Form

Refugee and special

humanitarian proposal 681

Who should use this form? Your role as a proposer is to assist in the settlement of the
entrants you have proposed. This includes:
This form should be used by persons wishing to propose
applicants under the Refugee and Special Humanitarian • meeting the entrant at the airport;
Program, including those eligible under the special ‘split family’ • providing accommodation for the entrant on arrival;
provisions that apply to immediate family members.* • assisting the entrant to find permanent accommodation; and
Proposals may be submitted by individuals or by organisations • providing information and orientation assistance to the
operating in Australia. To be eligible to propose as an individual, entrant.
you must be:
• an Australian citizen; or ‘Information and orientation assistance’ means assisting
• a permanent resident of Australia; or the entrant to access:
• an eligible New Zealand citizen. • Income support through Centrelink;
You must not be an irregular maritime arrival. • Permanent housing;
If you are eligible to propose, you will also need form 842 • Medicare;
Application for an Offshore Humanitarian visa to be • Health services (eg. doctor, dentist and pharmacy);
completed by the visa applicant and submitted together with • Employment services (eg. Job Network);
this form. • Education and training services (eg. Adult Migrant
English Program, children’s schooling);
Changes to the Special Humanitarian Program • Translating and interpreting services;
• Banking services;
People who arrived in Australia as irregular maritime arrivals
are not eligible to propose family under the Special • Childcare services; and
Humanitarian Program. These people may seek to sponsor • Transport.
family within the family stream of the Migration Program.
Further information on these categories can be found at
In Part D of this form, you will be asked to indicate whether
www.immi.gov.au/migrants/family
you are able to provide accommodation and information and
orientation assistance to the entrants you are proposing.
You should carefully consider your ability to fulfil the
About this form
requirements of a proposer. Unless there are exceptional
Important – Please read this information carefully before you circumstances, your failure to provide the level of support
complete your proposal. Once you have completed your indicated in your undertaking in Part D may adversely affect any
proposal we strongly advise that you keep a copy for your future proposals you submit under the Humanitarian Program.
records.
Am I eligible for support in my role as a proposer?
What is required of proposers? Yes. Proposer Support is available to all proposers. The aim of
If you are proposing applicants who are granted a subclass 202 this service is to ensure that proposers are able to:
(Global Special Humanitarian) visa the Australian Government • respond to the needs of entrants; and
is not responsible for the applicant’s travel to Australia, including
• fulfil their obligations to directly support entrants.
airfares.
As part of this service, prior to the entrant’s arrival, you will be
If you are proposing applicants under the ‘split family’
provided with information and guidance on how to:
provisions, and any of the following visa subclasses are granted:
• assist an entrant to settle in Australia; and
200 – Refugee;
• obtain further information and guidance, if required, after
201 – In-country Special Humanitarian; the entrant has arrived. This may include referral to other
203 – Emergency Rescue; service providers, for example, to assess the physical and
psychological health of the entrant.
204 – Woman at Risk;
the applicant’s travel costs will be paid by the Australian
Government.
An ‘applicant’ who is granted a visa and travels to Australia,
becomes an ‘entrant’ on arrival.

* Under the ‘split family’ provisions, holders of permanent humanitarian

(Class XB) visas granted overseas, or permanent Protection (Class XA) or
Resolution of Status (Class CD) visas granted in Australia, may support the
applications of immediate family members to enter Australia under the
Humanitarian Program. ‘Immediate family’ means a spouse or de facto
partner (including same-sex partner), dependent child, or parent of a
dependent child (if the child in Australia is under 18 years of age).

© COMMONWEALTH OF AUSTRALIA, 2012 681 (Design date 11/12a) - Page 1

 After a visa has been granted Your migration agent will be the person with whom the
department will discuss your application and from whom it will
If the person you are proposing is granted a humanitarian visa,
seek further information when required.
please encourage them to attend:
• the Australian Cultural Orientation Program (AUSCO) to You are not required to use a migration agent. However, if you
which they will be invited. AUSCO is delivered overseas use a migration agent, the department encourages you to use
before people begin their journey to Australia and provides a registered migration agent. Registered agents are bound by
practical advice on living in Australia and giving participants the Migration Agents Code of Conduct, which requires them to
the opportunity to ask questions about travel to and life in act professionally in their clients’ lawful best interests.
Australia; and Information on migration agents, including a list of registered
• a Pre-departure Medical Screening (PDMS) before they travel migration agents, is available on the Office of the MARA website
to Australia. Visa holders usually attend PDMS within 72 hours www.mara.gov.au
of departure for Australia to ensure they are ‘fit to fly’ and to You can also access information about migration agents on the
identify any medical treatment which will be immediately department’s website www.immi.gov.au
needed on arrival in Australia.
While participation in AUSCO and PDMS is voluntary, it is in the Exempt persons
best interest of humanitarian visa holders to participate in both The following people do not have to be a registered migration
programs. agent in order to provide immigration assistance, but they must
not charge a fee for their service:
Integrity of application • a close family member (spouse, de facto partner, child,
parent, brother or sister);
The Department of Immigration and Citizenship (the
department) is committed to maintaining the integrity of the • a member of parliament or their staff;
visa and citizenship programs. Please be aware that if you or • an official whose duties include providing immigration
the person you are proposing provide us with fraudulent assistance (eg. a Legal Aid provider);
documents or claims, this may result in processing delays and • a member of a diplomatic mission, consular post or
possibly the application being refused. international organisation.

Appointing a migration agent/exempt person

Immigration assistance
To appoint a migration agent/exempt person you should
A person gives immigration assistance to you if he or she uses, complete Part F Options for receiving written communications.
or claims to use, his or her knowledge or experience in
migration procedure to assist you with your visa application, Your migration agent/exempt person should complete form 956
request for ministerial intervention, cancellation review Advice by a migration agent/exempt person of providing
application, sponsorship or nomination. immigration assistance.
In Australia a person may only lawfully give immigration Form 956 is available from the department’s website
assistance if he or she is a registered migration agent or is www.immi.gov.au/allforms/
exempt from being registered. Only registered migration agents
may receive a fee or reward for providing immigration Options for receiving written communications
assistance.
If you do not appoint a migration agent/exempt person you
If an unregistered person in Australia, who is not exempt from may still authorise another person, in writing, to receive written
registration, gives you immigration assistance they are communications on your behalf. This person is called the
committing a criminal offence and may be prosecuted. authorised recipient.
Migration agents in Australia Authorised recipient information
Migration agents in Australia must be registered with the Office All written communication about your application will be sent to
of the Migration Agents Registration Authority (Office of the your authorised recipient, unless you indicate that you wish to
MARA) unless they are exempt from registration. have health and/or character information sent directly to you.
Migration agents outside Australia The department will communicate with the most recently
appointed authorised recipient as you may only appoint one
Migration agents who operate outside Australia do not have to authorised recipient at any time for a particular application.
be registered. The department may give some overseas agents
an ID number. This number does not mean that they are You will be taken to have received any documents sent to that
registered. person as if they had been sent to you.
Note: Some Australian registered migration agents operate To appoint an authorised recipient you should complete:
overseas. • Part F Options for receiving written communications; and
Migration agent information • form 956A Appointment or withdrawal of an authorised
recipient.
A migration agent is someone who can:
Note: Being a proposer does not authorise you to receive
• advise you on the visa that may best suit you;
written communications on behalf of the visa applicants you
• tell you the documents you need to submit with your are proposing. If you wish to receive written correspondence
application; on behalf of the visa applicants, the main applicant will need
• help you fill in the application and submit it; and to complete Question 17 and Question 45 on the attached
• communicate with the department on your behalf. form 842 Application for an Offshore Humanitarian visa.
If you appoint a migration agent, the department will assume Note: Migration agents/exempt persons do not need to
that your migration agent will be your authorised recipient, complete form 956A.
unless you indicate otherwise. Form 956A is available from the department’s website
www.immi.gov.au/allforms/

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Consent to communicate electronically Application Process
The department may use a range of means to communicate Step 1 – Complete this form
with you. However, electronic means such as fax or e-mail will
only be used if you indicate your agreement to receiving Carefully read and fully complete this form.
communication in this way.
Step 2 – Establish your eligibility to propose
To process your application the department may need to
If you are proposing as an individual, you must provide
communicate with you about sensitive information, for example,
evidence of your eligibility to propose (see Question 20).
health, police checks, financial viability and personal
Please provide a certified copy of your:
relationships. Electronic communications, unless adequately
encrypted, are not secure and may be viewed by others or • Australian birth certificate/certificate of Australian citizenship; or
interfered with. • evidence of your permanent residence in Australia; or
If you agree to the department communicating with you by • evidence that you are an eligible New Zealand citizen.
electronic means, the details you provide will only be used by Copies of documents must be certified as true copies of the
the department for the purpose for which you have provided original by a Justice of the Peace, a Commissioner for
them, unless there is a legal obligation or necessity to use them Declarations or a person before whom a statutory declaration
for another purpose, or you have consented to use for another may be made under the Statutory Declarations Act 1959.
purpose. They will not be added to any mailing list.
If you are proposing as an organisation, you must provide the
The Australian Government accepts no responsibility for the names of office holders, and a statement of the organisation’s
security or integrity of any information sent to the department objectives, activities and funding (see Part C).
over the internet or by other electronic means.
Step 3 – Send documents to the applicant
If you authorise another person to receive documents on your
behalf and they wish to be contacted electronically, their Once completed, send this form to the applicant, along with:
signature is required on form 956 or 956A to indicate their • Evidence of your eligibility to propose (whether you are
consent to this form of communication. proposing as an individual or an organisation, as stated in
Note: Electronic communication is the fastest means of Step 2); and
communication available and the department prefers to • form 842 Application for an Offshore Humanitarian visa.
communicate electronically because this results in faster
processing. Step 4 – Applicant completes and signs application form
When the applicants you are proposing receive the documents
Partner mentioned in Step 3, they should fully complete form 842, in
accordance with the instructions on that form.
‘Partner’ means a spouse or de facto partner (including same-
sex partners). Step 5 – Lodge the completed application
You must lodge this form (form 681) and the completed and
About the information you give signed form 842 Application for an Offshore Humanitarian
The department is authorised to collect information provided visa in accordance with the addresses specified below.
on this form under Part 2 of the Migration Act 1958 ‘Control of • If you wish to propose someone residing in the Middle East*,
Arrival and Presence of Non-citizens’. The information provided Afghanistan or Pakistan, applications must be lodged at the
will be used for assessing the eligibility of persons you have following address:
proposed for a Refugee and Humanitarian (Class XB) visa, or Victoria Offshore Humanitarian Processing Centre
may be used to assist in establishing the extent of the visa
applicant’s connection with Australia. By Post:
Information provided might also be disclosed to other agencies GPO Box 241
authorised to receive information in relation to foreign affairs, Melbourne VIC 3001
adoption, border control, business skills, citizenship, education, AUSTRALIA
health, law enforcement, taxation, pensions and benefits, service By Courier (no hand deliveries)
provision to refugees and eligible humanitarian entrants and
2 Lonsdale Street
their proposers, review of decisions and registration of
Melbourne VIC 3001
migration agents.
AUSTRALIA
The collection, access, storage, use and disclosure by the
(* Countries include Bahrain, Iran, Iraq, Jordan, Kuwait, Lebanon,
department of the information you provide in this form is
Oman, Qatar, Saudi Arabia, Syria, Turkey, United Arab Emirates
governed by the Privacy Act 1988 and, in particular, by the
and Yemen.)
11 Information Privacy Principles. The information form 993i
Safeguarding your personal information, available from offices • If you wish to propose someone residing in any other country
of the department, gives details about the agencies to which apart from those listed above, applications must be lodged at
your personal information might be disclosed. the following address:
Note: In order for the Proposer Support Service Provider to NSW Offshore Humanitarian Processing Centre
help you with relevant advice and assistance, it is necessary for By Post:
the information that you give on this form to be made available
to the provider. The acknowledgement in Part G of this form GPO Box 9984
enables the department to share the information on this form Sydney NSW 2001
with the Proposer Support Service Provider and other AUSTRALIA
settlement service providers as appropriate. By Courier (no hand deliveries)
26 Lee Street
Sydney NSW 2001
AUSTRALIA

© COMMONWEALTH OF AUSTRALIA, 2012 681 (Design date 11/12a) - Page 3

 For further information, please consult the following lodgement
information sheet Lodging Certain Humanitarian Applications
in Australia (see www.immi.gov.au)

Note: If you do not lodge the application in accordance with

the instructions above, the visa application may be invalid.
The department cannot process invalid applications.

Step 6 – Receipt of application

The office processing the visa application will acknowledge
receipt of the application accompanying your proposal in
writing.

Processing times
Processing times vary according to individual circumstances
such as where the applicant is living and any health conditions
that may require testing or treatment. Processing delays can
also occur where checks or tests to confirm identity or claimed
relationships between family members are needed. In addition,
local conditions such as poor phone lines and mail services or
the general security situation may affect how quickly interviews
can be arranged.
Applicants will be advised by the department as their visa
application progresses. If you want information regarding the
person you have proposed and are not their authorised
recipient, you should contact that person directly.
For information on the making and processing of visa
applications, see information form 1025i Visa applications.

How to complete this form

• Please use a pen, and write neatly in English using BLOCK
LETTERS.
• Tick where applicable.
• Answer all questions truthfully and completely.
• Where there is insufficient space for your answer please
continue on a separate page of paper. Clearly mark the
separate page with the question number it relates to.
• Sign the form at Part G.
• Lodge this completed proposal, along with application
form 842 to the office of the department as specified in
Step 5.
• Please take careful note of where and how the application
must be delivered to the department, as invalid applications
cannot be processed.
For information on how to make a valid application, see
information form 1025i Visa applications.

Home page www.immi.gov.au

General Telephone 131 881 during business hours
enquiry line in Australia to speak to an operator (recorded
information available outside these hours).
If you are outside Australia, please contact
your nearest Australian mission.

Please keep these information pages for your reference

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 Form
Refugee and special
humanitarian proposal 681

Please use a pen, and write neatly in English using BLOCK LETTERS.
11 Precise relationship of main applicant to you (give full details)
Tick where applicable 

Part A – Details of the persons you wish to

propose for entry to Australia 12 Full residential address (not post office box)
Please include any United Nations High Commissioner for Refugees
1 How many people are included in your proposal? (UNHCR) Registration number

2 Give details of the main applicant

Family name A1 POSTAL CODE

Given names
13 Give details of all other dependent family members of the main
applicant who are included in this proposal

3 Has the person you are proposing been known by any other names? A2
(such as name at birth, alias, previous married name) Family name
No
Given names
Yes Give details

Family name
Sex Male Female
Given names DAY MONTH YEAR

Date of birth
Relationship status
4 Citizenship Married legally Engaged Widowed
Married by De facto Never married or
tradition/custom been in a de facto
5 Sex Male Female Separated
relationship
Married religiously
Divorced
DAY MONTH YEAR

6 Date of birth Precise

relationship to the
main applicant
7 Place of birth
Town/city A3

Country Family name

Given names
8 Current country of residence

Sex Male Female

DAY MONTH YEAR
DAY MONTH YEAR
9 Date of arrival in current country of residence Date of birth
Relationship status
10 Relationship status
Married legally Engaged Widowed
Married legally Engaged Widowed
Married by De facto Never married or
Married by De facto Never married or tradition/custom been in a de facto
tradition/custom been in a de facto Separated
Separated Married religiously relationship
Married religiously relationship Divorced
Divorced
Precise
relationship to the
main applicant

© COMMONWEALTH OF AUSTRALIA, 2012 681 (Design date 11/12a) - Page 5

 Part B – Proposer’s details – Individuals
A4
Note: This part should only be completed if you are proposing visa
Family name applicants in your private capacity as an individual, and not as the
representative of any organisation.
Given names
14 Are you submitting this proposal as an individual?
Sex Male Female No Go to Part C – Proposer’s details – Organisations
DAY MONTH YEAR
Yes Complete the details below
Date of birth
Relationship status
15 Family name
Married legally Engaged Widowed
Married by De facto Never married or Given names
tradition/custom been in a de facto
Separated
Married religiously relationship
Divorced
Precise 16 Sex Male Female
relationship to the
main applicant DAY MONTH YEAR

17 Date of birth
A5
18 Place of birth
Family name
Town/city
Given names
Country

Sex Male Female 19 If born outside Australia: DAY MONTH YEAR

DAY MONTH YEAR Date of arrival in Australia

Date of birth
Relationship status 20 Are you an Australian citizen, Australian permanent resident or an
eligible New Zealand citizen?
Married legally Engaged Widowed
No You are unable to propose
Married by De facto Never married or
tradition/custom been in a de facto Yes Please provide evidence as described on page 3
Separated
Married religiously relationship
Divorced 21 Full residential address (not postal address)
Precise
relationship to the
main applicant
POSTCODE

A6
22 Postal address
Family name
(If the same as your residential address, write ‘AS ABOVE’)
Given names

Sex Male Female POSTCODE

DAY MONTH YEAR

Date of birth 23 Your contact telephone numbers (if available)

Relationship status COUNTRY CODE AREA CODE NUMBER

Married legally Engaged Widowed Office hours ( ) ( )

Married by De facto Never married or After hours ( ) ( )

tradition/custom been in a de facto
Separated Mobile/cell
Married religiously relationship
Divorced
Note: If your contact details change before this application is finalised,
Precise it is your responsibility to notify the office of the department at which the
relationship to the
application is being processed.
main applicant

If insufficient space attach additional details

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24 Do you agree to the department communicating with you by fax, e-mail 31 Full street address of organisation (not post office box)
or other electronic means?
No
Yes Give details POSTCODE
COUNTRY CODE AREA CODE NUMBER

Fax number ( ) ( )
32 Postal address
E-mail address (If the same as street address, write ‘AS ABOVE’)

25 Your current occupation (if not employed, write ‘unemployed’)

POSTCODE

For how many years have

you been in this occupation? 33 Contact telephone numbers of person authorised to sign this form
COUNTRY CODE AREA CODE NUMBER
26 Your partner’s occupation (if applicable) Office hours ( ) ( )

After hours ( ) ( )
For how many years has your
partner been in this occupation? Mobile/cell

Note: If the contact details of the person signing this form on behalf of
Part C – Proposer’s details – Organisations the organisation change before this application is finalised, it is your
responsibility to notify the office of department at which the application
Note: This part should only be completed if you are representing an is being processed.
organisation submitting a proposal, and you have the authority to
represent your organisation. 34 Please attach a written statement explaining your organisation’s
objectives (clearly mark this statement as ‘Question 34’)
27 Organisation’s full name/title Is the statement attached?

No
Yes

28 Name of person authorised to sign this form on behalf of

the organisation 35 Do you agree to the department communicating with you by fax, e-mail
or other electronic means?
Family name No
Given names Yes Give details
COUNTRY CODE AREA CODE NUMBER

Fax number ( ) ( )

29 Position held by this person in above organisation E-mail address

30 Please list all other office holders

© COMMONWEALTH OF AUSTRALIA, 2012 681 (Design date 11/12a) - Page 7

 Part D – Your ability to provide settlement
assistance to the entrant(s) you are
proposing
Accommodation Information and orientation assistance
36 Are you willing and able to provide accommodation for the entrants 38 Are you able to assist the entrant to access:
you are proposing? Income support (administered
No Go to Question 38 through Centrelink)? No Yes

Yes Permanent housing? No Yes

Medicare? No Yes
37 Will all the entrants live with you in your home? Health services (eg. doctor, dentist, pharmacy)? No Yes
No Please answer the following questions about the Employment services (eg. Job Network)? No Yes
accommodation that you will provide for the entrants if they
will not live with you Education and training services (eg. Adult
Migrant English Program, children’s schooling)? No Yes
Where and with whom will the entrants live?
Translating and interpreting services? No Yes
Banking services? No Yes
Childcare services? No Yes
Transport? No Yes
Other community services (eg. ethnic
community groups) No Yes
What type of dwelling is it? (eg. house, flat etc.)

Other forms of assistance

How many bedrooms does it have?
39 Will you meet the entrant at the airport? No Yes
How many people will live in this the dwelling,
including the entrants you are proposing? 40 Will you meet travel costs for all entrants No Yes
For how long will this accommodation be available you have proposed?
for the entrants? Note: Refer to page 1, ‘What is required
of proposers?’

Now go to Question 38

Yes Please answer the following questions about your

accommodation
What type of dwelling do you have? (eg. house, flat etc.)

How many bedrooms does it have?

How many people will live in this the dwelling,
including the entrants you are proposing?
For how long will you be able to provide accommodation
for the entrants?

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 Previous proposals Part E – Assistance with this form
41 Have you (or your organisation) previously proposed this visa applicant? 43 Did you receive assistance in completing this form?
No DAY MONTH YEAR No Go to Part F
Yes Date of previous application Yes Please give details of the person who assisted you

Office of the department where the previous application Title: Mr Mrs Miss Ms Other
was lodged
Family name

Given names
42 Have you (or your organisation) previously proposed any other applicants Address
for a humanitarian visa?
No
Yes Please provide the following details
POSTCODE
Name of the visa applicant you proposed
Telephone number or daytime contact
COUNTRY CODE AREA CODE NUMBER
DAY MONTH YEAR

Date of previous application Office hours ( ) ( )

File number Mobile/cell

Office of the department where the application was lodged 44 Is the person an agent registered with the Office of the Migration Agents
Registration Authority (Office of the MARA)?

Outcome of the application No

Granted Refused Not yet decided Yes Go to Part F

45 Is the person/agent in Australia?

Name of the visa applicant you proposed
No Go to Part F
Yes
DAY MONTH YEAR

Date of previous application 46 Did you pay the person/agent and/or give a gift for this assistance?
File number No

Office of the department where the application was lodged Yes

Outcome of the application Part F – Options for receiving written

Granted Refused Not yet decided communications
If you have proposed more than 2 applicants, please attach 47 All written communications about this application should be sent to:
details on a separate sheet. (Tick one box only)
Myself

OR
Authorised You should complete form 956A Appointment
recipient
or withdrawal of an authorised recipient
OR
Migration agent Your migration agent/exempt person should
complete form 956 Advice by a migration
OR agent/exempt person of providing
Exempt person immigration assistance

© COMMONWEALTH OF AUSTRALIA, 2012 681 (Design date 11/12a) - Page 9

 Part G – Acknowledgement
WARNING: Giving false or misleading information is a serious offence.
48 • I acknowledge that the Australian Government is not responsible for
the payment of travel to Australia by the entrants I have proposed
who are granted a subclass 202 (Global Special Humanitarian) visa.
• I acknowledge that I am responsible for the settlement of the entrants
to the extent that I have indicated in Part D of this form.
• I give permission for the information in this form to be given to service
providers engaged to assist me in my role as the proposer of
humanitarian visa entrants, and to other service providers engaged
to assist in the settlement of the entrant.
• I acknowledge that the information on my record as a proposer may
be used by the Department of Immigration and Citizenship in deciding
visa applicants made under the Refugee and Special Humanitarian
Program where I am the proposer.

Printed name

Signature
of proposer

DAY MONTH YEAR

Date

We strongly advise that you keep a copy of your proposal and

all attachments for your records.

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