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Statutory Declaration by A Supporting Witness in Relation To A Partner or Prospective Marriage Visa Application
Statutory Declaration by A Supporting Witness in Relation To A Partner or Prospective Marriage Visa Application
About this form Warning: Under the Statutory Declarations Act 1959, people
who intentionally make a false statement in a
This form must be completed by a person who:
statutory declaration are liable for punishment of
• knows the visa applicant and their partner or fiancé(e) and 4 years imprisonment. In addition, the Migration
the history of their relationship; Act 1958 (the Act) provides penalties for providing
• is at least 18 years of age; and false or misleading statements of 12 months
• is an Australian citizen or Australian permanent resident. imprisonment or a fine of AUD12,000.
Note: If the visa applicant is outside Australia and is unable to If you are not an Australian citizen or permanent resident and
have an Australian citizen or Australian permanent resident you reside outside Australia, your statement cannot be
complete this form, any person who knows the applicant and considered a statutory declaration under Australian law, even if
their partner or fiancé(e) may also complete this form. it is made using this form or the template provided by the
Attorney-General’s Department. However, under policy, your
The person completing this form must provide evidence of their
statement should be witnessed or certified according to the
current name, age and, where applicable, Australian citizenship
legal practices of the country in which you make the
or Australian permanent residency (for example, a certified copy
statement. Failing that, it should be witnessed by a person
of the birth certificate, Australian passport or passport
whose occupation or qualification is comparable to those
containing a permanent visa). All copies must be certified.
listed above. This person should sign, date and specify their
Note: You may be asked to submit up to 3 separate occupation at the bottom of the statement.
declarations during the processing of the visa application.
You should confirm the requirements with the nearest
You may also be contacted for further comment and/or
Australian mission overseas when you lodge your application.
interview in relation to the information you provide.
Contact details for Australian missions are available on the
department’s website www.immi.gov.au/contacts/overseas/
Purpose of this form
When assessing a Partner or Prospective Marriage visa About the information given in this form
application, the Department of Immigration and Citizenship
The department is authorised to collect information provided
(the department) must consider the social aspects of the
on this form under Part 2 of the Act. The information
claimed relationship. The department will use the information
collected will be used in the assessment of the visa
provided in this form (your statements), amount other things,
application. The information provided might also be disclosed
to assess these aspects.
to agencies who are authorised to receive information relating
The department’s policy is that these statements be provided to border control, health assessment, health insurance, health
in the form of statutory declarations. You may use this form, services, law enforcement, payment of pensions and benefits,
or alternatively, you may use the statutory declaration taxation, and review of decisions.
template, which is available on the Attorney-General’s
The information form 993i Safeguarding your personal
Department website at www.ag.gov.au
information gives details of agencies to which your
In Australia, statutory declarations must be witnessed by a information might be disclosed. The form is available from the
person prescribed by the Statutory Declarations Act 1959 and department’s website www.immi.gov.au/allforms/ or from
Statutory Declarations Regulations 1993. Any attachments to your nearest office of the department or Australian mission
the Declaration must be certified by a prescribed person. overseas.
Prescribed persons include those who are a:
The department has authority under the Act to collect a range
• Justice of the Peace;
of personal identifiers from non-citizens, including visa
• medical practitioner; applicants, in certain circumstances. For more detailed
• legal practitioner; information, you should read information form 1243i Your
• civil marriage celebrant or registered minister of religion; personal identifying information, which is available from the
• dentist; department’s website www.immi.gov.au/allforms/ or from
• nurse; your nearest office of the department or Australian mission
• optometrist; overseas.
• pharmacist;
• physiotherapist;
• full-time teacher;
• bank manager or bank officer with 5 or more continuous
years of service; Home page www.immi.gov.au
• postal manager or permanent employee of the Australian
Postal Commission with 5 or more continuous years of service; General Telephone 131 881 during business hours
• police officer; or enquiry line in Australia to speak to an operator (recorded
• public servant with 5 or more continuous years of service. information available outside these hours).
If you are outside Australia, please contact
A full list of prescribed persons can be found on the
your nearest Australian mission.
Attorney-General’s Department website.
Please use a pen, and write neatly in English using BLOCK LETTERS.
3 State how you know the applicant and the applicant’s partner or fiancé(e),
Tick where applicable and indicate how often you have been in contact with them
I, Family name
Given names
POSTCODE
Occupation or qualification
Telephone numbers
Office hours (AREA CODE )
Given names
Family name
Given names
No
Yes
Your signature
Declared at
DAY MONTH YEAR
On
Before me,
Signature of
qualified
person
DAY MONTH YEAR
Date
Details of person before whom the declaration is made in printed letters
Family name
Given names
Other
Contact address
POSTCODE
Occupation or qualification
Telephone number
Office hours (AREA CODE )