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Personal Privacy

Department of Home Affairs Record of

Application for a Visitor Short Stay Visa Responses

Terms and Conditions

View Terms and Conditions View Privacy statement
I have read and agree to the terms and conditions
Yes
Application context

Current location

Is the applicant currently outside Australia?

Yes

Give the current location of the applicant and their legal status at this location.
Current location: INDIA
Legal status: Citizen

Purpose of stay

Select the stream the applicant is applying for:

Tourist stream (tourism/visit family or friends)
Note: Once the application has been lodged, the stream cannot be changed. For more information on
each stream, click on the help icon above.
List all reasons for visiting Tourism
Australia:
Give details of any significant dates on which the applicant needs to be in Australia:
Group processing

Is this application being lodged as part of a group of applications?

No
Special category of entry

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This form submitted by : [email protected]
Role(s) : Self-registered user
Submitted on : 12/01/2024 21:39

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Is the applicant travelling as a representative of a foreign government, or travelling on a United

Nations Laissez-Passer?
No
Applicant
Information: Entering names incorrectly may result in denial of permission to board an aircraft to
Australia, or result in delays in border processing on arrival to Australia, even if the applicant has
been granted a visa.
Passport details
Enter the following details as they appear in the applicant's personal passport.
Family name: DEVADASAN
Given names: RUBINS
Sex: Male
Date of birth: 17 Apr 1982
Passport number: W5926476
Country of passport: INDIA - IND
Nationality of passport holder: INDIA - IND
Date of issue: 12 Oct 2022
Date of expiry: 11 Oct 2032
Place of issue / issuing TRIVANDRUM
authority:
It is strongly recommended that the passport be valid for at least six months.
National identity card

Does this applicant have a national identity card?

Yes

National identity card

Enter details exactly as shown on the national identity card.
Family name: DEVADASAN
Given names: RUBINS
Identification number: 5166 6585 2420
Country of issue: INDIA
Note: If the National identity card does not have a Date of issue or a Date of expiry, do not enter a
date. Leave the field/s blank.
Date of issue:
Date of expiry:
Pacific-Australia Card

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The Pacific-Australia Card is issued through an invitation process to Pacific leaders. If the applicant
does not hold a Pacific-Australia Card, select 'No' for this question.
Is the applicant a Pacific-Australia Card holder?
No
Place of birth

Town / City: PUTHUCURICHY

State / Province: KERALA
Country of birth: INDIA
Relationship status

Relationship status: Married

Other names / spellings

Is this applicant currently, or have they ever been known by any other names?
No
Citizenship

Is this applicant a citizen of the selected country of passport (INDIA)?

Yes
Is this applicant a citizen of any other country?
No
Previous travel to Australia

Has this applicant previously travelled to Australia?

No
Has this applicant previously applied for a visa to Australia?
No
Grant number

Does this applicant have an Australian visa grant number?

No

Other passports or documents for travel

Does this applicant have any other passports or documents for travel?
No

Other identity documents

Does this applicant have other identity documents?

No

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Health examination

Has this applicant undertaken a health examination for an Australian visa in the last 12 months?
No
Critical data confirmation
All information provided is important to the processing of this application.
If the information included on this page is incorrect, it may lead to denial of permission to board an
aircraft to Australia, even if a visa has been granted.
Confirm that the following information is correct and that it is in the correct fields.

Family name: DEVADASAN

Given names: RUBINS
Sex: Male
Date of birth: 17 Apr 1982
Country of birth: INDIA
Passport number: W5926476
Country of passport: INDIA - IND

Is the above information Yes

correct?
Travelling companions
Each person travelling to Australia must submit a separate visitor visa application. This includes
children and other family members. Listing a person's name on this page does NOT mean that the
person has applied for a visa.
Are there any other persons travelling with the applicant to Australia?
No
Contact details

Country of residence

Usual country of residence: INDIA

Department office
The applicant may be required to attend an Australian Government Office for an interview. Which is
the closest office to the applicant’s current location?

Office: India, New Delhi

Residential address

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Note that a street address is required. A post office address cannot be accepted as a residential
address.
Country: INDIA
Address: VARAVILATHOPPE
POOVAR PO
Suburb / Town: TRIVANDRUM
State or Province: KERALA
Postal code: 695525
Contact telephone numbers
Enter numbers only with no spaces.
Home phone: 9747121799
Business phone:
Mobile / Cell phone:
Postal address

Is the postal address the same as the residential address?

Yes
Email address

Email address: [email protected]

Authorised recipient
Does the applicant authorise another person to receive written correspondence on their behalf?
This authorises the department to send the authorised person all written correspondence that would
otherwise be sent directly to the applicant.
Yes, another person
This person is referred to as the 'authorised recipient'.
Authorised recipient contact details

Family name: KALLAMAPARAMBIL

Given names: LIJEN GEORGE
Postal address

Country: INDIA
Address: SAMA TRAVEL
SECOND FLOOR MANNAMKULATHIL TOWERS
Suburb / Town: KOTTAYAM
State or Province: KERALA
Postal code: 686002

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Contact telephone numbers

Enter numbers only with no spaces.
Business phone: 9961443308
Mobile / Cell phone:
Electronic communication
The Department prefers to communicate electronically as this provides a faster method of
communication.
All correspondence, including notification of the outcome of the application will be sent to:
Email address: [email protected]

Note: The holder of this email address may receive a verification email from the Department if the
address has not already been verified. If the address holder receives a verification email, they should
click on the link to verify their address before this application is submitted.

Non-accompanying members of the family unit

Does the applicant have any members of their family unit not travelling to Australia who are not
Australian citizens or Australian permanent residents?
No
Entry to Australia

Proposed period of stay

Does the applicant intend to enter Australia on more than one occasion?
No
How long does the applicant plan to stay in Australia?
Length of stay in Australia: Up to 3 months
Planned arrival date: 19 Feb 2024
Planned final departure date: 27 Feb 2024
Note: If granted, the stay period may be less than the period requested. The applicant should check
the Grant Notification Letter to confirm their period of stay in Australia.
Study while in Australia

Will the applicant undertake a course of study in Australia?

No
Relatives, friends or contacts in Australia

Will the applicant visit any relatives, friends or contacts while in Australia?
No

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Visa applicant's current overseas employment

Current employment details

Employment status: Self employed

Occupation grouping: Other
Occupation: Proprietor
Organisation: VISION FOCUZ PRIVATE LIMITED
Start date with current 29 Nov 2018
employer:
Organisation address
Note that a street address is required. A post office address cannot be accepted as an organisation
address.
Country: INDIA
Address: Third Floor Building no flat No 60/49/E
PANAMPALLY NAGAR
Suburb / Town: ERNAKULAM
State or Province: KERALA
Postal code: 682036
Contact telephone numbers
Enter numbers only with no spaces.
Business phone: 9061075782
Mobile / Cell phone:
Electronic communication

Email address: [email protected]

Financial support

Funding details

Give details of how the applicant's stay in Australia will be funded:

Self funded
What funds will the applicant I am running a partnership Business ,I have sufficient fund in
have available to support their bank account and I have fixed deposit all documents attached to
stay in Australia? this file
Health declarations
In the last five years, has any applicant visited, or lived, outside their country of passport, for more
than 3 consecutive months? Do not include time spent in Australia.

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No
Does any applicant intend to enter a hospital or a health care facility (including nursing homes) while
in Australia?
No
Does any applicant intend to work as, or study or train to be, a health care worker or work within a
health care facility while in Australia?
No
Does any applicant intend to work, study or train within aged care or disability care while in Australia?
No
Has any applicant:
• ever had, or currently have, tuberculosis?
• been in close contact with a family member that has active tuberculosis?
• ever had a chest x-ray which showed an abnormality?
No
During their proposed visit to Australia, does any applicant expect to incur medical costs, or require
treatment or medical follow up for:
• blood disorder
• cancer
• heart disease
• hepatitis B or C and/or liver disease
• HIV infection, including AIDS
• kidney disease, including dialysis
• mental illness
• pregnancy
• respiratory disease that has required hospital admission or oxygen therapy
• other?
No
Does any applicant require assistance with mobility or care due to a medical condition?
No
Character declarations
If the applicant answers ‘Yes’ to any of the character declarations they must give all relevant details.
For combined applications, state which applicant the declaration applies to.
If the matter relates to a criminal conviction, provide:
• the date and nature of the offence
• full details of the sentence
• dates of any period of imprisonment or other detention.
Has any applicant ever been charged with any offence that is currently awaiting legal action?
No
Has any applicant ever been convicted of an offence in any country (including any conviction which is
now removed from official records)?
No

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Has any applicant ever been the subject of a domestic violence 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
Has any applicant ever been the subject of an arrest warrant or Interpol notice?
No
Has any applicant ever been found guilty of a sexually based offence involving a child (including
where no conviction was recorded)?
No
Has any applicant ever been named on a sex offender register?
No
Has any applicant ever been acquitted of any offence on the grounds of unsoundness of mind or
insanity?
No
Has any applicant ever been found by a court not fit to plead?
No
Has any applicant ever 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
Has any applicant ever 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
Has any applicant ever been associated with a person, group or organisation that has been or is
involved in criminal conduct?
No
Has any applicant ever 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
Has any applicant ever served in a military force, police force, state sponsored / private militia or
intelligence agency (including secret police)?
No
Has any applicant ever undergone any military/paramilitary training, been trained in weapons/
explosives or in the manufacture of chemical/biological products?
No
Has any applicant ever been involved in people smuggling or people trafficking offences?
No
Has any applicant ever been removed, deported or excluded from any country (including Australia)?
No
Has any applicant ever overstayed a visa in any country (including Australia)?
No

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Has any applicant ever had any outstanding debts to the Australian Government or any public
authority in Australia?
No
Visa history
Has the applicant held or does the applicant currently hold a visa to Australia or any other country?
No
Has the applicant ever been in Australia or any other country and not complied with visa conditions or
departed outside their authorised period of stay?
No
Has the applicant ever had a visa for Australia or any other country refused or cancelled?
No

Declarations
Warning:
Giving false or misleading information is a serious offence.
The applicants declare that they:
Have read and understood the information provided to them in this application.
Yes
Have provided complete and correct information in every detail on this form, and on any attachments
to it.
Yes
Understand that if any fraudulent documents or false or misleading information has been provided
with this application, or if any of the applicants fail to satisfy the Minister of their identity, the
application may be refused and the applicant(s), and any member of their family unit, may become
unable to be granted a visa for a specified period of time.
Yes
Understand that if documents are found to be fraudulent or information to be incorrect after the grant
of a visa, the visa may subsequently be cancelled.
Yes
Will inform the Department in writing immediately as they become aware of a change in
circumstances (including change of address) or if there is any change relating to information they
have provided in or with this application, while it is being considered.
Yes
Have read the information contained in the Privacy Notice(Form 1442i).
Yes
Understand that the department may collect, use and disclose the applicant's personal information
(including biometric information and other sensitive information) as outlined in the Privacy
Notice(Form 1442i).
Yes

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Understand that 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.
Yes
Agree not to undertake study or training for more than three months.
Yes
Agree to leave Australia on or before the expiry of the period of stay of the visa.
Yes
Give consent to the collection of their fingerprints and facial image if required.
Yes
Understand that, if required to provide their fingerprints and facial image, the applicant's fingerprints
and facial image and biographical information held by the Department may be given to Australian law
enforcement agencies to help identify the applicant and determine eligibility for grant of the visa being
applied for, and for law enforcement purposes.
Yes
Give consent to Australian law enforcement agencies disclosing the applicant's biometric,
biographical and criminal record information to the Department to help identify the applicant, to
determine eligibility for grant of a visa and for law enforcement purposes.
Yes
Understand that the Visitor visa does not permit them to work in Australia.
Yes
Give consent to the Department using the applicant's biometric, biographical and criminal record
information obtained for the purposes of the Migration Act 1958 or the Citizenship Act 2007.
Yes
As an applicant:
I understand that if my visa ceases to be in effect and I do not hold another visa to remain in Australia
at that time, I will be an unlawful non-citizen under the Migration Act 1958. As such, I will be expected
to depart from Australia, and be subject to removal under the Migration Act 1958.
Yes
Priority Consideration (fast-track) service

The Priority Consideration service is a premium service providing priority processing to certain Visitor
visa (subclass 600) applicants for an additional fee of Australian dollar (AUD) 1000. For further
details see Priority Consideration (fast-track) service.
Does the applicant want to apply for the Priority Consideration service for a fee?
No

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Supporting evidence

Applicant 1 - RUBINS DEVADASAN (17 Apr 1982)

Evidence type Document type Description Date received Filename
Evidence of the financial status and Other (specify) Affidavit 12/01/2024 AFFIDAVIT.pdf
funding for visit
Evidence of the financial status and Other (specify) AOA 12/01/2024 AOA.pdf
funding for visit
National Identity Document (other National ID Card Aadhar Card 11/01/2024 Aadhar card.pdf
than Passport)
Evidence of the financial status and Bank Statement - Personal Bank Statement 11/01/2024 Bank Statement.pdf
funding for visit
Evidence of the financial status and Other (specify) COMPANY 12/01/2024 COMPANT GST
funding for visit REGISTERATION REGISTERATION.pdf
Form 956A Appointment or Form 956A Appointment or Form 956A 11/01/2024 FORM956.pdf
withdrawal of an authorised recipient withdrawal of an authorised recipient
Evidence of the financial status and Other (specify) Fixed Deposit 12/01/2024 Fixed Deposit.pdf
funding for visit
Evidence of the financial status and Other (specify) Fixed deposit 12/01/2024 Fixed deposit 2.pdf
funding for visit
Evidence of planned tourism Other (specify) Hotel Booking 12/01/2024 HOTEL BOOKINGS.pdf
activities in Australia
Evidence of planned tourism Itinerary Itinerary 11/01/2024 Itinerary.pdf
activities in Australia
Evidence of the financial status and Other (specify) MOA 12/01/2024 MOA.pdf
funding for visit
Travel Document Passport 11/01/2024 PASSPORT
COPY.pdf_PAGE_1.jpg
Evidence of planned tourism Other (specify) Ticket copy 12/01/2024 TICKET COPY.pdf
activities in Australia
Evidence of the financial status and Other (specify) sales deed 12/01/2024 sales deed.pdf
funding for visit
Evidence

Give details as to why the applicant will not be providing attachments prior to lodging this application.
all documents along with this file

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