OFFICIAL: Sensitive

Personal Privacy

Department of Home Affairs

Application for a Temporary

Work ( Skill Shortage) Visa

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
Give details of the applicant's current location.
Current location: BANGLADESH
Legal status: Citizen
Group processing

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

No
Visa application charge concession

Is the applicant eligible for a Visa Application Charge (VAC) concession?

Yes
Give details: Because I am worker
Primary 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: MOHAMMAD
Given names: NAZMUL HOSSAIN
Sex: Male

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This form submitted by : mdatikulislam2025
Role(s) : Self-registered user
Submitted on : 27/03/2025 10:56

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Application for a Temporary Work ( Skill Shortage) Visa

Date of birth: 28 Feb 2005

Passport number: A07648084
Country of passport: BANGLADESH - BGD
Nationality of passport holder: BANGLADESH - BGD
Date of issue: 24 Apr 2023
Date of expiry: 23 Apr 2033
Place of issue / issuing Bangladesh
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?

No
Place of birth

Town / City: MUNSHIGANJ

State / Province: CHAR GULGULIA, SIRAJDIKHAN, KUCHIA MARA-1540
Country of birth: BANGLADESH
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 (BANGLADESH)?

Yes
Is this applicant a citizen of any other country?
No
Other passports

Does this applicant have other current passports?

No
Other identity documents

Does this applicant have other identity documents?

No
Health examination

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Application for a Temporary Work ( Skill Shortage) Visa

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: MOHAMMAD

Given names: NAZMUL HOSSAIN
Sex: Male
Date of birth: 28 Feb 2005
Country of birth: BANGLADESH
Passport number: A07648084
Country of passport: BANGLADESH - BGD

Is the above information Yes

correct?
Additional identity questions
Provide further details below, where available.
Previous travel to Australia

Has this applicant previously travelled to Australia or previously applied for a visa?
Yes
Previous passports

Does this applicant have previous passports that have been used to travel to Australia?
Yes

Previous passports
Enter details exactly as shown on the passport.

Family name: MOHAMMAD

Given names: NAZMUL HOSSAIN
Sex: Male
Date of birth: 28 Feb 2005
Passport number: A07648084
Country of passport: BANGLADESH - BGD

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Nationality of passport holder: BANGLADESH - BGD

Date of issue: 24 Apr 2005
Date of expiry: 23 Apr 2033
Place of issue / issuing Bangladesh
authority:
Grant number

Does this applicant have an Australian visa grant number?

No

Accompanying members of the family unit

Are there any accompanying members of the family unit included in this application?
No
Contact details

Country of residence

Usual country of residence: AUSTRALIA

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: China, Guangzhou

Residential address
Note that a street address is required. A post office address cannot be accepted as a residential
address.
Country: BANGLADESH
Address: MUNSHIGANJ
MUNSHIGANJ
Suburb / Town: CHAR GULGULIA, SIRAJDIKHAN, KUCHIA MARA
State or Province: MUNSHIGANJ
Postal code: 1540
Postal address

Is the postal address the same as the residential address?

Yes
Contact telephone numbers

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Enter numbers only with no spaces.

Home phone: 88001836412437
Business phone:
Mobile / Cell phone: 88001836412437
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.
No
This person is referred to as the 'authorised recipient'.
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.

Entry to Australia

Proposed period of stay

Give details of the proposed period of stay in Australia.
Length of stay in Australia: Up to 48 months
Date from: 27 Mar 2025
Date to: 26 Sep 2029
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.
Note: If granted, the stay period may be different to the period requested. The applicant should check
the Grant Notification Letter to confirm the period of stay permitted in Australia and conditions of the
visa.
Does the applicant intend to enter Australia on more than one occasion?
No
Intended work in Australia

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Will the applicant be undertaking work with an Australian organisation?

No
Will the applicant be travelling with their employer to Australia?
No
As the applicant has indicated they are not working for an Australian organisation or travelling with
their employer, give details of the reason for travelling to Australia.
Give details: Australia work permit visa application
Activity

Position details
Give details of the type of activity the applicant will be undertaking in Australia.
Position: Worker
Occupation grouping: Labourers
Occupation (ANZSCO) Commercial Cleaner
Duties / activities: Australia job confirmed
Current overseas employment

Current employment details

Employment status: Self employed

Qualifications, skills and experience
Give details of the applicant's qualifications, skills and experience that are relevant to the proposed
activity in Australia.
Relevant qualifications: You can work in Australia for 4 years with this visa in an
Australian RTS company
Relevant skills: www.ringtread.com
Relevant experience: Name: MOHAMMAD NAZMUL HOSSAIN
Passport number: A07648084
Job and company name: food packaging worker by the Australia
RTS company LTD
Details : Congratulation! With reference to your educational
certificates copies submitted with us and the online interview you
had with us.
Registration / Licensing / You can work in Australia for 4 years with this visa in an
Professional membership Australian RTS company
requirements:
Financial support

Funding details

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Will the applicant receive payment for undertaking the work or activity in Australia?
Yes
Give details of the organisation providing payment to the applicant.
Organisation: Organisation in Australia to which the applicant provides
services
Additional information

AusAID or Foreign Affairs supported

Are any applicants currently or have they previously been an AusAID or Foreign Affairs supported
student or recipient?
Yes
Name of applicant: MOHAMMAD, Nazmul Hossain (28 Feb 2005)
Australia's interest

The department will only consider the work or activity to be in Australia's interest in limited
circumstances (eg. emergency workers assisting in a natural disaster).
Will Australia's national interest be affected if the applicant does not undertake the work or activity for
which they are intending to enter Australia?
Yes
Give details: Australia work visa apply
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.
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
Does any applicant intend to work or be a trainee at a child care centre (including preschools and
creches) while in Australia?
No
Does any applicant intend to be in a classroom situation for more than 3 months (eg. as either a
student, teacher, lecturer or observer)?
No
Has any applicant:
• ever had, or currently have, tuberculosis?

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• 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 ongoing medical care or need special equipment, assistive technology or
assistance from others for daily living?
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
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

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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
Has any applicant ever had any outstanding debts to the Australian Government or any public
authority in Australia?
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

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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
Understand that if this application is approved, any person not included in this application will not
have automatic right of entry to Australia.
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
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
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:

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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

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Supporting evidence

Applicant 1 - NAZMUL HOSSAIN MOHAMMAD (28 Feb 2005)

Evidence type Document type Description Date received Filename
Emergency Worker Evidence Letter of support from Australian Photo and passport 27/03/2025 1743032998270.jpg
Commonwealth, State or Territory
emergency authority
Travel Document Passport Passport:A07648084 27/03/2025 1743032998270_1.jpg
Identity, Evidence of Passport Passport:A07648084 27/03/2025 1743032998270_2.jpg
Personal Financial Status, Evidence Tax Document Photo 27/03/2025 1743033022229.jpg
of
Evidence of current employment or Letter from employer with current Photo 27/03/2025 1743033022229_1.jpg
self-employment role
Emergency Worker Evidence Letter of support from Australian Photo and passport 27/03/2025 1743033022229_2.jpg
Commonwealth, State or Territory
emergency authority
Qualifications, Skills and Skills Assessment 27/03/2025 1743033022229_3.jpg
Experience, Evidence of
Business case for extended period Letter/statement - visa applicant 27/03/2025 1743033022229_4.jpg
of stay
Employment in Australia, Evidence Employment Contract 27/03/2025 1743033022229_5.jpg
of
Health Insurance, Evidence of Overseas Visitor Health Cover 27/03/2025 1743033022229_6.jpg
(OVHC) Document
Health Insurance, Evidence of Health Insurance Document 27/03/2025 1743033022229_7.jpg
Evidence

Give details as to why the applicant will not be providing attachments prior to lodging this application.
MOHAMMAD NAZMUL HOSSAIN You can work in Australia for 4 years with this visa in an
Australian RTS company

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