Professional Documents
Culture Documents
1424
Refund request
Review rights
There is no right of merits review of the assessment when an
application for a refund is declined.
Home page
General
enquiry line
www.immi.gov.au
Telephone 131 881 during business hours
in Australia to speak to an operator (recorded
information available outside these hours).
Ifyou are outside Australia, please contact
your nearest Australian mission.
Form
1424
Refund request
Please use a pen, and write neatly in English using BLOCK LETTERS.
Tick where applicable
DAY
MONTH
YEAR
Date of application
Date of birth
Family name
Address
Given names
POSTCODE
MONTH
YEAR
DAY
MONTH
YEAR
Telephone numbers
Office hours
(AREA CODE
After hours
(AREA CODE
Mobile/cell
DAY
Online
Paper form in
Australia
Paper form
outside Australia
MONTH
YEAR
12 Receipt date
13 Amount paid
14 Currency
Go to Part E
Branch address
POSTCODE
Country
Australian account
DAY
BSB number
MONTH
YEAR
Date
Account number
Overseas account
MONTH
YEAR
Date of birth
Account number
Address
POSTCODE
Telephone numbers
Office hours
(AREA CODE
After hours
(AREA CODE
Mobile/cell
Signature of
authorised
person
DAY
MONTH
YEAR
Date
International
Banking Code
Acceptable
banking currency
Branch code
number
Given names
DAY
Country
IBAN
SWIFT
No
Yes
No
Go to Part G
Yes
No
Yes
Document
Attached?
10
15
24
Part I Declaration
WARNING: Giving false or misleading information is a serious offence.
DAY
MONTH
YEAR
Date