澳大利亚54家庭成员表-09new.pdf
家庭構成 54 Form 你想申請下列何種簽証1. 你只能用英文填寫此表。 2. 你必須填寫你在原籍國和外國的所有家庭成員的細節，其中包括同父異母（或同母異父）的兄弟姐妹和子女，繼父與其前妻（或繼母與其前 夫）所生的兄弟姐妹和子女，領養的兄弟姐妹和子女。（如果人已不在世，可在“家庭地址”一欄填上“已故”。如果去向不明，可在“家 庭地址”一欄填上“不知道”。 3. 你填寫此表時如果有人協助，你只能在所填資料真實和正確，而且你完全知道同意並理解資料的填入的情況下，才能在宣誓一欄下籤字。 旅遊 (676) 家庭擔保訪問 (679) 商務短期訪問 (456) 其它 / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 你本人 配偶 父親/母親 父親/母親 兄弟/姐妹 兄弟/姐妹 兄弟/姐妹 兒子/女兒 兒子/女兒 兒子/女兒 54 (Design date 07/10)© COMMONWEALTH OF AUSTRALIA, 2010 注意 家庭構成 / / / 事實婚姻 姓名出生 日 月 年 婚戀狀況 （請使用下表的代碼） 家庭地址以前是否來過澳大利亞 日 月 年 “婚戀狀況”代碼 M = 已婚 E = 訂婚 F = 事實婚姻 S = 分居 D = 離婚 W = 寡/鰥 N = 未婚或未有過事實婚姻 日月 年 申請人簽名 日月 年 見證人簽名 我特此宣誓 本表中填寫的資料完整而正確 在他人協助下填寫的本表任何部份的資料都是真實和 正確的而且我完全知道同意並理解資料的填入。 宣誓 Family composition 54 Form Are you applying for a: 1. You must complete this form in English only. 2. You must give details of all your family members living in your home country and abroad including half, step and adopted brothers, sisters and children (if not living, write Deceased in Home address column. If whereabouts unknown, write Unknown in Home address column). 3. If you have been assisted in completing this form, you should only sign the Declaration if the information is true and correct and has been included with your full knowledge, consent and understanding. Tourist visa (676) Sponsored family visitor (679) Business short stay (456) Other Home addressPrevious visits to AustraliaGiven namesDate of birth DAY MONTH YEAR / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / Family name Yourself Spouse Father/Mother Father/Mother Brother/sister Brother/sister Brother/sister Son/daughter Son/daughter Son/daughter Relationship status (use codes below) 54 (Design date 07/10)© COMMONWEALTH OF AUSTRALIA, 2010 DAY MONTH YEAR Note: Family composition / / / De facto Relationship status codes M = Married E = Engaged F = De facto S = Separated D = Divorced W = Widowed N = Never married or been in a de facto relationship DAYMONTHYEAR Signature of applicant DAYMONTHYEAR Signature of witness Declaration I declare that: the information I have given on this form is complete and correct. in any section of this form which has been completed with the assistance of another person, the information as set down is true and correct and has been included with my full knowledge, consent and understanding.
