Form

Notification of incorrect answer(s) 1023

Department of Home Affairs

Important – Please read this information carefully before you Important information about privacy
complete this form. Once you have completed this form we
Your personal information is protected by law, including the
strongly advise that you keep a copy for your records.
Privacy Act 1988. Important information about the collection,
Several provisions of the Migration Act 1958 require you to use and disclosure (to other agencies and third parties, including
inform the Department of Home Affairs (the Department) of any overseas entities) of your personal information, including
incorrect information that you may have given: sensitive information, is contained in form 1442i Privacy notice.
• in your visa application; Form 1442i is available from the Department’s website
• on a passenger card; or www.homeaffairs.gov.au/allforms/ or offices of the
Department. You should ensure that you read and understand
• in response to a notice given to you by the Department form 1442i before completing this form.
inviting you to comment on possible non-compliance with an
obligation to correct incorrect information.
This obligation remains even if you are subsequently granted a
visa.
Home page www.homeaffairs.gov.au
This form should be used to inform the Department of General Telephone 131 881 during business hours
incorrect information that you may have provided in one of enquiry line in Australia to speak to an operator (recorded
the situations outlined above. Should you wish to notify the information available outside these hours).
Department of any change in your circumstances, which If you are outside Australia, please contact
means that information you have previously provided to the your nearest Australian mission.
Department in a application is no longer correct, you should use
form 1022 Notification of changes in circumstances.
You must answer all questions on this form.
WARNING:
• If you do not comply with requirements to advise the
Department of incorrect information and give correct answers,
your visa is liable to be cancelled under the Migration Act 1958.
• If you have been granted a visa, the information you provide
on this form will be taken into account in deciding whether
you should continue to hold that visa.
• If you are an applicant for a visa which has not yet been
granted, the information you provide on this form will be
taken into account when assessing your visa application.
• If your visa is cancelled and you are in Australia, you will
become an unlawful non-citizen. Unless you are granted a
further visa, you will be detained and removed from Australia.
• If your visa is cancelled and you are outside Australia, and
you subsequently travel to Australia, you will be refused
immigration clearance and will be removed from Australia.
• Cancellation of a visa that already has been granted is
not automatic. If you are in Australia, you will be given
an opportunity to comment on the grounds for possible
cancellation before a final decision on cancellation is made.

Please keep this information page for your reference

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 Form

Notification of incorrect answer(s) 1023

Department of Home Affairs

Please open this form using Adobe Acrobat Reader. Details of other applicants
Either type (in English) in the fields provided or print this form
and complete it (in English) using a pen and BLOCK LETTERS. 11 Do you have a partner (spouse or de facto partner) and/or any
Tick where applicable 3 dependants who are/were included in your application?
No
Your details Yes Provide details below
1 Your full name 1. Family name
Family name Given names
Given names Day Month Year

Day Month Year Date of birth

2 Date of birth Country of birth
3 Place of birth Passport number
Town/city Country of passport
Country Residential address

4
Relationship status
Married Separated Never married or
Engaged Divorced been in a de facto Postcode

relationship
De facto Widowed
2. Family name
5 Details from your passport
Given names
Passport number Day Month Year

Country of passport Date of birth

6 Details of identity card or identity number issued to you by your Country of birth
government (if applicable) eg. National identity card.
Note: If you are the holder of multiple identity numbers because you Passport number
are a citizen of more than one country, you need to enter the identity
Country of passport
number on the card from the country that you live in.
Residential address
Identity number

Country of issue

7 Your present country of citizenship Postcode

3. Family name
8 Your current residential address
Note: A post office box address is not acceptable as a residential address. Given names
Day Month Year

Date of birth

Postcode Country of birth

9 Address for correspondence Passport number

(If the same as your residential address, write ‘AS ABOVE’)
Country of passport
Residential address

Postcode

10 Client number or file number issued to you by the Department (if known) Postcode

If insufficient space, attach additional details

© COMMONWEALTH OF AUSTRALIA, 2018 1023 (Design date 03/18) - Page 3
 Details of incorrect information Your visa and application details
12 The incorrect information provided was on: 15 Visa details (if known)
Day Month Year
visa application
passenger card Date granted

form 1022 Notification of changes in circumstances Stay period

13 List details of the information provided which was incorrect and provide Visa class
the correct information
1. Information which was incorrect 16 Application details (if known)
Day Month Year

Date of application

Stay period

Visa class

Correct details Declaration

WARNING: Giving false or misleading information is a serious offence.

17 I declare that:
• the information provided on or with this form is true and correct in
every detail.
• I have read the information contained in form 1442i Privacy notice.
• I understand the Department may collect, use and disclose my
2. Information which was incorrect personal information (including biometric information and other
sensitive information) as outlined in form 1442i Privacy notice.
Signature of applicant

-
Day Month Year

Correct details Date

Signature of other applicant (aged 18 years or over)

-
Day Month Year

Date
If insufficient space, attach additional details
Signature of other applicant (aged 18 years or over)
14 Why was incorrect information provided?

-
Day Month Year

Date

Signature of other applicant (aged 18 years or over)

-
Day Month Year

Date

If insufficient space, attach additional details We strongly advise that you keep a copy of this form and all
attachments for your records.

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