will be subject to condition
the page from your passport showing your photo and details. The 8501. This requires all visa holders to maintain adequate health
department will advise you if your application has been insurance while in Australia and holding a subclass 401 visa.
approved. Please keep a copy of the Visa Grant Notification in a Visa condition – 8303
safe place for your reference If your visa application is approved, it will be subject to condition
Health requirements 8303. Visa holders must not become involved in activities
All applicants must meet Australia’s health requirements. You and disruptive to, or violence threatening harm to, the Australian
any family members included in this application may be required community or a group within the Australian community.
to undergo a chest x-ray and health examination in order to meet In addition, there may be other conditions of your entry and stay
the criteria for the grant of a subclass 401 visa. in Australia applied to your visa.
For further information, refer to the department’s website
[Link]/allforms/health-requirements/health
[Link]
1482 (Design date 07/14) - Page 2
© COMMONWEALTH OF AUSTRALIA, 2025
How to apply
Step 1 –Sponsorship and nomination Step 4 – Visa application charge
To make a valid application for a subclass 401 visa, you must not Check if a Visa Application Charge is required.
make your visa application before the organisation that intends Not all applications attract a charge, but when a prescribed
to sponsor you has: charge is applicable, the application will not be valid unless
• made an application to become a long stay activity sponsor, payment has been received.
exchange sponsor, sport sponsor or religious worker sponsor; and A charge is not required if the nominated activity is listed in a
• made a nomination identifying you and the position that you Legislative Instrument.
intend to undertake in Australia. If a charge is required, payment must accompany your
If the organisation has been approved as a sponsor and the application. Payment of the charge does not guarantee this
nomination has been approved, your sponsor will provide you application will be successful and is generally not refundable.
with a copy of the Nomination approval letter for you to provide Charges may be subject to adjustment on 1 July each year.
with your visa application. If the sponsorship or nomination has Refer to Part N – Payment details of this form to calculate the
not been decided when you make your visa application the correct charge and make payment.
sponsor will provide you with the Nomination application To make a payment in Australia, please pay by credit card, debit
acknowledgement of receipt letter to confirm that a nomination card, bank cheque or money order made payable to the
has been made. Department of Immigration and Border Protection. Debit card
The visa application will not be assessed until the nomination is and credit card are the preferred methods of payment.
decided. We recommend that you lodge your visa application Step 5 – Making your visa application
after you receive confirmation that the nomination is approved. To make your visa application you must provide the completed
Step 2 – Check your passports application, payment and any attachments if required. Refer to
Make sure you and all family member(s) seeking to accompany Part O – Document checklist for the list of documents required.
you have valid passports. It is strongly recommended that If you are making a paper-based visa application in certain
passports be valid for at least 6 months. countries you will need to provide biometrics, see ‘Countries and
If you are already in Australia and are eligible to apply in Visa Subclasses included in the Biometrics Programme’ on the
Australia, check the expiry date of your current visa. If you can department’s website
apply whilst in Australia, you should make your visa application [Link]/allforms/biometrics/offshore/
before your current visa expires. Your application should be lodged at the correct address for this
Note: If you already have a visa for travel to Australia and you visa application. More information about Temporary Work (Long
are granted another visa, the first visa will cease. Stay Activity) visas and lodgement addresses is available from the
Step 3 – How to fill in this form department’s website
This form is available as a PDF file and can be completed on [Link]/visas/pages/[Link].
screen, printed and mailed to the department or you can print a Please read the information under ‘How to apply’ for the correct
copy and use a black or blue pen, write neatly in English using lodgement address for this application.
BLOCK LETTERS.
You will be required to select the visa stream that relates to the Let the department know if you change your address
position that you intend to undertake and that matches the If you change your residential address for more than 14 days
nomination type identified by your sponsor in the nomination. while your application is being processed, you must tell the
The 4 streams of the subclass 401 visa are: department your new address and how long you will be there.
Exchange – for skilled people entering under exchange The department will send communication about your application
arrangements, giving Australian residents reciprocal to the latest address for correspondence you have provided.
opportunities to work with overseas organisations
Sport – for sports people to improve the quality of sport in Communication about your application can be sent to another
Australia through participation in high-level competition with person that you have authorised, but you will be taken to have
Australian residents received the communication that the department sends to that
•Religious worker – for religious workers who want to person. The department must be informed (in writing) of any
undertake full-time religious work in Australia that directly address change for either you or your authorised person
serves an institution’s religious objectives
Domestic worker (executive) – for domestic staff to work in
the private household of an eligible Temporary Work
(Skilled) (subclass 457) visa holder or Temporary Work
(International Relations) (subclass 403) visa holder granted in
the privileges and immunities stream, who is a senior
executive in charge of an Australian office of the foreign
organisation or foreign government agency.
If you need more space to answer questions or wish to provide
additional relevant information, give details at Part Q –
Additional information or attach a signed and dated sheet giving
the required details.
Any alterations made on the form must be initialled and dated.
You will need to supply a recent passport-sized photograph of
each person included in this application. © COMMONWEALTH OF AUSTRALIA, 2025 1482 (Design date 07/14) - Page 3
Applications made by people who are in Australia Migration agents in Australia
Migration agents in Australia If you are applying for a class of Migration agents in Australia must be registered with the Office
visa which may be granted in Australia, this form also serves as of the Migration Agents Registration Authority (Office of the
an application for any class of Bridging visa (Classes A, C or E) for MARA) unless they are exempt from registration.
which you may be eligible to apply. Further explanation is
available on the department’s website Migration agents outside Australia
[Link]/visas/bridging/ Migration agents who operate outside Australia do not have to be
If you need to travel overseas temporarily before the application registered. The department may give some overseas agents an ID
is decided, you should contact the processing office to enquire number. This number does not mean that they are registered.
about a Bridging visa B, to enable you to return to Australia. Note: Some Australian registered migration agents operate
If you are seeking to change the work conditions of your existing overseas. Migration agent information A migration agent is
visa before the application is decided, you should apply on form someone who can:
1005 Application for a bridging visa. advise you on the visa that may best suit you;
You should lodge the form at the nearest office of the department tell you the documents you need to submit with your
in the state or territory in which you are at the time of application;
application (if you are in NSW, you may lodge your application in help you fill in the application and submit it; and
the ACT if it is closer to where you live). communicate with the department on your behalf.
This application will not be valid if you are a holder of a criminal If you appoint a migration agent, the department will assume that
justice entry visa, or if you are a detainee who has not made an your migration agent will be your authorised recipient, unless
application within the prescribed time limits, or if you are a you indicate otherwise.
holder of a visa subject to a condition preventing the grant of a Your migration agent will be the person with whom the
substantive visa while you remain in Australia. department will discuss your application and from whom it will
seek further information when required.
What happens next? You are not required to use a migration agent. However, if you
Your application will be considered and you may be asked to use a migration agent, the department encourages you to use a
provide additional information to enable a decision to be made. registered migration agent. Registered agents are bound by the
If you want to change any details after you have made the Migration Agents Code of Conduct, which requires them to act
application, or if you want to withdraw it, please contact the professionally in their clients’ lawful best interests.
office where you made the application. Information on migration agents, including a list of registered
You should also advise the office if any of the information you migration agents, is available on the Office of the MARA website
gave in your application changes while your application is being [Link]
considered. You will be advised in writing whether your You can also access information about migration agents on the
application has been approved or not. department’s website [Link]
If your application is approved you will be advised that you have
been granted a subclass 401 visa on the basis of satisfying one of Exempt persons
the following streams: The following people do not have to be a registered migration
Exchange; agent in order to provide immigration assistance, but they must
Sport; • Religious worker; or not charge a fee for their service:
Domestic worker (executive). a close family member (spouse, de facto partner, child,
Family members who will accompany you or who applied parent, brother or sister);
separately to join you will receive advice that they have been a member of parliament or their staff;
granted a subclass 401 visa. If your application is refused, you an official whose duties include providing immigration
will be given a reason for the decision as well as information assistance (eg. a Legal Aid provider);
about your review rights. a member of a diplomatic mission, consular post or
international organisation.
Immigration assistance
A person gives immigration assistance to you if he or she uses, or Appointing a migration agent/exempt person
claims to use, his or her knowledge or experience in migration To appoint a migration agent/exempt person you should complete
procedure to assist you with your visa application, request for Part M – Options for receiving written communications. Your
ministerial intervention, cancellation review application, migration agent/exempt person should complete form 956 Advice
sponsorship or nomination. by a migration agent/exempt person of providing immigration
In Australia a person may only lawfully give immigration assistance.
assistance if he or she is a registered migration agent or is Form 956 is available from the department’s website
exempt from being registered. Only registered migration agents [Link]/allforms/
may receive a fee or reward for providing immigration
assistance.
If an unregistered person in Australia, who is not exempt from
registration, gives you immigration assistance they are
committing a criminal offence and may be prosecuted

1482 (Design date 07/14) - Page 4 © COMMONWEALTH OF AUSTRALIA, 2025

Options for receiving written communications Important information about privacy
If you do not appoint a migration agent/exempt person you may Your personal information is protected by law, including the
still authorise another person, in writing, to receive written Privacy Act 1988. Important information about the collection, use
communications on your behalf. This person is called the and disclosure (to other agencies and third parties, including
authorised recipient. overseas entities) of your personal information, including
sensitive information, is contained in form 1442i Privacy notice.
Authorised recipient information Form 1442i is available from the department’s website
All written communication about your application will be sent to [Link]/allforms/ or offices of the department. You
your authorised recipient, unless you indicate that you wish to should ensure that you read and understand form 1442i before
have health and/or character information sent directly to you. completing this form.
The department will communicate with the most recently As sponsorship is required for your visa subclass, the outcome of
appointed authorised recipient as you may only appoint one your application may be made known to the person/ organisation
authorised recipient at any time for a particular application. who has submitted a sponsorship form regarding your
You will be taken to have received any documents sent to that application.
person as if they had been sent to you.
To appoint an authorised recipient you should complete:
Part M – Options for receiving written communications; and
form 956A Appointment or withdrawal of an authorised
recipient.
Note: Migration agents/exempt persons do not need to complete
form 956A. Form 956A is available from the department’s website
[Link]/allforms/

Consent to communicate electronically

The department may use a range of means to communicate with
you. However, electronic means such as fax or 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.
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.
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.
Home page [Link]
If you authorise another person to receive documents on your
General Telephone 131 881 during business hours in
behalf and they wish to be contacted electronically, their
enquiry line Australia to speak to an operator (recorded
signature is required on form 956 or 956A to indicate their
information available outside these hours). If
consent to this form of communication.
you are outside Australia, please contact your
Note: Electronic communication is the fastest means of
nearest Australian mission.
communication available and the department prefers to
communicate electronically because this results in faster
processing

Please keep these information pages for your reference

© COMMONWEALTH OF AUSTRALIA, 2025 1482 (Design date 07/14) - Page 5
This page is intentionally blank
 Application for a Form
Austrolian Government
Deparrtment of Immigration
Temporary Work (Long Stay Activity) visa 1482
and Border Protection

Please use a pen, and write neatly in English using BLOCK LETTERS
Tick where applicable

Part A – Application information

1. Are you currently outside Australia?
No
Yes > Intended arrival date
DAY MONTH YEAR
5 Has your sponsor made a nomination that identifies you in
02 AUG 2025
relation to undertaking employment or an activity in Australia?
No >Important – To apply for this visa a nomination
2 How many applicants are included in this application
application must already be made or approved.
(including yourself and your family members)?
Yes > Nomination ID number
3 If you are required to attend an office of the department, 198-713-145-890-11653
which office is 3 the closest to your current location? Note: Nomination ID number can be found on the
BANGLADESH Nomination approval letter or on the N omination
application. acknowledgement of receipt letter that was
4 Do you have a sponsor who is approved or who has made
provided to the sponsor from the department.
an application for approval as a:
Long stay activity sponsor;
Attach a copy of the letter, see Part O – Document checklist.
Exchange sponsor;
Sport sponsor; or 6 Which stream of the visa does this application relate to? For further
Religious worker sponsor? information see Step 3 – How to fill in this form Sport on page 3.

No Exchange >Attach a copy of the staff exchange

>Important – To apply for this visa a sponsorship
agreement, see Part O – Document checklist.
application must already be made or approved.
Yes > Sponsor name Sport >If the position relates to a contracted position,
Mattew Cottrell attach a copy of the contract
, see Part O – Document checklist.
Organisation name
Religious worker
The BHP Grope Australian Inc.
Approval date Domestic worker > Attach a signed employment declaration from
DAY MONTH YEAR
(executive) your sponsor, see Part O – Document checklist.
02 AUG 2025
7 The Visa Application Charge (VAC) will not be required if the
Sponsor class
primary applicant is listed as a class of person in a Legislative
2nd Class Instrument. Your sponsor will be able to provide you with advice.
Sponsorship application ID number (if known) Is the nominated position you will be undertaking in an exempt group
HG746843 No
Yes

1482 (Design date 07/14) - Page 7

 Part B –Your details
8 Are you applying as a: 12 Relationship status
Primary applicant > Go to Question 9 Married Divorced Never married or
Family member applying > Give details of the primary person De facto Separated been in a de facto
separately and wishing to join a you intend to join and stay with in Engaged Widowed relationshi
person who already holds a visa Australia
13 Are you or have you been known by any other name?
Family name (including name at birth, previous married names, aliases)
No
Yes > Give details
Given names

Sex Male Female 14 Are you a citizen of any other country?

DAY MONTH YEAR No
Date of birth Yes > List countries

Note: You must be aged 18 or over if applying

in the domestic worker (executive) stream.
15 Do you have other current passports?
Visa subclass held No
Client ID or Yes > Give details
visa grant number Passport number A16284449

Country of passport BANGLADESH

10 Give the following details exactly as they appear in your passpor 16 Do you hold an identity card or identity number issued to
t It is strongly recommended that passports be valid for at least 6 months. you by your government (eg. National identity card) (if
applicable)?
Note: If you are the holder of multiple identity numbers
Family name SUMON because you are a citizen of more than one country, you
need to enter the identity number on the card from the
Given names RANA country that you live in.
No
Yes > Give details
Sex Male Female Family name SUMON
DAY MONTH YEAR

Date of birth 01 JUN 1987 Given names RANA

Passport number A16284449

Type of document NID
Country of passpor BANGLADESH
Identity number 198-713-145-890-11653
Nationality of BANGLADESH Country of issue BANGLADESH
passport holder
Date of issue 02 AUG 2025 17 Name in Chinese Commercial Code Number (if applicable)
NO
Date of expiry 01 AUG 2030
18 In which country are you currently located?
Place of issue/ BANGLADESH
DIP/DHAKA
issuing authority
19 Legal status in your current location

11 Place of birth Citizen Student No legal

Visitor Work visa
Town/city CHANDPUR Permanent resident status
State/province CHANDPUR Other > Give details

Country BANGLADESH

1482 (Design date 07/14) - Page 8

20 POSTCODE Your current residential address 25 Give details of ALL family members who are included in this
Note: A street address is required as a post office box address cannot application and who will accompany you to Australia
be accepted. . Enter the following details exactly as they appear in their passport.
CHANDPUR It is strongly recommended that passports be valid for at least 6
months.
Family name

POSTCODE: 824818 Given names

Country BANGLADESH
Date of birth Male Female
21 Address for correspondence Place of birth
(If the same as your residential address, write ‘AS ABOVE’)
Town/city
CHANDPUR
Country
Relationship to the
primary applicant
POSTCODE: 824818
Relationship status
Country BANGLADESH
Married Divorced Never married or
De facto Separated been in a de facto
22 Contact telephone numbers
Engaged Widowed relationshi
COUNTRY CODE AREA CODE NUMBER
Citizenship
Hom ( ) ( )
Passport number
Office ( ) ( ) Country of
passport
Mobile/cell +8801725916074
Date of issue
23 Do you agree to the department communicating with you by email and/or
fax? Date of expiry
This may include receiving notification of the outcome of this application.
Note: We can communicate about this application more quickly using Place of issue/
email and/or fax issuing authority
No
Yes > Give details Is this family member or has this family member ever been known
by any other name?
Email address yesminsultana807@[Link]
COUNTRY CODE AREA CODE NUMBER NO Yes > Give details

Fax number ( ) ( )

Is this family member a citizen of any other country?

Part C – Family members NO Yes > List countries

24 Do you have any family members who will accompany you to Australia?
No > Go to Part D
Does this family member have other current passports?
Yes
NO Yes > Give details

Passport number
Country of passport

Does this family member have national identity documents?

NO Yes > Give details

Type of document
Identity number
Country of issue
Name in Chinese Commercial Code Number (if applicable)
2..Family name 2..Family name

Given names Given names

DAY MONTH YEAR DAY MONTH YEAR

Date of birth Male Female Date of birth Male Female
Place of birth Place of birth

Town/city Town/city
Country Country
Relationship to the Relationship to the
primary applicant primary applicant
Relationship status Relationship status
Married Separated Never married or Married Separated Never married or
Engaged Divorced been in a de facto Engaged Divorced been in a de facto
De facto Widowed relationship De facto Widowed relationship

Citizenship Citizenship
Passport number Passport number
Country of passport Country of passport
DAY MONTH YEAR DAY MONTH YEAR
Date of issue Date of issue
Date of expiry Date of expiry
Place of issue/ Place of issue/
issuing authority issuing authority
Is this family member or has this family member ever been known
Is this family member or has this family member ever been known
by any other name?
by any other name?
NO Yes > Give details
NO Yes > Give details

Is this family member a citizen of any other country? Is this family member a citizen of any other country?
NO Yes > List countries NO Yes > List countries

Does this family member have other current passports? Does this family member have other current passports?
NO Yes > Give details NO Yes > Give details

Passport number Passport number

Country of passport Country of passport

Does this family member have national identity documents? Does this family member have national identity documents?

NO Yes > Give details NO Yes > Give details

Type of document Type of document

Identity number Identity number

Country of issue Country of issue

Name in Chinese Commercial Code Number (if applicable) Name in Chinese Commercial Code Number (if applicable)

1482 (Design date 07/14) - Page 10 © COMMONWEALTH OF AUSTRALIA, 2024

 Part D – Visa information
26. Have you or any other person included in this application previously
2..Family name travelled to or applied to travel to Australia?
No
Yes > Give details
Given names
1. Full name
Class of visa
DAY MONTH YEAR applied for
DAY MONTH YEAR
Date of birth Male Female
Place of birth Date of issue

Place of issue
Town/city The visa application was/is:
Country Granted Refused
Withdrawn Pending
Relationship to the
primary applicant Visa label V <
number
Relationship status

--
--

--

--

--

--

--

--

--
Visa grant number (if granted a visa without a label, please provide the
Married Separated Never married or 13-digit visa grant number, as shown on the letter notifying the
Engaged Divorced been in a de facto applicant of the grant of the visa)
De facto Widowed relationship
DAY MONTH YEAR
Citizenship Visa expiry date
Passport number
Country of passport 2 Full name
DAY MONTH YEAR Class of visa
applied for
Date of issue DAY MONTH YEAR
Date of expiry
Date of issue
Place of issue/
issuing authority Place of issue

Is this family member or has this family member ever been known The visa application was/is:
by any other name? Granted Refused
NO Yes > Give details Withdrawn Pending

Visa label V <

number
--
--

--

--

--

--

--

--

--
Visa grant number (if granted a visa without a label, please provide the
13-digit visa grant number, as shown on the letter notifying the
Is this family member a citizen of any other country?
applicant of the grant of the visa)
NO Yes > List countries
DAY MONTH YEAR

Visa expiry date

Does this family member have other current passports? 3 Full name
NO Yes > Give details Class of visa
applied for
DAY MONTH YEAR
Passport number
Date of issue
Country of passport
Place of issue
Does this family member have national identity documents?
The visa application was/is:
NO Yes > Give details Granted Refused
Withdrawn Pending
Type of document
Visa label V <
Identity number number
--
--
--

--

--

--

--

--

--

Country of issue Visa grant number (if granted a visa without a label, please provide the
13-digit visa grant number, as shown on the letter notifying the
Name in Chinese Commercial Code Number (if applicable) applicant of the grant of the visa)

DAY MONTH YEAR

Visa expiry date

1481 (Design date 07/14) - Page 11

27 In the last 10 years have you or any other person included in this application lived in a
country other than your usual country of residence for 12 months or more (in total?
NO
Yes > Give details

Dates lived there Last permanent address in

Full name Country
MONTH YEAR that country

FROM

TO

FROM

TO

FROM

TO

FROM
TO

FROM

TO

FROM
TO

FROM

TO

FROM

TO

FROM

TO
FROM

TO
FROM

TO
FROM

TO

FROM

TO

FROM

TO

FROM

1482 (Design date 07/14) - Page 12

 Part E – Employment or activity details 3 Contact person in organisation
Family name SUMON
28 Give details of the proposed period of stay in Australia
DAY MONTH YEAR DAY MONTH YEAR
Given names RANA
Date from 02 AUG 2025 to 01 AUG 2030

Position Employee
29 What is the proposed period of employment or
activity? Note: The dates should be the same dates as Telephone
number {AREA CODE }
given on the nomination application provided by your
sponsor. +8801725916074
Mobile/cell
DAY MONTH YEAR DAY MONTH YEAR

Date from 02 AUG 2025 to 01 AUG 2030

Part F-Funding for stay
Note: If the proposed period of stay is for 12 months or 34 Will you receive remuneration for undertaking the work or activity in
more a police clearance certificate will be required, see Part Australia?
O – Document checklist. NO > Give details of how you will fund your stay
30 Give details of the type of employment or activity that
you will be undertaking in Australia
Position/role
WORKER
Yes > What does the remuneration package include?
Name of the occupation (if applicable) Monetary value (AUD)
Food packaging AUD 0.000.00
Salary/wages >
Duties of the position
Weekly
Employee assignrd to the assigned work of tha Monthly
office Annually
Other > Specify

31 Give details of the organisation for whom the work or

Accommodation AUD
activity will be undertaken
Name of the organisation Meal allowance AUD
The BHP Grope Australian Inc. Other living allowance AUD
Registration type Travel allowance AUD
Australian Business Number (ABN Commissions, shares AUD
5 6 8 5 8 7 3 2 3 5 6 and/or bonuses
Other packaged items
--
--
--

--

--

--

--

--

--

Australian Company Number (ACN) (if applicable) AUD

or benefits including
8 9 2 4 6 9 4 3 2 but not limited to, cars,
--
--

--

--

--

--

--

phones, laptop computers,

Australian Registered Body Number (ARBN) (if
airline club memberships,
applicable)
medical cover, child care,
4 8 6 2 6 8 9 clothing allowances
--
--

--

--

--

--

--

--

Australian Stock Exchange Code (ASX Code) (if Give all relevant details
applicable)
Monthly allownce will be determined based on
NO discussin and skills
Certificate of Incorporation (if applicable)
NO

32 Street address where the employment or activity will take place

Note: A street address is required as a post office box address
cannot be accepted. If insufficient space, give details at Part Q-Additional information

2-24 The Crescent,Mildura,Victoria,3500 AUS Atach evidence of financial capacity, se Part 0-Document checklist

POSTCODE: 2500

If more than 2 addresses, give details at Part Q –

Additional information
1482 (Design date 07/14) - Page 13
© COMMONWEALTH OF AUSTRALIA, 2025
 Part G – Employment history Part H – Qualifications, skills and experience
35. Have you been employed in the last 10 years? 37. Give details of your qualifications, skills, experience and
No Go to Part H registrations/licenses that are relevant to the proposed
Yes employment or
activity in Australi
36. Give details of your employment history in the last 10 years List relevant qualifications/academic merit
List your most recent employment first.
N/A
1. Position
Employer
name - -

Country
DAY MONTH YEAR DAY MONTH YEAR
Date from TO List relevant skills
Description - - Knowledge of food handling, storage, and packaging
of duties - - procedures Experience in operating food packaging
machinery Understanding of hygiene and sanitation
standards in food production Ability to work in fast-
2. Position paced environments and meet production targets
Strong teamwork and communication skills
Employer
name -

Country Describe the relevant experience

DAY MONTH YEAR DAY MONTH YEAR anaged automated food packaging machines to ensure
Date from TO efficient operations Maintained hygiene standards and
followed HACCP guidelines Inspected packaging materials
Description - for quality control Ensured proper labeling and sealing of
of duties - food products

3. Position
Employer Registration/Licensing/Professional memberships/achievements
name - (if applicable)

N/A
Country
DAY MONTH YEAR DAY MONTH YEAR
Date from TO

Description -
of duties -

If insufficient space, give details at Part Q – Additional information

4. Position Attach a copy of your qualifications and experience,
see Part O – Document checklist.
Employer
name -

Country
DAY MONTH YEAR DAY MONTH YEAR
Date from TO

Description -
of duties -

1482 (Design date 07/14) - Page 14

 Part J – Health details
41 Do you, or any other person included in this application,
38. In the last 5 years, have you, or any other person included in this intend to work, or be a trainee, at a child care centre
application, visited or lived outside your country of passport for (including preschools and creches) while in Australia?
more than 3 consecutive months? No
1. Position Yes > Give details
Employer No, I do not, and no other person included in this
name - application intends to work or be a trainee at a child care
centre (including preschoolsand creches) while in Australia.
Country
DAY MONTH YEAR DAY MONTH YEAR
Date from TO
42 Do you, or any other person included in this application,
- intend to be in a classroom situation for more than 3 months
2. Position (eg. as either a student, teacher, lecturer or observer)?

Employer No
name - Yes > Give details
- No, I do not, and no other person included in this
Country
application intends to be in a classroom situation for more
DAY MONTH YEAR DAY MONTH YEAR than 3 months as a student, teacher, lecturer, or observer
Date from TO while in Australia.

-
3. Position 43. Have you, or any other person included in this application:
ever had, or currently have, tuberculosis?
Employer
- been in close contact with a family member that has active
name
tuberculosis?
Country ever had a chest x-ray which showed an abnormality?
No
DAY MONTH YEAR DAY MONTH YEAR
Yes > Give details
Date from TO
No, neither I nor any other person included in this
-
If insufficient space, give details at Part Q – Additional information
application:
Have ever had, or currently have, [Link] been
39. Do you, or any other person included in this application,
in close contact with a family member who
intend to enter a hospital or a health care facility (including
nursing homes) while in Australia?
No
Yes > Give details 44 During your proposed visit to Australia, do you, or
any other person included in this application, expect
No, I do not, and no other person included in this application
to incur medical costs, or require treatment or medical
intends to enter a hospital or a health care facility (including
follow up for:
nursing homes) while in Australia, except in the case of a
blood disorder;
medical emergency or necessary healthcare treatment.
cancer;
heart disease;
hepatitis B or C and/or liver disease;
HIV Infection, including AIDS;
• kidney disease, including dialysis;
40. Do you, or any other person included in this application,
mental illness; • pregnancy;
intend to work as, or study to be, a doctor, dentist, nurse or
respiratory disease that has required hospital
paramedic during your stay in Australia?
No admission or oxygen therapy;
Yes > Give details other
No
No, I do not, and no other person included in this application Yes > Give details
intends to work as, or study to be, a doctor, dentist, nurse, or
paramedic during our stay in Australia. No, neither I nor any other person included in this
application expect to incur medical costs,or require
treatment or medical follow-up for any of the following
during our proposed visit to Australia:
 Part K – Character details
45. Do you, or any other person included in this application, require
assistance with mobility or care due to a medical condition?
No 47 Have you, or any person included in this
Yes > Give details application, ever:
been convicted of a crime or offence in Yes No
No, neither I nor any other person included in this application
any country (including any conviction
require assistance with mobility or care due to a medical
which is now removed from official
condition.
records)?
been charged with any offence that is Yes No
currently awaiting legal action?
been acquitted of any criminal offence Yes No
or other offence on the grounds of
mental illness, insanity or unsoundness
46. Have you, or any other person included in this application, of mind?
been removed or deported from any Yes No
undertaken a health examination for an Australian visa in the
last 12 months? country (including Australia)?
left any country to avoid being removed Yes No
No
Yes > Give details (including HAP ID if available) or deported?
been refused a visa for Australia or any Yes No
No, neither I nor any other person included in this application other country?
have undertaken a health examination for an Australian visa in been excluded from or asked to leave Yes No
the last 12 months. any country (including Australia)?
committed, or been involved in the Yes No
commission of war crimes or crimes
against humanity or human rights?
been involved in any activities that Yes No
would represent a risk to Australian
national security?
had any outstanding debts to the Yes No
Australian Government or any public
authority in Australia?
• been involved in any activity, or been Yes No
convicted of any offence, relating to the
illegal movement of people to any
country (including Australia)?
Yes No
served in a military force or state
sponsored/private militia, undergone any
military/paramilitary training, or been
trained in weapons/explosives use
(however described)?

If you answered ‘Yes’ to any of the above questions, you must

state who it applies to and 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.

If insufficient space, give details at Part Q – Additional information

1482 (Design date 07/14) - Page 16

 Part P – Declaration

WARNING: Giving false or misleading information or documents is a Signature

serious offence. of primary
48. This declaration must be signed by the primary applicant and each person D
DAY MONTH YEA
person aged 18 years or over who is included in this application.
Date
I declare that:
I have read and understood the information provided in this Signature of family members included in this application
application;
Signature
I have provided complete and correct information in every detail in
this application, and in any attachments to it; Name
I will inform the department in writing immediately as I become
aware of a change in circumstances (including change of address) Signature
or if there is any change relating to information I have provided in Name
or with this application, while it is being considered;
Signature
I will respect Australian values as outlined on page 1 of this form,
during my stay in Australia and will obey the laws of Australia; Name
I have read the information contained in form 1442i Privacy notice;
I understand the department may collect, use and disclose my Signature
personal information (including biometric information and other Name
sensitive information) as outlined in form 1442i Privacy notice;
• I understand that if any fraudulent documents or false or Signature
misleading information has been provided with this application, or Name
if I fail to satisfy the Minister of my identity, my application may be
refused and I, and any other member of my family unit, may We strongly advise that you keep a copy of your application
become unable to be granted a visa for specified periods of time; and all attachments for your records.
if documents are found to be fraudulent or information to be
incorrect after the grant of a visa, the visa may subsequently be
cancelled.
For offshore applicants who are required to provide their fingerprints
and facial image.
I declare that:
I understand that my fingerprints and facial image 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 the visa I have applied for, and
for law enforcement purposes.
I consent to:
Australian law enforcement agencies disclosing my biometric,
biographical and criminal record information to the department for
any of the purposes outlined above;
the department using the information obtained for the purposes of
the Migration Act 1958 or the Australian Citizenship Act 2007. If a
visa is granted, I understand that:
I must abide by the conditions of the visa;
if a ‘no further stay’ 8503 condition is imposed on this visa, it will
limit the ability to remain in Australia beyond the authorised
period of stay of the visa.
For the primary applicant, I understand that:
I will be responsible for any registration or licensing that is
required before I can begin employment in Australia;
I must abide by Australian employment conditions and awa
 Part Q – Additional information

Question number Additional information

If insufficient space, attach additional details 1482 (Design date 07/14) - Page 18